[44F] With extreme fatigue and widespread numbness and tingling

Patient Description

A 44-year-old female reports experiencing extreme fatigue and widespread numbness and tingling for the past 6 months to a year. The fatigue is constant throughout the day, causing her to fall asleep at inappropriate times, go to bed early, and still have trouble waking up in the morning. She feels constantly tired, which has significantly impacted her quality of life. The numbness and tingling affect both sides of her body, covering her hands, arms, legs, and feet. There are no specific activities or situations that exacerbate these symptoms.

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Arora's Assessment

What might be happening

Based on the symptoms you've described, here are some possible explanations:

  1. Chronic Fatigue Syndrome (CFS)

    • Rationale: Extreme fatigue that doesn't improve with rest and has been ongoing for more than six months is a hallmark of CFS. This condition can also cause sleep disturbances and cognitive difficulties.
    • Typical Treatments/Testing: Diagnosis is often made by ruling out other conditions. Treatment focuses on symptom management, including medications, cognitive behavioral therapy (CBT), and graded exercise therapy.
  2. Peripheral Neuropathy

    • Rationale: Tingling and numbness in your hands, arms, legs, and feet could be due to peripheral neuropathy, which is often caused by diabetes, vitamin deficiencies, or other underlying conditions.
    • Typical Treatments/Testing: Blood tests to check for diabetes, vitamin levels, and other potential causes. Treatment may include medications for pain relief, physical therapy, and addressing the underlying cause.
  3. Anemia

    • Rationale: Anemia can cause extreme fatigue and is often associated with other symptoms like weakness and pale skin. It can also contribute to tingling and numbness if it leads to vitamin B12 deficiency.
    • Typical Treatments/Testing: Blood tests to check hemoglobin levels and iron studies. Treatment may include iron supplements, dietary changes, or addressing the underlying cause of anemia.
  4. Irritable Bowel Syndrome (IBS)

    • Rationale: While IBS primarily affects the digestive system, it can also contribute to fatigue due to poor nutrient absorption and chronic discomfort.
    • Typical Treatments/Testing: Diagnosis is usually based on symptoms and ruling out other conditions. Treatment includes dietary changes, medications, and stress management techniques.

What you can do

Extreme Fatigue

  • See a doctor: It's important to consult a healthcare provider to rule out serious conditions like anemia or chronic fatigue syndrome. They may recommend blood tests and other diagnostic procedures.
  • Lifestyle changes: Ensure you are getting adequate sleep, maintaining a balanced diet, and engaging in regular physical activity. Even light exercise can help improve energy levels over time.
  • Symptom tracking: Use MDandMe to journal your symptoms, track your progress, and share your notes with your healthcare provider.

Tingling and Numbness

  • Consult a healthcare provider: A doctor can help determine if your symptoms are due to peripheral neuropathy or another condition. They may recommend blood tests or nerve conduction studies.
  • Home care: Ensure you are getting enough vitamins, particularly B12, and consider ergonomic adjustments to reduce strain on your limbs.
  • Symptom tracking: Document when and where you experience tingling and numbness using MDandMe to help your doctor identify patterns and potential triggers.

Irritable Bowel Syndrome (IBS)

  • Dietary changes: Consider a low-FODMAP diet or other dietary adjustments to manage IBS symptoms. A dietitian can provide personalized advice.
  • Stress management: Techniques like mindfulness, yoga, or CBT can help manage stress, which often exacerbates IBS symptoms.
  • Symptom tracking: Use MDandMe to record your dietary intake, bowel habits, and symptom severity to identify triggers and share with your healthcare provider.

What you should look out for

Given the severity and duration of your symptoms, it's important to seek medical care as soon as possible. Reasons to seek care even more urgently include:

  • Severe weakness or paralysis: This could indicate a more serious neurological condition.
  • Shortness of breath or chest pain: These could be signs of a cardiovascular issue.
  • Sudden changes in vision or speech: These could indicate a stroke or other serious condition.

Remember, while I can provide information and suggestions, it's crucial to consult with a healthcare professional for a formal diagnosis and appropriate treatment. If you have more questions or need further assistance, feel free to continue the conversation.

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5 mo ago


People Also Ask


What are the common symptoms of Chronic Fatigue Syndrome (CFS)?

Common symptoms of Chronic Fatigue Syndrome (CFS) include extreme fatigue that doesn't improve with rest, sleep disturbances, cognitive difficulties, muscle or joint pain, headaches, and sore throat. These symptoms must persist for more than six months.


How is peripheral neuropathy diagnosed and treated?

Peripheral neuropathy is diagnosed through a combination of medical history, physical examination, blood tests to check for diabetes and vitamin deficiencies, and sometimes nerve conduction studies. Treatment focuses on managing symptoms and may include medications for pain relief, physical therapy, and addressing the underlying cause.


Can anemia cause numbness and tingling in the body?

Yes, anemia can cause numbness and tingling, especially if it leads to a vitamin B12 deficiency. Anemia is characterized by a lack of healthy red blood cells, which can result in fatigue, weakness, and neurological symptoms like tingling.


What lifestyle changes can help manage extreme fatigue?

To manage extreme fatigue, it's important to ensure adequate sleep, maintain a balanced diet, and engage in regular physical activity. Even light exercise can help improve energy levels over time. Additionally, tracking symptoms and consulting with a healthcare provider for a proper diagnosis and treatment plan is crucial.


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