Tired Man.... Just So Tired

[Aswin]

The answer to many ailments seem to be the universal, eat healthy and exercise. strong body, strong mind.

I did stayed at the holiday inn last night.

[Datsun240Z]

The answer to many ailments seem to be the universal, eat healthy and exercise. strong body, strong mind.

Very true: Body & Mind in perfect balance.

[robblok]

The answer to many ailments seem to be the universal, eat healthy and exercise. strong body, strong mind.

Very true: Body & Mind in perfect balance.

I just hope for your body that isnt true

[Luang]

Thought i would give an update for those who contributed so selflessly previously.

Went to see Dr J at BD. After showing her the thyroid results she was sure that this was not responsible for the symptoms of chronic fatigue/malaise etc. (said i may be considered subclinical hypothyroid in some institutions).

We then discussed Adrenal testing (ACHT stimulation test) and some other tests. Then the costs!! To cut a long story short i went to another hospital for testing at half the cost (Also something for others to consider before throwing cash away!) She again though felt sure i did not have Adrenal symptoms.

Ok, to the point. They could not do ACTH at the local hospital but did a baseline cortisol which the doc said would show up any Adrenal concerns. Result came back normal (actually slightly high) so that rules out Adrenal insufficiency. Also, doc said no symptoms at all for excessive Adrenal function.

Urine analysis normal. Urine Protein normal. eloctrolytes, calcium and phosphorous, albumin and globulin, magnesium, blood cells ALL normal!

Ok, back to the drawing board and over the net to you guys please. The doc i saw however, i must say , i was not very impressed with -no questions to me really and it was me that seemed to look for alternatives/answers to my symptoms. In fact, he gave no further recommendations as i left the hospital except to do a blood sugar test when i feel fatigued which was my suggesstion as i asked him if it could possibly be blood sugar spiking as i crave chocalate all the time now , which i have never done before. So what's next all ?

Luang

[Sheryl]

A couple of thoughts:

1. As you do have a mild hypothyroidism I suggest a trial of low dose replacement. In my experience this often makes more of a difference than the lab values would have suggested. It is important to "treat the patient, not the numbers".

Did Dr. Rosanee do a full thyroid panel or only a TSH? Makes a difference. If she did a full panel what was the free T3 and T4? I ask because in some cases use of thyroid extract has advantages over the more commonly prescribed levothyroxine.

If you have hypertension or heart disease shoukld not take thyroid without medical supervision. In any event start at lowest dosage and stop if any palpitations, trembling hands, etc.

2. The slightly high cortisol levels are consistent with stress. The craving for chocolate, ditto -- chocolate raises serotonin levels. A trial of low dose SSRI (e.g. sertraline, paroxetine -- sertraline being least expensive as there are local generics) might also be indicated. Remember that they take 2-3 weeks to show effect. Available OTC but do not self-adminisiter if you have (or may have) liver or kidney impairment -- should have recent (i.e. within past year) test of liver and kidney function (ALT/AST, creatnine/BUN; if you have had a general physical these will have been included). Aso be sure to read up on side effects and potential drug interactions, do this even if taking under medical suopervision as doctors tend not to provide enough information.

If you prefer a more "natural" approach, can try 5-HTP or tryptophan, these are serotonion precursers. Can be hard to find in Thailand though.

Also suggest a course of meditation (see www.dhamma.org) as a means of naturally reducing stress levels in the brain.

Short-term therapy may be helpful especially if there are some specific stresses/issues in your life now or past stresses/issues still going through your mind. See pinned resource list.

3) Lastly diet: AVOID all processed carbs (even though this is what you crave) and maximize protein intake especially in the morning, even if you don't feel hungry at breakfast force yourself to take in some protein. Eat at regular intervals, no skipped meals and no between meal snacking. This may all be hard at first but with time will greatkly help regulate blood sugar and metabolism.

To avoid confusing the picture do not start more than one medication at a time, i.e. either thyroid replacement or SSRI but not both at same time. If one does not work, or works only partially, can add the other, but if you start both at same time you will not be able to tell which is having what effect, also risk of adverse effects greater.

The dietary changes, meditation etc can be done in combo, no problem.

I don't recall if you drink or not, but if you do -- STOP. Totally. ALcohol is a processed sugar which will play havoc with your blood sugar levels.

Good luck and let us know how it goes.

[Luang]

Thanks for all your time again Sheryl.

I saw Dr. Jun at BD. I had thyroid panel done previously at another hospital: T3=99 (64-140) T4=5.65 (4.5-12) so well within normal ranges.

Dr. Jun did not feel at all that my symptoms were due to my Thyroid levels, neither did she feel it was an Adrenal issue , which has been confirmed.

My Glocose levels were in the middle of the range when tested so does that rule out a blood sugar problem or could this be spiking and dropping?

