Help, I feel awful For years I have had pain

Patient: Help, I feel awful. For years I have had pain in my neck and shoulders causing muscle weakness and numbness in my arms. Have daily headaches, extreme fatigue, and was recently diagnosed with IST. I take digoxin, propafenone,and cymbalta.Just got labs and xrays done…cervical xrays negative.Labs:WBC 12.5LYMPHOCYTES 2.77NEUTROPHILS 8.80AST 47ALT 56BUN/CR RATIO 30.8VIT D 23.4ANY IDEAS??

Symptoms: Fatigue, neck/shoulder pain, headache

Doctor: Welcome to Ask The Doctor. We are here to help you.Usually such generalized fatigue, stress, weight loss are due to anxiety or fibromyalgia.However to state that we should first of all rule out issues like Anemia, Calcium and Vitamin D deficiency.In case you snore in night, you might be having Obstructive sleep apnea, that can be one of the reason for the tiredness and yawning in the day time.Ask your family members, if you snore excessively in night then you need to get a Sleep study done and to work for weight loss in case you are overweight.I would advise you to get following tests done:1. Fasting Blood Sugar- to rule out diabetes2. Thyroid Profile- to rule out hypothyroidism3. Hemogram- to check for anemia.4. Serum Calcium and Vitamin D levels- to see for the deficiencies.If any issues are found in your reports you would be treated accordingly. Otherwise your Doctor will treat you with SSRI’s like Fluoxetine, Escitalopram.I hope it helps.Stay Healthy