I have a very good friend who has been undergoing tests since January. Symptoms are extreme fatigue (not just tired) which commenced October 2011, upper stomach pain after eating, (commenced mid January) which progressed to prolonged pain and is now almost constant, lack of appetite and insomnia.
He has high cholesterol as a result of long term high dose steroids for a kidney condition when he was a child, managed with statins, so he does have regular blood tests.
The first round of general blood tests produced higher than normal liver function tests, but they had been elevated for a couple of years, apparently, and the GP didn't tell him. His GP then ordered the full gamut of liver-type tests and anything which could be wrong with it. All were within normal levels. Stomach pain had worsened by the time he went back so he was given Omeprazole. This helped slightly. There followed a CT scan and an endoscopy. CT scan all clear, "slightly inflamed" was the only observation with the endoscopy. Now on Lansoprazole, which is helping a bit. During the course of all the appointments, waiting, try this, try that approach, he's had a number of general blood tests to assess his general health - never been told anything was out of line, other than the liver function. Consultant prescribed an anti-spasmodic gastro medication (which I don't know the name of), plus Lansoprazole, possibly long term, and closed the case, referring him back to the GP.
Change of GP (original one retired) resulted in the new one calling him in to discuss results. New doctor said he was a "whisker away from being diagnosed with diabetes" as one of the results was 6.9 (don't know when this one was done). Was was told to start a no-sugar diet and see doctor again in a week to get the results of HbA1c done before the visit. Told to suspend the stomach medication as well to see what happened. The week ended Friday and he feels no better at all. Been to the surgery today and GP is "sort-of pinning everything on Pre-Diabetes", although he's not actually diagnosed that yet. He's 37, has a BMI of 26.1 and has lost about 8lbs due to lack of appetite. HbA1c result is 49. He's been told to leave things another month and stay on the "diabetic diet" (ANOTHER month!) and Lansoprazole and anti-spasmodic has been re-prescribed as leaving them off caused worsening of cramps and discomfort. Referral to a chronic fatigue clinic has been mentioned, but that isn't possible while he's undergoing the possible/rule out of diabetes/pre-diabetes.
I've advised he buys himself a blood glucose monitor, which he's going to do now, so that when he goes back to the GP he can produce results, whether he feels better or not.
If you've got this far, well done!
My question is: Can anyone throw any light on why he might feel so debilitatingly fatigued, and why would having pre-diabetes cause such stomach pain?
He can't even drive to get his daughter from school any more and is unable to work. He's effectively housebound, which is having a detrimental effect on his mental wellbeing as well as everything else.
As someone diagnosed and living with ME/CFS for many years, I would say that your friend's GP is doing all the right things by ruling out all other possibilities for his symptoms, including diabetes. I was tested many times and I was always within the normal range. There are many other conditions that also cause fatigue so any abnormalities need to be invesigated. I had very bad IBS pain as part of my symptoms although it's not as bad as it was. Digestive problems and IBS in particular are very common in ME/CFS.
I've had one random blood test carried out by a doctor of 7.9 and I'm waiting for the results of my fasting glucose. My symptoms of fatigue have been a lot worse over the past three months but it is very difficult for me to differentiate between an exacerbation of the symptoms of ME and symptoms of other illnesses because I'm used to feeing exhausted and unwell as a way of life. I also know that there is a lot of overlap between the symptoms of ME and diabetes as both conditions can cause extreme fatigue.
I know they've done scans etc. but have they thought of gallstones? MH's gallstone was so huge it didn't show on the scans he had. That sounds idiotic but they thought they were looking at a swollen gallbladder that didn't appear to have any stones in it. He was sent home with antibiotics (to treat the supposed infection that was causing the swelling) so that they could remove the gallbladder when it was a more normal size.
The g/bladder didn't shrink so they operated anyway and removed a stone the size of a bantam egg. MH had all of your friend's symptoms and was in a very bad way. If the g/bladder had perforated we would have lost him. As it was, a 45 minute op took them well over three hours.
I'm not sure that people with ME are more prone to diabetes than the general population,but I'm sure that the sedentary lifestyle doesn't help one bit. Many people with ME go 'sugar free' anyway and I'm sure that helps prevent it.
