Fatigue getting out of control, any advice?

[AlexRRR]

Could be anything but really if tests show up "normal" then its either allergy or mental...exwife has mental health issues and was fatigued yet lead a normal life, nose allergy for me just about shut me down slowly over 10 years, its not just dust in the air, stale air, vapour from paint on walls polish on timber floors and furniture, carpet you name it then food allergy, take your pick.

20 million Americans suffer from allergy's your not alone and thats where i would start.

[Jeffkp]

Don't discount depression. I've suffered from it most of my life. I've gone long periods with no symptoms, but have to be very aware. I had great success with small doses of Prozac.

[pest]

Try a month off the Palio diet wean your self off the red meats and up the veg

[richard_smith237]

Symptoms parallel depression.. you've been checked for Hypothyroidism..

You may find value in speaking with a *Psychiatrist who can evaluate you after omitting other possible factors.

This is not a black and white science; the brain releases chemicals (serotonin and norepinephrine) - if your brain is not producing these chemicals in the correct amounts the physical symptoms of Depression may surface...

See a specialist...

In such circumstances much in the same way a diabetic needs insulin someone with depression may see improvements when taking certain medication (SSRI or SNRI).

*Note: Don't mix up Psychiatrist with Psychologist - they are different disciplines (one physical the other mental).

Thanks Richard.

I was diagnosed with depression at around 14 years old and took SSRI (fluoxetine mostly) until around the age of 21. During that time I was depressed much of the time, to the extent of having suicidal tendencies. I felt much happier once I was off the medication as I felt more connected (the medication made me feel numb, as if I was watching my life on a movie screen).

I understand quite well the manifestation of depression and I'm not sure it's that anymore. I'm certainly happier than I've ever been these days and don't feel like I don't want to get out of bed because the world is a deep, dark hole (like I used to feel). Any irritability I have is minor and usually because of my feelings of fatigue.

That being said, I don't discount that brain chemistry is hugely important and I wonder if that's a factor. Would this show in any lab tests?

My mother has bi-polar and after years of misery and ineffective drug treatment is weaning off all pills and seems happier than I remember seeing her, so I remain skeptical (both because of my own experience and hers) but no adverse to anything.

Thanks for your input.

No, there are no blood tests which could evaluate brain chemistry... This diagnosis is usually made after other possibilities such as Hypothyroidism have been eradicated.

It is a common misunderstanding that Depression has to involves feeling upset, suicidal, sad etc... you could have depression and still have a positive outlook but simply be physically fatigued and mentally drained at times.

There are many different brands / types of SSRI's and SRNI's - treatment for depression often takes months of experimentation to find out whats right for you.

As you mentioned - SSRI's didn't seem to work too well. Your Psychiatrist 'should' have recognised this... it is possible your Psychiatrist 'should' have also tried to SNRI's to see if there was any improvement after SSRI's failed to bring about the desired response.

Again... it really is very important that you have these discussions with your Dr. Not just a normal Dr. but a Psychiatrist who will have a far better understanding of your symptoms and maybe able to make a far more accurate evaluation of your mental health than a normal Dr and certainly more than we are able to do.

A Psychiatrist will go through your diet, exercise patterns, stress patterns etc...

[jimmiejackson]

Thanks for all the input so far!

Seems like my biggest possibilities are Thyroid (although the blood test last year seems to have ruled that out), Diabetes, Allergies, Lyme disease or Depression.

Well at least that's narrowed the field from every single malady out there!

I understand that with fatigue-related symptoms it's very hard to narrow down. I remember telling my Doctor many years ago that I just felt very tired all the time for no particular reason and she told me that it's just normal in the Modern world. Maybe she was right.

For the person who said I might have hypochondria - haha thanks for that first of all. I have thought about that before but I really don't think most people feel the way I do, which makes me believe it's real and there is something out of balance. The reason I've tried so many things to fix it is because nobody seems to know what it is.

I would be overwhelmed with happiness to know what it is, fix it and wake up feeling fresh and energetic each day, that's what I'm working towards.

[mikiea]

blood test: actual values.

What do you do all the day...just an overview

What vitamins/supplements you take and how much

training details

living conditions

what you eat

only as example: hard training that is OK in cool area, in Thailand + to hot at the recovery time can drain you out.

hard training and you always eat meat but not in the heat you eat fruits but train the same may cause problems

details details details

Sure -

Most days I wake up around 9, gym 3 times a week (strength training and conditioning, about 2 hours total each time - so the "big 3" lifts, Olympic lifts, accessory work and 20 minutes or so HIIT for conditioning). Then various non physical activities (writing, reading, correspondence) for the rest of the day - little other physical activity.

