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Lack of energy

A 91-year-old woman wonders about the cause of her lethargy. 

QUESTION:

I am a 91-year-old woman. I live alone. Since August I have been suffering from a terrible lack of energy. Initially it was worse in the morning, better towards evening.

I made the mistake of telling my doctor of a time in my 20s when I suffered from depression in the mornings. But I don’t have that blue, hopeless feeling, just extreme tiredness.

The doctor prescribed Sertra, a mood-lifter, three months ago with little benefit. One possible side-effect is diarrhoea, which I already have after having part of my gut removed six years ago, because of adhesions from a previous 1963 operation.

I had tests for vitamin B12, vitamin D and thyroid deficiency, heart and blood pressure. I have a sleep every afternoon. I can walk, dig a garden bed, even run 50-70 metres.

Why do I have this awful lethargy most of the time?

ANSWER:

A lack of energy can have many causes. Your doctor has checked some. There are a few more that can be looked into. Removal of the bowel leads to lethargy and diarrhoea, a condition called short bowel syndrome.

You need to have a blood test to check your vitamin A, E, D, K, folic acid, calcium, magnesium and iron levels as these can all be affected. If so, it is likely you have short bowel syndrome and will need to be seen by a dietician and a gastroenterologist.

Your adrenal gland should also be checked by a blood test. If underactive it can contribute to lethargy and a referral to an endocrinologist will be needed.

Lethargy could be caused by some medications, so any you are taking should be checked to determine their effect on you.

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