I'm also wondering about the effects of stress on the body. I'm sure it is a factor in the development of many illnesses. My neighbour became diabetic after a lot of stress although she is a rather large lady and that wouldn't have done her any favours. My risk factor is physical inactivity, and my age I suppose. I did the online quiz at Diabetes UK and my odds were 1 in 200! My weight is good, BMI 20.4, my waist to hip ratio is 0.71, no family history. I can't exercise because of ME, so what lifestyle options are available to reverse the possibility of prediabetes?
Re the gallbladder: I went to the Dr a few months ago with severe abdominal pain and had an ultrasound scan ofnthe gallbladder, that was completely clear. Always worth getting checked out as it is something that can be treated.
Yes I am indeed named after the old sufferin general I was born there in 1965 and am back there in 2012 with my eyes .
I think unrelenting stress is a big problem in life I remember reading Alex Ferguson's book and he said whatever was going on in his life at the time as soon as his head hit the pillow he was out like a light until the morning. As a bad sleeper myself I believe he doesn't know how lucky he is to be able to switch off like that and I think it must be a big health benefit
I was born in the Rottenrow but I had a few trips to the Sufferin' in my youth. Those weren't the days! Haha!
Hope they're looking after you in there.
Stress - definitely has an impact. I had a chat with my therapist at the ME/CFS unit yesterday and she said with what she knows from the research, stress ups the cortisol levels which leads to a release of glucose into the bloodstream. If we are in a state of fight or flight but can't actually go out and batter someone or run or whatever then all this glucose isn't being used up. Chronic stress, I am certain, will tip people into diabetes if their body chemistry is being primed for the fight or flight response all the time.
I would think a pinched muscle in your back would be what is causing this to happen. It isn't the pinched muscle within itself, but what it does while being pinched. When you pinch a muscle in your back they are so close to the nerves where they leave the spine that the muscles can press into them when they are pinched. That pressure causes messed up messages to the brain, it thinks you just ate so it allows more acid to be pumped into your stomach for digestion and that acid in time starts to burn the lining of your stomach. You are having this happen more when you have had your body in a position where it caused more pressure on the pinched area so it had more acid pumped into it again. To get rid of the pain you have to release your back muscles, here's how to do that: Back: (do from a sitting position) Place your left hand on your left leg next to your body. Place your right hand over your left shoulder and find the muscles next to your spine and press on them and hold. After 30 seconds slowly lower your body forward and to the outside of your left leg, keeping your left arm fairly straight as you do. When you reach your lap remain there for another 10 seconds, release the pressure but rest there for another 30 seconds. Then reverse your hand positions and do your right side. Before doing this, take a deep breath and exhale, then try to keep your body this relaxed for best results.
I would also suspect gallstone issues. If he hasn't already had an abdominal ultrasound, I think it would be a good idea. I also had severe upper abdominal pain and my ultrasound came back with 3 huge gallstones, fatty liver and fatty pancreas. Your friend's elevated liver tests can also point to fatty liver.
BTW Fatty liver (just like in the poor geese they force feed grains to produce foie gras) is caused by over-consumption of grains/carbohydrates. I also suspect I had a small intestinal bacterial overgrowth (SIBO) that was causing IBS/reflux issues. Around the time I was diagnosed with diabetes, I also had a UTI and given antibiotics - most of my gastrointestinal issues resolved shortly afterwards and have continued to improve since I switched to a grain free, LCHF diet to help lower my blood glucose.
As for the fatigue, please make sure his vitamin D3 level is checked. Mine was discovered to be low and within a week of taking high supplementation as prescribed by the endocrinologist, I felt like someone had turned on the light. It was a stunning difference and I recommend that everyone is tested for it as it is believed low levels are very common, especially in countries where people aren't exposed to constant sunlight. It is even becoming a health issue here in Australia where sunshine isn't an issue - however the 'low fat'/'low cholesterol' diets are probably involved - you need dietary cholesterol for the production of vitamin D.
I'm Not Dead Yet 61yo F, Western Australia T2 diagnosed 7/3/2012 with GTT: Fasting 6.4 - 1 hr 14.2 - 2 hrs 12.9 HbA1c - 12/3/2012: 6.2% 45 mmol/mol - 19/9/2012: 5.5% 37 mmol/mol 22/1/13 - Metformin 1x500mg Eating to my meter & eating real food