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Old 05-03-10, 10:34 AM   #1
DanRH
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Update on my fatigue condition.

Yesterday Kath and I went out for our AIDS/Lifecycle 9 training ride. It was an 80 mile slugfest that had 4900' of climbing and hit Morgan Territory Road (for you NCAL types). I suffered, big time anytime we went up. I even had to stop a few times and catch my breath. This is totally out of character for me.

So, now we're thinking it could be a few things. Over training (I'm now only riding once a week), thyroid or possibly testosterone issues. I've got another appointment with Kaiser tomorrow but will tell you, my condition is getting worse. The idea of a thyroid came up because I've started to gain a little weight as well. I know, not riding the bike? Duh...no, I'm walking a lot and trying to cross train a bit. Also, I'm always tired. If you don't remember, I had a Holter HR monitor and blood work done three months ago and everything came out great. If anything a low HR which points to over training...

Hopefully, the new Dr appointment will shed some light.
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Old 05-03-10, 01:04 PM   #2
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Not to be a black cloud, but have you looked into blood-sugar levels? I wouldn't say your symptoms are exactly what you'd expect, but if you've got lightheadedness/weakness and general 'flu-like' feelings, diabetes is certainly possible.

Best of luck, and God Bless!
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Old 05-03-10, 10:36 PM   #3
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Not to be a black cloud, but have you looked into blood-sugar levels? I wouldn't say your symptoms are exactly what you'd expect, but if you've got lightheadedness/weakness and general 'flu-like' feelings, diabetes is certainly possible.

Best of luck, and God Bless!
Three months ago my blood levels were in the normal range. And I'm not experiencing flu-like symptoms at all. Just fatigue when climbing. Tomorrow, I go to Kaiser for another round of probing...
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Old 05-03-10, 10:48 PM   #4
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Let us know the the Doc says. I guess you just start eliminating things it could be. I hate puzzles!
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Old 05-03-10, 11:53 PM   #5
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This may be a bit of a reach considering the minimal data, but have you considered magnesium levels? ATP only works with proper Mg++ levels. I'm assuming you are not anemic. Does the fatigue relate to recent food intake, or lack of intake? Maybe you are just getting a bit hypoglycemic.

Good luck solving this puzzle. If Kaiser does grand rounds, try to get presented. It never hurts to have more input.
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Old 05-04-10, 08:19 AM   #6
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Weight gain could be due to fluid excess. Makes me wonder about cardiac and renal issues. See your doc pronto.
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Old 05-04-10, 12:22 PM   #7
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Didn't you and Kath just get married?

This article from today's Telegraph may be relevant:

Beautiful women can be bad for your health, according to scientists

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Originally Posted by Daily Telegraph
"This study showed that male cortisol levels increased after exposure to a five-minute short social contact with a young, attractive woman."

Cortisol can have a positive effect in small doses, improving alertness and well-being. However, chronically elevated cortisol levels can worsen medical conditions such as heart disease, diabetes, hypertension and impotency.
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Old 05-04-10, 01:09 PM   #8
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Well just got back from a different doc. I got another blood test done (this time after fasting). Also, they scheduled me for a stress test on two weeks. Other than that, they say I'm in great shape. And yes, I've put on a few pounds for really no reason because I'm really not eating anymore, just not riding as much (80 miles a week as opposed to 150-200). Also, I go for long, fast and strenuous walks (5-8 miles).
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Old 05-04-10, 02:40 PM   #9
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Dan,
I'm sure you will be fully back in the saddle soon. My experience, albeit very limited, with Kaiser Permanente has been very positive. Contrary with what folks tend to think about HMOs whenever I had what could have been a real problem I've gotten very fast "service".

You ought to be able to spin what Ritterview dug up in your favor in any event

Cheers,
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Old 05-04-10, 03:36 PM   #10
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Thyroid issues are constantly being mis-diagnosed. Mine was. Had such lack of energy.

Mine was solved through dietary changes.
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Old 05-04-10, 03:44 PM   #11
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Thyroid issues are constantly being mis-diagnosed. Mine was. Had such lack of energy.

Mine was solved through dietary changes.
Exactly what my wife is sayin'. Hitting the kelp and sea weed hard!
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Old 05-04-10, 04:04 PM   #12
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Hitting the kelp and sea weed hard!
Are you sure that is wise?. I'm not going to argue with your wife, But a common cause of hyperthyroidism include: Excessive iodine intake. Kelp & sea weed are saturated in Iodine.

http://www.medicinenet.com/hyperthyroidism/article.htm

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Excessive iodine intake

The thyroid gland uses iodine to make thyroid hormones. An excess of iodine may cause hyperthyroidism. Iodine-induced hyperthyroidism is usually seen in patients who already have an underlying abnormal thyroid gland. Certain medications, such as amiodarone (Cordarone), which is used in the treatment of heart problems, contain a large amount of iodine and may be associated with thyroid function abnormalities.
Common symptoms include:

