Conversation: The conversation between human and AI assistant.
[|Human|] I m a runner and a cyclist, and compete in races (less so in the last 1-2 years....). I m fairly competitive in these events and usually place in the top 5% or better. Two years ago, I was taking gabapentin for nerve injury from a car wreck. My muscles had extreme fatigue from exercise, my knees hurt, my eyes occasionally had blurry vision, and I had leg cramps. I stopped the medicine and my symptoms improved, but did not all completely go away. It seemed that I tired more easily and did not recover as quickly. I had a few races where 2/3 of the way through the race, it felt like I had hit the wall in a marathon -- I was out of energy. A year ago, I had some pitting edema and pain in my foot/toes. The edema got somewhat better, but I don t believe that it ever went away. My current condition is that I fatigue more quickly in exercise, and I ve noticed it more in races and/or hilly routes. And my knees are sore, which is especially noticeable when on the stairs. I noticed that the pitting edema is back (or perhaps never really went away completely). I m not sure if this is related to my problems or not, but I also had what seems to have been plantar fascitis in August. It had bothered me only in the morning for a while, but got so bad that it hurt walking on it. A cortisone shot seemed to help, but it took about 3 weeks before I noticed improvement. I noticed earlier this year that my arch doesn t seem as high as it used to be -- mostly it s just the sensation of being able to feel it touching the floor when I m standing barefoot. I never used to feel that -- perhaps it s some swelling. I don t know. Recent blood test showed TSH of 5.41. The doctor says that is in the normal range of 0.5 to 6.0. CpK was somewhat elevated (around 250). I m 48 years old. 6 3 and about 195 pounds. Suggestions?
[|AI|]  Hi, From what I have read I think the issue is cardiovascular in origin rather than neurological. Symptoms like fatigue after exercise and edema point to a cardiac related issue.  If I were your treating physician I would start with ECG, and stress induced ECG's, Echocardiogram, x-ray of the chest.  I would measure your blood pressure and ask you to keep a diary for blood pressure. I would also order blood tests to rule out diabetes, high cholesterol level, kidney function tests. For therapy, it will really depend on test results.  Hope I have answered your query. Let me know if I can assist you further. Take care