Eat mostly a "paleo" diet, lots of meat and fish, low gluten levels. The occasional pizza or similar "junk" but usually about once a week. Lots of fruit. Was previously obese, haven't been for at least 5 years.

I live in a comfortable home, aircon brand new and regularly cleaned. No signs of mold (at least visual).

Vitamins/supplements - Creatine monohydrate (10g/day dissolved in hot water), B12 (methylcobalamin) 5000mcg, Metyhl Folate (5-methyltetrahydrofolic acid) 800 mcg, Magnesium Malate 425mg, Cetrizine (for allergies) 10mg. I previously have taken all kinds of vitamins and supplements but no longer do as everything was making brain fog worse. Have tried selenium, K2, D3, L-theanine, Noopept, Provigil, Nuvigil, Vitamin A, Vitamin K2, Piracetam, Copper, Iron and probably more I can't remember.

Happy to give more details and thanks for your help!

dude , go spend a few bucks , get a chem 20 blood test . it will show any blood

"problems " , if you eat what you say you eat , stop with the supplements you are wasting money . if you eat healthy , that is all a body needs . exercise to maintain your health not make your body what it is not . do this quickly as you may forget .........................

[Sheryl]

OP,

From the additional information provided (including that you have had a full panel of blood work done thus excluding anemia and diabetes) and given that you have already addressed sleep apnea, I am inclined to agree with those who think this is probably pyschosomatic (and that is certainly what any doctor you go to with these symptoms is likely to think). You do not need any additional physical tests beyond what you already have had. If you want to pursue food allergies, the simplest and best approach is just an elimination diet removing one tye of food at a time and giving it a few weeks to see if it makes a difference.

I would also while you are at it drop the cetrizine as that can certainly cause/worsen fatigue and brain fog. Also if you are taking any nootropics (I didn't see any on your list, but OP mentioned it) drop them as well. I.e. no meds at all other than supplements.

However I disagree with those pointing you in the direction of a pyschiatrist and medications. You have already had experiences with psychotropic meds and to me, what you describe sounds less like an innate chemical imbalance than the extreme fatigue that results from a constant psychic effort to suppress unpleasant emotions, conflicts and memories. Such suppression is natural and even helpful at certain points in ones life (especially childhood) when one does not have the strength and ability to deal with them, but there comes a time when you need to stop and let it gradually out and deal with it. If you do, you will experience a huge surge of pyschic energy. This is not something most people can do on their own, though -- whatever is suppressed is so for a reason i.e. it was painful, scary etc and you did not have the tools to deal with it. So what I suggest is short-term pyschotherapy. See the pinned mental health resource list. http://www.thaivisa.com/forum/topic/90910-mental-health-resource-list/

I can virtually guarantee that if you do this you will find that great stores of psychic energy -- which rather than physical energy, is what you are really lacking -- get freed up.

The relationship with the therapist is key (more important than the specific techniques they employ) and depends a lot on individual chemistry so if the first one you consult doesn't feel right, keep trying until you find one who does. It needs to be someone you feel is empathetic and able to understand you, and of course whom you can come to trust.

How long it will take is variable. Unlike what many people fear, this process does not result in all of a sudden being faced with everything you have tried to suppress. It is more like a slow ooze of pus after inserting a needle into an abscess. It comes out gradually and at a pace you can handle, and what that pace is will determine how long it takes.

[phitsanulokh]

The cheapest way (to avoid unnecessary expensive tests), is ask your doctor/hospital for a blood tests.

2 year ago I was extremely tired, went to a doctor to ask for a blood test, and I was diagnosed with “scrub typhus” (it kills the red blood cells)

https://en.wikipedia.org/wiki/Scrub_typhus

Important: Repeat the blood test after 5 months, to control the disease is totally gone.

I fail to do this, and got it for the 2^nd time in 14 months, while I don’t live in the jungle.

Good Luck.

[fang37]

Maybe simplistic but does the weather have an effect eg humidity?

[jimmiejackson]

OP,

From the additional information provided (including that you have had a full panel of blood work done thus excluding anemia and diabetes) and given that you have already addressed sleep apnea, I am inclined to agree with those who think this is probably pyschosomatic (and that is certainly what any doctor you go to with these symptoms is likely to think). You do not need any additional physical tests beyond what you already have had. If you want to pursue food allergies, the simplest and best approach is just an elimination diet removing one tye of food at a time and giving it a few weeks to see if it makes a difference.

