SUMMARY: For quite a while (as in several years), I’ve been experiencing some rather intense fatigue and weakness much like flu symptoms. This article outlines the efforts to isolate the culprit.
[ MEDICAL MYSTERY MACHINE ] -ONLY ME: On October 3rd, several blood tests were conducted to assess several routine functions of my body. These include common items such as Hemoglobin A1C (diabetes index), Complete Metabolic Panel (CMP), Complete Blood Count (CBC), Thyroid, Testosterone, PSA (screening for signs of prostate cancer), Tacrolimus (one of my primary transplant medications), and a few other items.
As the results began to show up, I jokingly wondered if my blood had been mixed up with someone else’s. The amount of “green” colors attached to the results was welcomed but not expected. My kidney and liver functions are great. My A1C is below the maximum level for a diagnosed diabetic patient. My thyroid and testosterone levels are within normal limits. With the exception of my cholesterol levels (not lifestyle issues), even those levels were unimpressive as sources of concern.
My Tacrolimus level was below the normal therapeutic range. However, my dosage has been adjusted and will be checked again in a few weeks.
So, we come to the search for why I have been experiencing the fatigue and systemic inflammation issues. As my immune system is almost nonexistent, I’m susceptible to what are called “opportunistic infections”. Over 90% of the population are carriers of two viruses that can be associated with the fatigue symptoms. These are Cytomegalovirus (CMV) and Epstein-Barr Virus (EBV). As an active CMV infection could be lethal, I’m regularly screened for this virus. Both tests returned negative indications for active infections. Tests for vitamin B and vitamin D deficiency were also negative. My thyroid and testosterone levels are within normal levels. Essentially, without going deeper into the more obscure possibilities, nothing in the normal realm is poking its head up say, “Hey, it’s me!”, giving you a hard time.
Before my December follow-up visit with my primary care physician (PCP), I will have more labs to delve into the more obscure possibilities. However, due to the incredible number of medications and diagnoses, isolation of a candidate is also an incredibly challenging task. That is until I entered my “Thought Tank”, otherwise known as the shower. And there, the day after my visit with my PCP, what should have been an obvious answer long ago made itself known once again.
Years ago, the team at Vanderbilt started me on a drug called “Pravastatin”. It is used to help improve your cholesterol levels. Upon starting the medication, I experienced an immediate reaction…muscle weakness and fatigue. The reaction was documented and my tolerated dose reduced to 10mg daily.
Several years later and a new transplant center (Tampa General Hospital), I was again prescribed Pravastatin for cholesterol control at a dosage of 40mg daily. Yeah, that’s four times the dosage I could tolerate without becoming symptomatic. The history with this medication had become a faded memory by this time. Now, nearly six years later…as I search in vain for the cause of my extreme fatigue issues…I finally remembered why that drug has never been my friend.
After consulting with my PCP and sharing my previous experiences with this meditation, I have discontinued taking it for about three to four weeks. This will give my body (and liver) enough time for complete clearance. If my symptoms begin to dissipate, then I’ve established the first part of a proven cause of my symptoms. To completely eliminate the drug and its association with the fatigue symptoms, I will have to take the medication for a short period to see if the symptoms return. As many factors are constantly in play, this is the best way of identifying or isolating the culprit from the incredible number of possibilities.
As I approach the end of the first week without the Pravastatin, I continue praying the symptoms decline and that I have finally found a simple solution to a truly shitty situation.
My friends in the medical community are already aware of this common problem associated with “statins” or cholesterol drugs. I’m incapable of explaining why I’m just now remembering the history and reaction to this drug. Maybe the sheer number of medications in my personal pharmacy blinded my comprehension. Time, age, memory recall and mental stress are also contributing factors to consider amongst the possibilities.
For reasons requiring an article of exploration of its own, the state of my mind and mental health have been and continue along a path of diminishing capacity. The contributing factors exist primarily beyond my control creating a dangerous self-fueling mechanism of decline.
