instruction: hello doctor I am a 39 year old female fatigue sluggish difficulty concentrating and migraines I have difficulty regulating temperature with periodic tightness in the chest and fluttering sensation my ekg chest it and chest ray are normal with negative couid test my vitamin b12 folate and levels were low and I started supplements last month and the levels are in normal range now but I am still having symptoms I have borderline low white cell count and abs lymphocyte count and slightly high platelets I was diagnosed with lupus as a teenager but then in early 20s I was told that I do not have it father died at 59 of a sudden catastrophic event possibly a heart attack also my dime was slightly elevated and so was my sed rate please help I am currently on lamictal lexapro and birth control pills
output: hi following is my opinion for your asked question your attached abc complete blood count report is within the limit platelets count and all are also in borderline and you might need not to worry about that for your fatigue and sluggishness investigate with sept serum glutamic pyearuvic transaminase serum urea creatinine estimation serum ash thyearoid stimulating hormone estimation etc to rule out the liver kidney disease and thyearoid problem as a cause of fatigue ana antinuclear antibody estimation also should be done to do workup for autoimmune disease if no cause found than egg electromyography or nav nerve conduction velocity like investigation done to do workup for fatigue kindly consult a nearby physician for a detailed physical examination