Way to differentiate Crohn's-based fatigue from something else?

fatigue, post endurance stress syndrome, etc are actually my worst symptons when my Crohn's flares up and i take all my maintenance meds. its been this way ever since i was diagnosed. i dont even have that bad of bathroom problems, but my fatigue, lack of energy is debilitating...

I can relate. My GI put me on vitamin B complex, a multivitamin, a vitamin d, calcium and magnesium supplement and ensure to combat malnutrition and fatigue. Still, I do suffer from the latter. I stay in bed and sleep several times/day during the weekend to recharge for the working days.

Vitaka do you have Lyme?
Isn't fatigue the primary symptom?

Do I have Lyme? To be honest, I'm not sure. I had a bite and a raging infection in July and was in the hospital, but it takes months before you test positive and I never went back. I did take two months of doxycycline to treat the infection though.

Gumby: I'd lean toward no. I've been on the traz and klonopin for six years and the klonopin in the lowest dose possible. If I don't take the trazodone, I don't sleep (I'd had insomnia for nearly 20 years). Even with it, my sleep quality is pretty poor and has been worse lately because of night sweats and having to pee throughout the night.

I've probably been on the Zyrtec off and on for most of the last decade and certainly for the last several years continuously.

I'm starting to wonder if this is an adrenal issue.

vitaka said...
Thanks for the links gumby.

In some ways, fatigue might just be the worst symptom of all. My more classic Crohn's symptoms have certainly put me out of commission, but the fatigue is there 24 hours a day, every day, for years. When I'm driving, my biggest concern used to be if I was in an unfamiliar area and needed a bathroom; now it's me fighting to stay alert on my way to/from work, or taking my kid somewhere. I'm at the point where my memory is shot (which is no fun when you're standing in front of a room of grad students, let me tell you) and I can't focus enough to get my work done.

I do the same minnie re having to spend the weekend (or sometimes a weekday) recovering from a busy stretch at work. Some days my body won't let me get out of bed; yesterday, I got extremely lightheaded and nauseous about two hours after getting up and doing some housework, so I had to lay down for the next 2-3 hours before I could function.

I really thought I was making progress as my Crohn's symptoms had diminished, but everything seems to have come roaring back in February and my last infusion didn't help nearly as much as I hoped.

Not much to do but keep moving forward... at whatever pace I can manage.

wow, finally someone with symptoms just like me. fatigue, achiness, no energy, etc are my worst symptoms. as long as i take my maintenance meds i wont have any bathroom problems even if i flare up a bit (the meds seem to keep that under control) ... but its the chronic fatigue that wipes me out completely, and worse when i finally have one good day, i end up trying to catch up on work and overdoing it so i end up being punished for several days but just trying to do normal everyday chores...

Haha gumby! That's hilarious...in a sad kind of way. :)
Since last summer, I have intense dreams nearly every night with very strange themes (usually connected to that day). Maybe that's why I'm sweating so much--my dreams are running me ragged.

Midnight, according to my GI (who calls me with bloodwork results), my iron is fine. I can't remember if she checked ferritin in addition to the standard iron test. I am usually borderline anemic so I was a bit surprised to hear that. Also, my Vitamin D was 50 (last year it was 19).

I saw my neurologist today and told her about what's been going on. She gave me a mega dose shot of B12 (even though my levels were fine, she said I should get the shot because it goes straight to the brain...whatever). Anyway, I'm going to have a brain MRI to make sure there isn't anything going on there. She said I have too many symptoms for something to not be going on and then mentioned that she has 10 MS patients whose primary symptom is fatigue. At that point, I decided to just go along with the testing (I've wanted a brain MRI anyway because of my migraines) and not worry about other dire diagnoses.

In the meantime, I just get to up my dose of Nuvigil, which is basically Adderall.

So I just got my MRI results electronically, haven't heard from my neurologist yet. As usual, the medical speak is a bit hard to interpret but the bottom line is there are some abnormalities that are consistent with many things...Here's the report:

"FINDINGS: The ventricular system is midline and normal in size and shape with no mass effect, midline shift or hydrocephalus. There are a few punctate T2 signal intensity abnormalities noted in the left frontal periventricular white matter with no surrounding edema, mass effect or enhancement likely consistent with nonspecific gliosis. Other differential possibilities would include vasculopathy, small vessel ischemic disease, postinflammatory/infectious etiologies or demyelinating process. There are no enhancing intracranial masses, hemorrhage, acute CVA with attention to diffusion weighted images, extra-axial fluid collections or osseous abnormalities. Normal intracranial flow voids are seen. The paranasal sinuses and mastoid air cells are well aerated.

CONCLUSION: A few punctate T2 signal intensity abnormalities in the left periventricular white matter with differential possibilities as discussed above. Correlate clinically."

I'm been looking up most of the terms, and non-specific gliosis seems very broad. Any thoughts as I wait to talk to doc (which may not be for over a week)?