If I Just Knew What It Is!

[Lenman]

After several years of dealing with feeling rotten, and visits to about ten different doctors, I still don't know why I feel this way.  What should I do?  Please help!

Here's my fact sheet.


male 52 years old

Symptoms: (in order of severity and frequency)

1. extreme fatigue at times
   (mornings are usually better than afternoons and evenings)

2. occasional dizziness & “light-headedness”
   …also dizzy when I stand up from a low position (even slowly)
   (I have low blood-pressure)

3. lots of headaches  seem to be sinus-related   (2 to 7 per week)

4. periods of “hot-headeness” (my glasses actually “fog-up”)


diagnosed “pre-diabetic”
not overweight
non-smoker

no shortness of breath, wheezing only when I do the peak flow meter
not a problem when I exercise . . . I’m in fairly good shape

I have a “mild asthma condition” according to my physician.
peak flow meter Tuesday, July 8 (during a period of extreme fatigue) reads 490   (normal is 570-600)

I take singulair once per day
discontinued advair about 8 months ago
have albuterol inhaler but doesn’t seem to help
(my allergy physician says I should begin shot treatment, but I’m not convinced it works, is safe, or is the solution)


Supplements:
  take vitamin B complex, multivitamin
  take after meals (for blood sugar control):    
      fenugreek, cinnamon, or prickly pear


How do I get to feeling better?  Thanks!

[National Jewish Health]

What you describe suggests that you might have dysfunction of the autonomic nervous system.  The following abstracts provide information on these syndromes.  You might begin by sharing this information with your doctors and consultation with a neurologist, preferably one familiar with this disorder.

Authors Full Name Klein, Caroline M.
Institution Department of Neurology, The University of North Carolina School of Medicine, 3114 Bioinformatics, Campus Box 7025, Chapel Hill, NC 27599-7025, USA. ***@****
Title Evaluation and management of autonomic nervous system disorders. [Review] [52 refs]
Source Seminars in Neurology. 28(2):195-204, 2008 Apr.
Abstract Autonomic nervous system dysfunction may manifest with a variety of symptoms, with orthostatic intolerance (including orthostatic hypotension or tachycardia) and sweating abnormalities (increased or decreased sweating) being common problems requiring medical evaluation and treatment. Determination of the underlying diagnosis for these symptoms is critical in terms of classification of the disorder and its prognosis. Recent advances in evaluation of patients with these conditions and treatment modalities have enabled physicians to improve overall management of patients with these disorders. These advances include testing for ganglionic acetylcholine receptor antibody in patients with suspected autoimmune autonomic neuropathy and use of pyridostigmine for treatment of patients with orthostatic hypotension or tachycardia. [References: 52]

Authors Full Name Grubb, Blair P. Vesga, Boris E. Guzman, Juan Camilo. Silva, Federico A. Morillo, Carlos A.
Institution Medical College of Ohio, Toledo, Ohio, USA.
Title [Autonomic dysfunction syndromes associated with orthostatic intolerance]. [Review] [57 refs] [Spanish]
Source Biomedica. 23(1):103-14, 2003 Mar.
Abstract In recent years increased interest has focused on the nature and pathophysiology of orthostatic intolerance and syndromes associated with autonomic disorders. Understanding the pathophysiology underlying these syndromes has led to the recognition of several distinct clinical entities with overlapping features and the associated need to reclassify many of the previously unrecognized syndromes. Among the clinical manifestations, syncope and near syncope are frequently associated with orthostatic intolerance. In addition, however, a wide spectrum of symptoms have been described ranging from chronic fatigue to recurrent neurally mediated vasodepressor reactions. The present review focuses on the pathophysiology and classification of syndromes of autonomic dysfunction associated with orthostatic intolerance. Primary and secondary causes of dysautonomia as well as therapeutic approach to these frequently unrecognized syndromes is presented. [References: 57]