I work nights (10pm-6am since June 2014) but no matter

Patient: I work nights (10pm-6am since June 2014) but no matter how much sleep I get, I’m still constantly tired. For the last few months I’ve also been very nauseated with a burning sensation in my stomache also not much of an appetite (my tube were tied 4yrs ago so I know I’m not pregnant). I have also noticed weird hand twitches and losing grasp of things easily.

Doctor: