First , somatic psychogenic , wouldn ' t use that term to describe your HTN . I think the word you ' re looking for is organic . Second you have a wide array of symptoms , which could very rarely be tied together in a serious organic illness , but could very well be benign as well . It sounds like you have three main symptoms hematomas , fatigue , and presyncope sensation . For the hematomas amyloid creates a bleeding diasthesis , but it does not typically present ACUTELY . Rapid development of a bleeding diasthesis could include a leukemia , DIC , etc would start with just a CBC and coags and see how the symptoms progress . If your CBC and coags are normal and you have no other manifestations of bleeding , that ' s reassuring . For the muscle fatigue do you have objective weakness , or are you just fatigued ? Just fatigue would more likely point towards a systemic etiology . Would be reassured with normal CBC coags , electrolytes , and could perhaps consider ESRCRP , although your symptoms do not seem infectious . If you are objectively weak , can get a CK . For the presyncope would have them check orthostatics in the lab to rule out orthostasis . Adrenal insufficiency can sometimes cause muscle fatigue and presyncope , but this tends to be orthostatic syncope so see what your blood pressure is doing . Is your lamotrigine for seizure disorder ? Iron tests will not be of much use unless you are anemic on your CBC . Zinc , cobalamine , folate deficiency again vitamin deficiencies do not tend to present so acutely . Going for an LP honestly sounds quite out there .