Regarding the cortisol level-573 (9am) (range 171-536) it is very slightly over and i am under no stress at all right now so i feel i can rule that out.

Had a liver function test and ultrsound last year and all clear (slightly high ALT of 49 (0-40) but again, the Gastroenterologist felt there was nothing abnormal.

Do you still think it really could be Thyroid causing such chronic fatigue and malaise issues? I'm beginning to think i may be barking up the wrong tree altogether.

Thanks again for your time, it is most apprecciated.

Luang.

P.s. I do drink, and probably too much but i always have and this fatigue seems to be a symptom of something more specific. Maybe i should think about some heart health tests next?

[Sheryl]

My Glocose levels were in the middle of the range when tested so does that rule out a blood sugar problem or could this be spiking and dropping?

They would have tested your fasting glucose. Normal result rules out diabetes but you could still have abnormalities of glucose metabolism, these are often the result of consumption of alcohol and/or other processed carbohydrates. I definitely advise that ou eliminate all processed carbs including alcohol.

Regarding the cortisol level-573 (9am) (range 171-536) it is very slightly over and i am under no stress at all right now so i feel i can rule that out.

Had a liver function test and ultrsound last year and all clear (slightly high ALT of 49 (0-40) but again, the Gastroenterologist felt there was nothing abnormal.

Do you still think it really could be Thyroid causing such chronic fatigue and malaise issues? I'm beginning to think i may be barking up the wrong tree altogether.

I do not think thyroid alone accounts for your problems but mild hypothyroidism may contribute especially to the lethargy in the morning. Only way to be sure is to try low dose replacement and see if it makes a positive difference.

I do drink, and probably too much but i always have and this fatigue seems to be a symptom of something more specific. Maybe i should think about some heart health tests next?

Excessive drinking catches up with one after a while and definitely is something you need to address. The slightly high ALT is a further indication that your body is having trouble handling it.

Re heart, I was under the impression you had already had a thorough physical check up but if not, of course should.

Other possibility is Chronic Fatigue Syndrome. See this link for diagnostic criteria. http://www.cdc.gov/cfs/cfsdiagnosis.htm

As it is primarily a diagnosis of exclusion (and there is not much that can be done for it), should exhaust other possibilities first. Although you feel you are not under stress I still think a mood disorder or other pyschological problem is quite possible.

It is a rare person who drinks too much but is not, underneath it all, depressed or anxious or both. Get off the booze and underlying anxiety and/or depression will likely become quite evident at which point you can address it directly. Most alcohol and drug abuse is actually an attempt at self-medication. So are food cravings. Obviously, better to properly medicate the anxiety or depression and address its causes.

[sreiter]

From own experience: I could not see anyone mentioning the possibility of sleep apnea. Do you snore? If you do, there is the possibility that you stop breezing when you sleep- often a(nother) function of getting older as the muskles in your throat get worn out. Every time you stop breezing you wake up enough to start breezing again- so you never enter the deep stage of sleep you need to recharge your batteries. This condition can make you extremely tired at all times! Ask the person that shares your bed/bedroom! Cheers Stefan

[zenman]

Luang it seems like a lot of good advice from an allopathic perspective. Have you considered undertaking a cleanse and detox at one of the many centers in Thailand?

If hundreds or thousands of people are flying into LoS from around the world every year for this type of treatment and getting great results for all types of presenting symptoms and conditions is it worth your while considering this.

I personally know of an airline pilot who was stood down from work without pay for a condition that one would not expect to be treated successfully by detox. After a 14 day program he went back home and underwent thorough testing and was passed fit to resume duty.

Good Luck with a solution for your problem.

[Sheryl]

From own experience: I could not see anyone mentioning the possibility of sleep apnea. Do you snore? If you do, there is the possibility that you stop breezing when you sleep- often a(nother) function of getting older as the muskles in your throat get worn out. Every time you stop breezing you wake up enough to start breezing again- so you never enter the deep stage of sleep you need to recharge your batteries. This condition can make you extremely tired at all times! Ask the person that shares your bed/bedroom! Cheers Stefan

A good suggestion and worth checking into.

[zorro1]

You may have sleep apnea and not be aware, millions of people have it. It will make you increasingly tired as you air ways close and you are deprived of oxygen all night. Have a sleep study done as well

[verydumbubba]

I believe ya might have low blood sugar levels - if I dont eat 6/10 small meals a day, I can get lethargic.

Exercise is critical, so is hydrating. Lay off the swimming for a week or two, see if that refreshes you.

A large lunch/beer will induce power naps - I did those for months when I quit cigarettes many years back. Habit.

Change your daily routine - stop with all the tests - one day when y'all broke the malady will leave.

Rest quality is critical. Hit the gym, go heavy, get a high quality protein shake also.

Stop fretting - enjoy your health. Sodium chloride is dangerous, poisonous.

Bubba

[Luang]

It's def. not sleep apnea.

Also, i have noticed that a sweet drink or snack doesn't lift the fatigue. If i had a glucose metabolism issue wouldn't this be the case? However, i do intend to test glucose levels when i am fatigued as to rule it out.

Could IBS cause such chronic bouts of fatigue? Again, though the IBS comes and goes, but the fatigue is constant and regular.

For those still curious, my main symptoms include bouts of chronic fatigue-these seem to become significant around 4-5 hrs after waking and get worse as the day goes on. When i get home i am immediately flat out on the sofa and in a chronic fatigue state for 2-4 hours. Only after this time can i get myself up and begin to function again, albeit at around 50% capacity. Memory loss and general malaise is now significant as is mood swings (slightest things can anger me at times). I am also craving sweet foods constantly.

Anyway, thanks again all who have offered advice and suggestions.

Luang.

[Datsun240Z]

The answer to many ailments seem to be the universal, eat healthy and exercise. strong body, strong mind.

Very true: Body & Mind in perfect balance.

I just hope for your body that isnt true

Not for me Rob ! No way.

[Luang]

It's def. not sleep apnea.

Also, i have noticed that a sweet drink or snack doesn't lift the fatigue. If i had a glucose metabolism issue wouldn't this be the case? However, i do intend to test glucose levels when i am fatigued as to rule it out.

Could IBS cause such chronic bouts of fatigue? Again, though the IBS comes and goes, but the fatigue is constant and regular.

For those still curious, my main symptoms include bouts of chronic fatigue-these seem to become significant around 4-5 hrs after waking and get worse as the day goes on. When i get home i am immediately flat out on the sofa and in a chronic fatigue state for 2-4 hours. Only after this time can i get myself up and begin to function again, albeit at around 50% capacity. Memory loss and general malaise is now significant as is mood swings (slightest things can anger me at times). I am also craving sweet foods constantly.

Anyway, thanks again all who have offered advice and suggestions.

Luang.

Thought i'd bump this up to see if anyone has any alternative ideas to what has been said (which are all valued by the way).

Update is that i just had a random glucose level test and that came back at 115 which is well within limits for that test i believe(range -150).

Consultant at Bum. doesn't believe at all that my thyroid levels are causing the symptoms. I'm inclined to go with her on that at the moment. Parasite meds next, then onto plan x i think as i'm running out of tests to do.

Any thoughts, please share folks.

Luang.

[zzdocxx]

It's def. not sleep apnea.

How do you know this?

Also, how is your emotional health?

[Old Croc]

Get your iron levels checked. A simple blood test.

You could have haemachromatosis.

[Luang]

zz- my partner is sure it's not an issue. Re. emotional health, generally it's fine and my life is stable. I do have mood swings right now but that is a symptom of the problem and not vice versa, as is the memory loss and fatigue. (i spent 5 mins today looking for my atm card that i had literally 1 minute earlier locked in my desk ).

Croc - I've had the complete blood count and it was normal.

Thanks anyway guys, your input is apprecciated.

[patklang]

Seems like you have alzeimers too lol

[Old Croc]

Croc - I've had the complete blood count and it was normal.

Thanks anyway guys, your input is apprecciated.

That's good.

I'm surprised the iron level test was included in your complete blood count.

Most doctors don't consider the iron studies to be part of normal screening.

(Particularly as Haemachromitosis is considered more likely to occur in people with a Celtic background and is rare in S E Asians)

Edited September 12, 2009 by Old Croc

[zorro1]

It's def. not sleep apnea.

How do you know this?

Also, how is your emotional health?

yes how would you know without a sleep study. All your blood work okay looking very very likely its OSA

[Luang]

Mmmm....well, my partner hasn't noticed any breathing difficulties, i don't snore, and i'm not waking or sweating during the night so think i'ts unlikely.

Croc, you are right i though the haemoglobin count covere iron but seems it doesn't. I don't have any arthritic or liver poroblems though. Though, i confess to knowing nothing of this condition.

Luang

[Old Croc]

Croc, you are right i though the haemoglobin count covere iron but seems it doesn't. I don't have any arthritic or liver poroblems though. Though, i confess to knowing nothing of this condition.

Luang

The condition can show up in many ways in an individual. One symptom is a form of chronic fatique.

Worth checking.

[CobraSnakeNecktie]

This is a little out of the box for many people but go see a Traditional Chinese Medicine (TCM) accupuncturist. They will check your pulse meridians and tongue appearance for signs of imbalance and make recommendations for dietary change and balancing herbs.

Sure sure people will flame me for this recommendation but it will not cost much and many times it's a simple matter of changing the yin/yang influence of your diet. Also practicing Tai Chi or receiving accupuncture treatment can restore the normal body energy balance.

[Sheryl]

In terms of coping strategies, acupuncture is certainly worth a try, so is gentle yoga if you can summon up the energy for it.

