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Lupus

Continuous and daily lack of energy

07/30/2004

Question:

Dear Sir/Madam, I am a 20 year old female, who for the past 4 years has suffered from lack of energy on and off, but for months at a time. At age 16, I was sitting significant exams and was constantly exhausted. The doctor put this down to stress, but took a blood test to rule out any other possibilities. The results showed a slightly low white blood cell count, but I was told it was nothing to worry about. The tiredness was never eleviated by more sleep; most days for months at a time I felt like I could spned all day sleeping and would still be tired. I eat relatively healthily and have always been active, participating in different sports at school and college, etc. Since I was a kid, I have always been an early-riser but often at 10 or 11am I will be feeling significantly lethargic. My most energy comes in the evening. I do not have any significant sleep problems - I sleep pretty soundly. I have recently been diagnosed with depression and have, for 4 months now, been taking a mild anti-depressent (fluoxetine). I feel this has worked in improving my attitude and reducing the occurence of my blue days, but the tiredness I previously had put down to depression seems to have made a return! I have down days still, but I am reluctant to put this down to depression still, because my suicidal feelings and darker days are so much less frequent and insistent. I attend college in London, and have a fairly active social life, of course often having nights of little sleep but it often feels like my energy is much higher on the days I get less than 8 hours sleep. I`m on a two-month stay in the United States at the moment, and the heat affects me to some extent, but I am being careful to drink plenty to fluids. I feel I have little energy to stay active all day, like I have done as a kid. Please help - it is affecting my enjoyment of activities I would normally be able to enthusiastically participate in and I don`t feel able to spend a whole day doing anything, but sleeping or resting.

Answer:

Tiredness can occur due to myriad of physical and mental problems. It would be difficult to make any recommendations without proper history and examination. A thorough and detailed evaluation by an internist would be helpful.

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Response by:

Ram Raj   Singh, MD Ram Raj Singh, MD
Associate Professor of Clinical Medicine
College of Medicine
University of Cincinnati