Dr Dan Rutherford in the Daily Telegraph – 23 June 2009

Q I recently had blood tests carried out by a rheumatologist in an attempt to pinpoint why I feel so poorly. I have aching joints, feel exhausted, weak and often weepy. I’m only 36 but feel as if I am trapped in the body of an 80 year-old, and at times get very depressed.


Apparently, all is functioning as it should be, and I do not have any serious diseases. The rheumatologist did say that my tests showed a very lowwhite blood-cell count, and mentioned something about that being anm indicator of possible viral infection, but did not go into detail. Should I have been more insistent?

DR DAN RUTHERFORD WRITES:

A One of the most common reasons for someone to go to a doctor is that theyfeel tired all the time. It’s immensely frustrating to be told after havingtests that no cause can be found to explain your symptoms. Part of the problem is that our tests are crude, whereas human beings are complicated.

We simply don’t have the ability as yet to explain in satisfactory terms why large numbers of people feel persistently fatigued. This is not the same as being sure that there is nothing wrong, but many doctors fail to see thedifference. It is unusual that you have a low white cell count but the significance of this depends on just how low it is and whether the proportions of the different types of white cells in the blood are unusual.

Yes, you should be more persistent and ask your GP to refer you for a further medical opinion as you do not yet have a diagnosis. A blood specialist (haematologist), for example, would be able to say if the low white cell count is significant. It is also important that your mood is low. Even if this is secondary to feeling physically unwell it is possible that treatment to boost your mood would have a positive effect on everything else

you are experiencing.

It may turn out that you have chronic fatigue syndrome. If so, it should be positively diagnosed. People with CFS are as entitled to help and support asthose with other debilitating long-term illnesses. See the ME Association website, www.meassociation.org.uk for more on the condition.