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Forum Name: Endocrinology Topics

Question: Diagnose me? -- Very thin, mild narcolepsy


 beng - Mon May 26, 2008 11:18 pm

Hi,

I'm very thin (5'10", 125 lbs), yet I eat a lot, or at the very least, normally. Recently, I tried to gain weight by having a fairly large serving of pasta every lunch, and pizza every night... For 3 weeks... On weekends, every saturday, I would order a full pizza and eat it all. I did not gain a pound.

I'm suffering from mild narcolepsy -- even if I'm well rested, I have a tendency to nod off in the middle of the day... Before or after meals... Even coffee won't prevent it. It's causing me trouble at work... Hard to be productive when you spend half the day fighting to stay awake... I also have a very low reaction time... Poor attention span... I can feel that something's different from when I was a kid, I feel slow.

Another odd thing is that I look much younger than most people my age... I'm 23 and facial and chest hair is still scarce, even though men in my family are generally hairy.

I'm thinking the fact that I apparently can't store any fat whatsoever and the fact that I'm generally feeling tired, somewhat weak, are linked...

I was wondering if this sounds like anything typical... I've done "generic tests" over the years, and they never found anything wrong... They were all blood tests, and counts of various things were normal, I'm healthy as can be, apparently.

Particularly, I'm wondering what I should ask my doctor next time I see him... Any specific tests that would be useful, or maybe a specialized practitioner I should try to get an appointment with?

And how serious could it be? I've been looking at insulin resistance, which has a lot of symptoms I can relate to... Wouldn't want it to degenerate into diabetes if it can be prevented...

Thanks for any advice!

- ben
 John Kenyon, CNA - Mon Aug 11, 2008 8:53 pm

User avatar Hello -

It is difficult to make educated guesses at a distance, and diagnosing is, of course, impossible without the ability to look at and talk with a patient in "real" time. That said, your complaints sound as though they could be due to two different things going on at once: narcolepsy is almost always due to sleep apnea, which would go a long way toward explaining that part, if a sleep study were done and confirmed the diagnosis. However, sleep apnea is most common in people who are overweight (but this is not a rule, just a footnote); second, you do sound as though you may be suffering from a malabsorption syndrome as well, due to the inability to gain weight. Ironically, if you do have celiac disease (the most common cause of malabsorption) then your consuming large amounts of pasta and pizza would only aggravate the problem.

Now then: celiac disease generally also causes abdominal discomfort, bloating, and irregular, highly aromatic, fatty stools as well. It can also cause fatigue, lack of stamina, etc. If any of these apply in your case there is a blood test to determine if you have this problem, and it is managed by eliminating gluten from the diet, meaning far less pasta, pizza, and a few other things (gluten, the offending substance, is in a surprising number of foods one wouldn't associate with wheat).

Both these problems need to be ruled out (or in) as well as some other metabolic disorders which could be causing your symptoms. I hope you'll follow up with an inernist and get the appropriate specialty referrals in order to find out what's going on and get it managed.

Good luck to you. Please follow up with us here.

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