I would also while you are at it drop the cetrizine as that can certainly cause/worsen fatigue and brain fog. Also if you are taking any nootropics (I didn't see any on your list, but OP mentioned it) drop them as well. I.e. no meds at all other than supplements.

However I disagree with those pointing you in the direction of a pyschiatrist and medications. You have already had experiences with psychotropic meds and to me, what you describe sounds less like an innate chemical imbalance than the extreme fatigue that results from a constant psychic effort to suppress unpleasant emotions, conflicts and memories. Such suppression is natural and even helpful at certain points in ones life (especially childhood) when one does not have the strength and ability to deal with them, but there comes a time when you need to stop and let it gradually out and deal with it. If you do, you will experience a huge surge of pyschic energy. This is not something most people can do on their own, though -- whatever is suppressed is so for a reason i.e. it was painful, scary etc and you did not have the tools to deal with it. So what I suggest is short-term pyschotherapy. See the pinned mental health resource list. http://www.thaivisa.com/forum/topic/90910-mental-health-resource-list/

I can virtually guarantee that if you do this you will find that great stores of psychic energy -- which rather than physical energy, is what you are really lacking -- get freed up.

The relationship with the therapist is key (more important than the specific techniques they employ) and depends a lot on individual chemistry so if the first one you consult doesn't feel right, keep trying until you find one who does. It needs to be someone you feel is empathetic and able to understand you, and of course whom you can come to trust.

How long it will take is variable. Unlike what many people fear, this process does not result in all of a sudden being faced with everything you have tried to suppress. It is more like a slow ooze of pus after inserting a needle into an abscess. It comes out gradually and at a pace you can handle, and what that pace is will determine how long it takes.

Thanks Sheryl.

I'll be honest, that isn't the type of reply I expected from you (having read many of your replies to other threads), not that that's a bad thing!

It's hard to think that maybe this is "all in my head", but I guess it is - it's "in my head" that I feel the fog and the fatigue most.

I feel like I used substances to cover up a lot of emotional issues and when I stopped using, I had a very tough period where a lot came flooding out. I feel I've addressed those demons now but I could very well be wrong. I do still have certain triggers of things that I avoid or it can bring me back to a place I don't like to be mentally.

It's interesting to think about certainly.

As for my bloods, I don't believe any of it covered diabetes (I didn't get hb1ac or a urine glucose analysis) so perhaps that's worth ruling out first.

Whether the symptoms are psychosomatic or not, they are very real to me and have a very real impact on my life, so however I can solve that I'm totally game.

Thanks for your feedback as always.

[F4UCorsair]

8+ hours sleep, but is it quality sleep.

Sleep apnoea/apnea may be a possibility, and many sufferers, don't realize it.

[F4UCorsair]

Maybe simplistic but does the weather have an effect eg humidity?

Humidity does affect most people. 33 degrees at 90% humidity will sap energy faster than 33 degrees at 20% humidity.

[h90]

I would just stop exercising and eating supplements + eat relative normal with plenty of carbs for 1 week. Than look what happens.

[jimmiejackson]

The cheapest way (to avoid unnecessary expensive tests), is ask your doctor/hospital for a blood tests.

2 year ago I was extremely tired, went to a doctor to ask for a blood test, and I was diagnosed with “scrub typhus” (it kills the red blood cells)

https://en.wikipedia.org/wiki/Scrub_typhus

Important: Repeat the blood test after 5 months, to control the disease is totally gone.

I fail to do this, and got it for the 2^nd time in 14 months, while I don’t live in the jungle.

Good Luck.

Thanks for that. I have no issue getting blood tests and usually do so from Bria Labs as they are far cheaper than most hospitals.

The thing is to know what to test for. You could easily spend 10s of thousands of Baht getting tested for everything, so it's important to know what options to select when going in. I guess that's where a Doctor can direct me perhaps. I'm just a little wary of private hospitals here in terms of being over zealous with everything when they make profit on every item and not trusting enough of public ones.

[Bernard Flint]

Diabetes 2

hepatitus 3

anabolic steriod mis use

???????????????????????????????????????????

[Sheryl]

From what he says, has already had a full blood panel which would always include fasting glucose.

