Chronic fatigue syndrome: what tests should be taken
Chronic fatigue syndrome
I didn't have time to wake up and get up, as I was already tired. Are we familiar?
The causes of chronic weakness are most often:
- anemia or latent iron deficiency, mixed anemia with B12 and B9 deficiency
- hypothyroidism, obvious clinical or subclinical
- autoimmune thyroiditis
- slow-flowing inflammation in the body (often viral, but there may be a mix of chronic infections), when we see in a general blood test:
~ low neutrophils
~ high lymphocytes
~ often still low leukocytes
- dysfunction of the adrenal glands, when we have low cortisol in the first half of the day, but high before sleep.
Have a check-up with the doctor:
1. General blood analysis:
• Hemoglobin - > 135 for women
• MCV > 88 and < 90
2. Markers of inflammation:
• SOE < 10-15 for women
• Eosinophils < 3
• CRP < 5 mg/l
• EKB (ECP) < 15
• Ferritin – can be lowered with anemia and increased with inflammation. You will not understand this indicator yourself, it is necessary to include the clinical thinking of the doctor.
3. We rule out hypothyroidism and AIT:
• TSH < 2.5
• T3 and T4 are free in the average reference
•ATTPO and ATTG - lower limits of references
4. Analysis of the cortisol curve.
Daily profile of cortisol.
5. Diagnosis of B19 and B9 deficiency:
• holo-B12 (not cyanocobalamin in the analyses!)
• homocysteine < 7
• methylmalonic acid in urine.