Medical advice sought

In My Humble Opinion
1

70-year-old male, in reasonably good health.

For many years, I would come down with a mysterious ailment approximately twice a year. Symptoms included fatigue, bad muscle aches, and general malaise, but never a fever. Invariably, it would last two weeks. Tests never showed much of anything. Doctor’s advice: “go home and rest.”

Recently, however, I have been coming down with this much more frequently, like every 6 weeks or 2 months. Same deal, tough it out for two weeks, then it goes away.

This time, they ran all sorts of tests. At first they thought it might be Lyme, or some other tickborne disease. Negative. Then they said my blood sugar was very high, so I went back for a fasting test and a diabetes draw. Same deal, negative. And evidently no cancer or liver disease.

The advice this time: watch my carbs and sugar intake, if it spikes, it can make you feel sick. Some internet browsing seems to confirm that, but… for two weeks?!?

Since retiring six years ago, my alcohol intake has (had) increased to as much as 6 drinks a day. Am now down to 2 or three a day in the hopes that might help.

It’s baffling though. And other than moderating the booze, I’m not sure what to do next. Is there a specialist that could help?

Calling Dr. Kildare… Ben Casey… whatcha got??

2

Not a doctor here!!

Have they checked for anything autoimmune or autoinflammatory? As a non-doctor, those came to mind as something that might come and go with no evident pattern. I’m also not sure what bloodwork would be done to check them out (C-reactive protein?).

On the alcohol intake: 6 drinks a day was definitely not doing you any good, so it’s good to hear you’ve cut that back. If you’re routinely doing 2-3 drinks a day, that’s better, but may or may not be involved in triggering a flareup of whatever you’ve got going on. Have you noticed a change in the pattern of flareups since cutting back?

Could you try cutting back even more, to 1 a day, and see if there’s a change then?

I have zero clue as to whether moderate alcohol could affect anything autoimmune (if that’s what’s happening).

3

They tell me the bloodwork they did ruled out lupus, rheumatoid arthritis, etc.

It’s only been 10 days, so hard to tell. So far, so good.

I’m working on it!

4

[Not any sort of doctor]

Do you have a glucometer so you can check your blood sugar? Did they put a number on the “very high” blood sugar? Elevated blood sugar can lead to the symptoms you describe (but no reason they would last specifically two weeks other than coincidence).

5

Your symptoms are not in my wheelhouse (retired surgeon) and you shouldn’t rely on anything other than very general non-specific medical advice you get on the internet anyway. Without knowledge of your physical exam, history and lab results, a reliable diagnosis cannot be made or relied on.

If you aren’t happy with your PCP’s handling of your condition you should ask him/her to refer you to a specialist who can better help (perhaps start with a neurologist).

I do think chronic fatigue syndrome (myalgic encephalomyelitis), or possibly fibromyalgia should be part of your differential diagnosis. There are no cures for these ailments, but symptoms can be effectively managed. Google these and see if they match your symptoms. Good luck!

6

Retired family medicine doc here, I concur with @Tibby. I suspect alcohol could be playing a role also. That’s a lot of daily booze intake. Alcoholic myopathy is common and underdiagnosed in the US drinking culture.

7

Your “very high” blood sugar - how high was it?

I find it a little strange that they seem to have dismissed this so readily (assuming I am interpreting your wording correctly), even after a normal fasting test.

And, yeah, alcohol.

mmm

8

I think the alcoholic myopathy makes the most sense. Still working on cutting down on the sauce.

9

My doctor wants me to cut down from 6 drinks a week to 2 or 3 and never two days in a row. The only benefit that I can find so far is my liquor cabinet supply is going to last longer.

10

If he had both a normal fasting glucose and a normal A1C, I’d dismiss it as a cause too, given other evidence he’s provided.

11

If it is alcoholic myopathy, best chance of improving it is abstaining from alcohol completely.