Fatigue
Excessive sweating
Heat intolerance
Increased bowel movements
Tremor (usually fine shaking)
Nervousness; agitation
Rapid heart rate
Weight loss
Decreased concentration
Irregular and scant menstrual flow
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Old 05-04-10, 04:13 PM   #13
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Dan,

I have been dealing with fatigue issues since 2003. I was diagnosed with Addison's Disease in 2003 after I collapsed from fatigue. In 2004 I was diagnosed hypothyroid.
From 2005 to 2008 I felt pretty good. Then I suddenly had extreme fatigue and muscle soreness after doing a 300 mile week in Nov 2008.
I have been recovering ever since and there was never an explanation for it except maybe the statin drugs I was on.
A lot of people with thyroid problems are underdiagnosed because the reference range varies greatly depending on what lab and doctor you see.
They might tell you that your thyroid is normal when it is not. If you are hypothyroid you need to take thyroid hormone, diet will not work.
PM me if you want to explore further.
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Old 05-04-10, 05:54 PM   #14
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If you are hypothyroid you need to take thyroid hormone, diet will not work.
But what if its something in his diet that is causing it???...
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Old 05-04-10, 07:12 PM   #15
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But what if its something in his diet that is causing it???...
There are certain foods called goitrogens which can ne a factor in thyroid disease, another cause can be iodine deficiency which is rare in the U.S. because iodine is added to salt.
You would have to eat a lot of goitrogens such as broccoli to have an effect. I don't believe they cause hypothyroidism but could make it worse if you have it.
Hypothyroidism is most commonly caused by autoimmune disease. A proper diagnosis should be made by an endocrinologist.
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Old 05-04-10, 08:16 PM   #16
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No cyclist wants to hear this, but PathDoc's got a good point. I have known of avid cyclists who went down to heart disease (too addicted to a high carb diet). One of them had a regular training ride and sought help when he noticed his time slipping. Result: two stents and back in the saddle.

About that Kaiser comment: When I was in the Bay Area, we referred to Kaiser as the place you sent people to die. That was quite a while ago, but remember to follow the money: these physicians are under pressure to do less for you. Be the squeaky wheel until you have a diagnosis that makes sense. Push for every test that is needed, and then some.
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Old 05-05-10, 03:22 AM   #17
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Glandular fever?
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Old 05-05-10, 04:28 PM   #18
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You would have to eat a lot of goitrogens such as broccoli to have an effect. I don't believe they cause hypothyroidism but could make it worse if you have it.
Goitrogens are substances that suppress the function of the thyroid gland by interfering with iodine uptake, which can, as a result, cause an enlargement of the thyroid.

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You would have to eat a lot of goitrogens such as broccoli to have an effect. I don't believe they cause hypothyroidism but could make it worse if you have it.
My thoughts exactly.

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Hypothyroidism is most commonly caused by autoimmune disease.
Again, food & drinks suppress the immune system.
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Old 05-05-10, 07:16 PM   #19
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Push for every test that is needed, and then some.[emphasis added]
And then you can be sure to be diagnosed eventually with a disease that you don't have, and then suffer complications from treatment that you never needed. We have an old saying: The only normal people are those who haven't had enough lab tests.

Just my contrarian view that the HMO doc who hesitates about ordering every test in the book really may have your best interests at heart. (Yes, I know about the perverse incentives to under-investigate in some HMOs, and the perverse incentives to over-investigate to generate revenue and profit in other practice models.) Watchful waiting with careful follow-up is often the best medicine for unexplained symptoms that don't suggest "red flags" right off the bat, hard as this is to hear in our time-obsessed "instant-results" culture on both sides of the border. With time, either an obvious diagnosis emerges, or the patient remains "undiagnosed" but no worse. Only rarely (Cancer Society propaganda notwithstanding) does making a diagnosis a few months earlier benefit the patient materially, and the occasional diagnostic success has to be balanced against the stress of chasing numerous inconclusive test results that point nowhere in particular, except toward more dangerous invasive procedures like angiograms. "Iatrogenic illness" (i.e., caused by us doctors) is very real, and good doctors try to prevent it. It's partly where the dictum, "First do no harm" comes from.

That said, it can be difficult for health-care professionals to understand the concerns of even recreational-level athletes. When I look around the hospital where I spend my days, very few of the nurses and doctors would in their wildest dreams imagine riding a bicycle even 80 miles a week, much less the OP's normal 150-200 miles. For a lot of us, the joke is actually true: "When I get the urge to exercise, I lie down on the couch and eat ice cream until the urge passes." So it can take some careful and empathic communicating to make sure that doctor and athlete-patient are really hearing each other.

And there is hardly ever enough time.

Good luck and best wishes for your health.
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Old 05-06-10, 05:44 AM   #20
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Did your blood work include iron overload? It can cause fatigue.
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