Every spring my daughter gets something that seems like sinus. Her head feels congested, she has headaches and she sneezes, though not often. The worst part is the fatigue. She sleeps much more than normal and finds it hard to stay awake. Her pediatrician checks her for thyroid, anemia and mononucleosis and they are always negative. She mentioned that some allergies can cause this type of fatigue, but didn't suggest that my daughter be tested. Can allergies cause this type of fatigue and should she be tested? It lasts about a week or so, but she misses quite a bit of school and it's difficult for her. If not allergies, then could it be sinus and if not, then any other suggestions?
Answer: ---->
Seasonal symptoms of this nature are certainly highly suspicious for allergy. Allergic symptoms often do not exclusively consist of those considered "classic" such as sneezing, itchy watery eyes, nasal dripping, and congestion. Headaches and fatigue are actually fairly common symptoms of both chronic allergy as well as sinus disease. Additionally allergic processes may lead to sinus disease.
I assume that in your daughter's case, fatigue is a predominant symptom. It has been my experience that fatigue, occasionally profound in degree, is actually a quite common symptom of sinus disease particularly in the adult population. In fact, I have had many patients in whom fatigue was the major and predominant symptom overshadowing even nasal symptoms. Certainly anemia and hypothyroidism obviously must be ruled out when fatigue is a predominant symptom. Assuming they have, I would not only consider allergy as a possible cause of your daughter's symptoms, but secondary sinusitis as well.
I would suggest screening for allergy and would also consider sinus x-rays during symptomatic periods.
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Steve Dankle, MD
Otolaryngology-Head and Neck Surgery
Milwaukee, Wis
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