This week's question comes from M.M. in Tuckahoe: Since I recently gave birth to my son, I have been so very fatigued, but all of my blood tests look “good.” Any thoughts?
As with any health problem, in order to feel better you first have to know what’s wrong.
Looking for a quick fix rarely gives lasting results. In fact, taking stimulants will, in the long run, usually make the problem worse, so put the coffee down and let’s sort this out.
As with any problem, we start at the beginning with a differential diagnosis. Unfortunately, in the various textbooks of differential diagnosis, the list of illnesses that have fatigue as a major component of their presentation goes on for pages and pages of very small print. If the fatigue is really debilitating then that list has to be seriously looked at.
This is where experience and common sense come in handy as a way to eliminate most of the causes. For instance, since you recently gave birth to your son (congratulations, by the way) then it’s a safe bet that you don’t have prostate cancer. But, there is a variety of problems with your endocrine system (balance of hormones) that can cause severe fatigue and are related to pregnancy. Some of these include thyroid or adrenal imbalances and diabetes, just to get us started. The “usual” blood tests won’t pick up an early thyroiditis, for example, as special blood tests are needed and must be specifically ordered.
During pregnancy there are many changes that occur to your biochemistry. With the increased demands placed upon it, nutritional deficiencies are a real possibility. Since biochemistry underlies everything, if it gets out of balance your hormones can quickly follow suit and a so called post-partum depression may ensue, which often has fatigue as a prominent symptom.
Furthermore, many changes occur to your immune system during those blessed 40 weeks which can result in the onset of new allergies, re-activation of a dormant viral infection or the development of an autoimmune problem where, again, severe fatigue is a leading problem.
It’s not good medical practice to just do an Epstein-Barr VCA IgG antibody test, have it come back positive and say that you have “chronic fatigue syndrome” (CFS). To diagnose a chronic or reactivated EBV infection requires a six-antibody blood test panel; anything less is guess work. Also, according to the CDC, before you can diagnose CFS you must eliminate that looooong list of differential diagnoses, that I mentioned, and then methodically address the problems that show up. Taking short cuts won’t work.
In the mean time, attend to what you can: a good, balanced, predominantly organic food diet; going to sleep — not to bed to read or watch TV — by 10 p.m. is very important; mild, regular exercise, plenty of water and enlisting help from hubby are all very helpful steps that you can take today and are not to be underestimated. Beyond that, a thorough medical evaluation followed by well coordinated integrative care is your best bet for regaining your health.
Send in your questions and be well.