Severe fatigue (elevated bilirubin and ferritin plus a highly reduced vitamin D3)

Dear Medical Doctor,

My medical question is about my chronic fatigue becoming really frustrating through the years so that I can hardly tolerate sleep times lower than 12 hrs, with the awake times of no energy.
I have met several MDs in neurology, oncology, internal medicine, and physical medicine areas.
I have got several blood and urine tests along with an MRI of brain and the whole spine, X-ray images of my back and neck, and a complete ultrasound imaging of my stomach.
Everything was apparently normal except a few items in my blood tests from which elevated ferritin and total bilirubin is worth mentioning together with a highly reduced vitamin D3 level. Could you please help me to find my disease? Are those abnormal results related to any specific illness that causes a chronic severe fatigue?
By the way, some (blind) medications have been prescribed for me before (such as Zoloft, Clonazepam, Olanzapine, Depakine, etc.) with no clear effect on my problem (at best).
A recent complete answer of my blood and urine tests follow for your observation:

Personal Information:
Gender Male
Age 30
Hematology:
WBC 6.31 10^3/uL
WBC Differential (%)
Neutrophil 49.7
Lymphocyte 41.0
Monocyte 6.8
Eosinophil 2.2
Basoph 0.3
RBC 5.63 10^6/uL
Hemoglobin 15.4 g/dl
Hematocrit 43.9 %
MCV 78.0 fL
MCH 27.3 pg/cell
MCHC 35 g/dl
RDW–CV 12.7 %
Platelets 262.0 10^3/uL
PDW 11.1 %
MPV 9.6 fL
RBC Morphobgy:
Hypochrom +
Aniso. +
ESR (1hr) 3 mm
Urine Culture:
Color Yellow
Appearance Cloudy
Reaction PH 5.0
Specific Gravity 1.020
Protein Neg.
Glucose Neg.
WBC /hpf 1–2
RBC /hpf 0–1
Epithelial Cells Rare squamous
Casts /lpf None
Crystals Amorph.
Bacteria Few
Mucus Sl. Amount
Blood Biochemistry:
Glucose (Fasting) 90 mg/dl
Cholesterol 212 mg/dl
Triglyceride 143 mg/dl
High Density Lipoprotein 36 mg/dl
Low Density Lipoprotein 147 mg/dl
LDL/HDL 4.1 Ratio
Cholesterol/HDL 5.9 Ratio
Sodium 139 Meq/L
Potassium 4.57 Meq/L
Calcium 9.5 mg/dl
Phosphate 3.4 mg/dl
Bilirubin (Total) 2.70 mg/dl
Bilirubin (Direct) 0.50 mg/dl
Iron (Chem.method) 178 ug/dl
Immunoserology:
RA (Immnunoturbidimetric) 7.0 IU/ml
CRP (Immunoturbidimetric) Less than 2.0 mg/l
Hematology & Coagulation:
Glu.6.phos.dehyd. (G.6.P.D.) Normal
Special Biochemistry:
Ferritin (ECL) 384.5 ng/ml
Vitamin B12 (ECL) 362.7 pg/ml ECL
Folic Acid (ECL) 4.5 ng/ml ECL
25OH-Vit.D3 (EIA) 5.1 ng/ml

Thanks a lot for your help,

Mg7

I am not a doctor so I cannot comment on most of what you have posted. I do have a 15 year old son who was diagnosed with chronic fatigue syndrome years ago. With no "cure" and little that the medical community could suggest, I started looking for answers. One holistic doctor finally tested his vitamin D level which was found to be very low as well. I feel that taking high doses of D3 has been very helpful for him. After a year, his D level was almost normal. Many of his symptoms have decreased or disappeared. I wish you luck in finding an answer to your illness. My son has also taken many other supplements suggested by his chiropractor or a holistic MD, so he has taken more than just vitamin D3. Now the rheumetologist says he has a form of arthritis and has him on an anti-inflammatory. It makes his joints feel better, but now he is back to getting sick a lot. I wish you luck. We have been dealing with this for 4 years.

Interesting. I too suffer severe fatigue and muscle pain, and after 12 years a doctor finally decided to test my vit. D., which is severely depleted. He said it will take probably as long as 2 years to build it back up, but won't it be wonderful if there is something that finally makes a difference?! The bilirubin might be of some concern-- have you been tested for Hepatitis C? It attacks the liver, and could well have been lurking in your body undetected for God knows how long. Otherwise, have you seen a Rheumatologist? They deal with fibromyalgia, arthritis, Lupus, all of which severe fatigue piggybacks on as an added attraction (ha).

I wish you the best and hope you find some answers soon.

---

Have Fibromyalgia, Polyneuropathy, Hep. C, rheumatoid arthritis

Hi Dear Rosie cat,

Thank you for your answer and your kind heart.
I have also taken many supplements and recently started to get moderate doses of vitamin D3. My doctor told an overdose can open up new problems of deposits in the liver and the kidneys.
Three weeks ago, they prescribed dexamethasone and betamethasone injection for my seasonal allergy. Surprisingly, my fatigue almost disappeared for few days.
For this, the rheumatologist whom I recently saw recommended a hormone test I had not given. He told me that my adrenal gland might produce inadequate cortisone which is necessary for the human’s body metabolism.
Now, I know that a severe chronic fatigue should first be examined through at least 3 suspects before diagnosis as a chronic syndrome:
1. anemia
2. thyroid disorder
3. adrenal disorder
I had passed the two former, but not the last one up to recently. Then I went through an ACTH (cosyntropin) stimulation test to examine my adrenal and pituitary glands.
I know syndromes are not easy to treat. Sometimes, a severe chronic fatigue may be related to an MS-type disease. Then, I hope the result will be informative.
I sincerely hope your son become healthy and wish him many blessings.

Thanks,

mg7

Dear ReadDeeply,

Thank you cordially for your answer. I also suffer from irregular pains in my leg muscles as strange cramps.
I have been tested for all types of Hepatitis that were negative. An infectious disease doctor suspected CFS and told me that there is no obvious treatment for this if proved.
But, recently, I saw a rheumatologist who suspected a kind of hormone disorder in my adrenal gland because I feel far better when I take corticosteroid anti-inflammatory drugs for my allergy. He told me that there is no detected inflammation in my tests. I am going to ask him about fibromyalgia, however. I am really grateful to you for your hint.

As far as I know, a severe chronic fatigue should apparently be examined through at least 3 tests before diagnosis as a chronic syndrome:
1. anemia
2. thyroid disorder
3. adrenal disorder
I had passed the two former, but not the last one up to recently. Then, I went through an ACTH (cosyntropin) stimulation test to examine my adrenal and pituitary glands.

I also wish you the bests in a healthy life sooner than 2 years ahead!

Thanks,

mg7

Post Edited (mg7) : 5/7/2011 6:08:09 AM (GMT-6)