In terms of figuring out the underlying cause:

(1) I think we have assumed you're male but looking back I don't see confirmation of that. If by any chance you are a woman, are the symptoms worse in the 2 weeks priopr to your period and noticeably better after your period starts? (would suggest PMDD)

(2) If you are male and are of northern European ancestry, Croc's suggestion of hemachromatosis is worth looking into. In advanced state there would be liver complications, and diabetes, but in earlier stages might not, and fatigue is indeed an early sign. Age fits also as onset of symptoms usually around age 40-50. To rule this out, check serum ferritin level.

(3) You have not mentioned so I assume not, but to be sure: any tenderness or enlargement of lymph nodes? Muscle/joint pain? Sore throat?

(4) Have you had recent liver enzymes checked? (thinking of chronic hepatitis, sometimes there is no jaundice, just fatigue)

[Sheryl]

P.S.

Are you on any long term medications?

Do you get a (reasonably) balanced diet?

[Luang]

In terms of coping strategies, acupuncture is certainly worth a try, so is gentle yoga if you can summon up the energy for it.

In terms of figuring out the underlying cause:

(1) I think we have assumed you're male but looking back I don't see confirmation of that. If by any chance you are a woman, are the symptoms worse in the 2 weeks priopr to your period and noticeably better after your period starts? (would suggest PMDD)

(2) If you are male and are of northern European ancestry, Croc's suggestion of hemachromatosis is worth looking into. In advanced state there would be liver complications, and diabetes, but in earlier stages might not, and fatigue is indeed an early sign. Age fits also as onset of symptoms usually around age 40-50. To rule this out, check serum ferritin level.

(3) You have not mentioned so I assume not, but to be sure: any tenderness or enlargement of lymph nodes? Muscle/joint pain? Sore throat?

(4) Have you had recent liver enzymes checked? (thinking of chronic hepatitis, sometimes there is no jaundice, just fatigue)

Sheryl, in answer to your q's.

1.Yes, male.

2. Yes, northern European (and Celtic) ancestory.

3. No

4. Had a liver function test and hepatitis tests last year and all clear.(slight elevation on ALT i think but nothing major).

Also, tried the worm tablet yesterday but again, negative.

The only problem i am aware of is high cholesterol and triglycerides but i have not heard of this causing chronic fatigue

Not taking any medication except asthma inhaler.

Thanks again for all suggestions all. keep them coming, got to get to the bottom of it eventually

[ianwuk]

I am also tired all the time and will try the glass of salt walter thing mentioned. I am 26.

Ian

[fullwhenempty]

Fatigue and sugar craving? Since you have excluded a number of other possibilities, my hunch is Candida. A crude check for Candida is to do a 'Spit Test'. First thing in the morning, before cleaning your teeth, work up some saliva and spit into an 8oz clear glass of water. Don't disturb it. If, after 15-30 minutes, the saliva extends down into the water like jellyfish legs, then you've almost certainly got a fungal/Candida overgrowth. 70% of the ladies I see, fail this test and respond very well to an anti-fungal program. Men ARE susceptible too.

Whatever the reason for your fatigue, I would do a fast with a parasite cleanse. It can resolve issues where other strategies fail. It's also not reliant on (usually incorrect) diagnosis. Failing that stop ALL sugar, sugar substitutes and carbs for a few days. Nothing sweet allowed, except Stevia.

Since fungi thrive on sugar, the 'Lemonade Diet' (Master Cleanse) is out. You can try a 'Lassi' or 'Virgin Coconut Oil' fast. If you want more info search online or send me a message.

[Luang]

Fatigue and sugar craving? Since you have excluded a number of other possibilities, my hunch is Candida. A crude check for Candida is to do a 'Spit Test'. First thing in the morning, before cleaning your teeth, work up some saliva and spit into an 8oz clear glass of water. Don't disturb it. If, after 15-30 minutes, the saliva extends down into the water like jellyfish legs, then you've almost certainly got a fungal/Candida overgrowth. 70% of the ladies I see, fail this test and respond very well to an anti-fungal program. Men ARE susceptible too.

Whatever the reason for your fatigue, I would do a fast with a parasite cleanse. It can resolve issues where other strategies fail. It's also not reliant on (usually incorrect) diagnosis. Failing that stop ALL sugar, sugar substitutes and carbs for a few days. Nothing sweet allowed, except Stevia.

Since fungi thrive on sugar, the 'Lemonade Diet' (Master Cleanse) is out. You can try a 'Lassi' or 'Virgin Coconut Oil' fast. If you want more info search online or send me a message.

No offence meant FWE, but the more research i do, the more i hear suggestions that Candida is nothing more than a scam. Was the term even initially constructed (construed) by some 'alternative (?) therapy company? Not that i'm being cautious at all

Only asking, by the way!