OP - urine glucose is not an important test (and if you had a physical check-up that usually includes a urinalysis which would show glucose if present, which of course it seldom is). Any check-up package will have included fasting glucose but if you are in doubt easy enough to get one. Hb1ac is not necessary if fasting glucose has always been in normal level.

As mentioned I really think you need to pursue psychological causes. And stop the certizine and nooptropics. No meds but supplements.

Simply tell the therapist what you have said here..that you have a history of depression & so forth, previous substance abuse, and have been troubled for years by severe fatigue and mental fogginess for which a physical cause has not been found and which is getting worse.

That it is getting worse indicates that it is taking more and more effort to keep it all suppressed i.e. it is time for it to come out.

Vipassana meditation which another poster mentioned is also helpful but my instinct from what you describe is that you should get some pyschological therapy first before considering it. Vipassana does knock down the barriers between conscious and unconscious mind but if there is a lot of really troubling stuff piled up in the unconscious it is best to work through that with the support of an empathetic therapist first. You may otherwise be unable to tolerate the Vipassana.

[robertson468]

A simple thing that you might like to look at is are you rehydrating yourself sufficiently, particularly in a tropical climate and exercising.

[allanos]

Especially because you are looking for the most cost-efficient way of diagnosing what ails you, I suggest you obtain a book called "The Edge Effect" by

Dr Eric R Braverman. Read it, work your way through the psychological test questionnaires which are contained within, and evaluate your "Personality Type".

Braverman believes that all physical ills are a result of a brain (neurotransmitter) imbalance. I, myself, followed the material in the book avidly, and believe

it helped me enormously.

[jimmiejackson]

Diabetes 2

hepatitus 3

anabolic steriod mis use

???????????????????????????????????????????

The first two maybe, don't like needles enough for the third!

[humqdpf]

Go to a quality hospital. Depending on their system, go to a doctor and tell him/her your symptoms. Go to the various specialists and all the tests done (in a quality hospital that should take you a couple of days at most). This will tell you what is wrong with you.

The worst thing to do is to ask this forum. No matter how well-meaning and well qualified they are, any doctor would need to have the support of other specialists and actually see you in person. My only comment is that your symptoms are coherent with a number of conditions. Get tested.

[MANFROMBOCA]

You eat Paleo,, great,, had all the blood work done good.. may want to try and cut down a bit on your exercise routine until it clears ( not eliminate try doing much higher reps at a lower weight) stop craeatine and other suppliments for a while replace with multi vit and MULTI B with some ginko ( can be bought at boots they usually have good sales on vits just gets a months supply) i am presuming you ride a motor bike so i would have to agree that your problem is oxygen intake may be from a sleeping problem may or may be from a reaction to the pollution here,,, i had same symptoms after i lived here for one year, like you did every test.... Try drinking PLENTY of LIQUIDS and check your paleo list for foods that replace your electrolites ( try gatorade for a month once a day with new vits ) AND go to FASCINO pharmacy and get a small can of O2 (oxygen) and inhale it..if you see any imporovement then get a big canister and inhale @40% for 15minutes a day then as needed,,, if the can does not help then i would look at your night breathing, but stay hydrated as these are signs of dehydration and oxygen deprived,,

then as you feel better start re-introducing your workout and vitamin routine if it appears again stop or take less,,, this is what i did it worked for me,,, but it may or may not be your problem

[jimmiejackson]

Go to a quality hospital. Depending on their system, go to a doctor and tell him/her your symptoms. Go to the various specialists and all the tests done (in a quality hospital that should take you a couple of days at most). This will tell you what is wrong with you.

The worst thing to do is to ask this forum. No matter how well-meaning and well qualified they are, any doctor would need to have the support of other specialists and actually see you in person. My only comment is that your symptoms are coherent with a number of conditions. Get tested.

I'm sure you're right. I do appreciate all the inputs however, it's good to get some actual experience from other people.

I'm concerned the costs will escalate out of control, we've all heard the stories. Still, I guess I don't have much choice.

[jimmiejackson]

You eat Paleo,, great,, had all the blood work done good.. may want to try and cut down a bit on your exercise routine until it clears ( not eliminate try doing much higher reps at a lower weight) stop craeatine and other suppliments for a while replace with multi vit and MULTI B with some ginko ( can be bought at boots they usually have good sales on vits just gets a months supply) i am presuming you ride a motor bike so i would have to agree that your problem is oxygen intake may be from a sleeping problem may or may be from a reaction to the pollution here,,, i had same symptoms after i lived here for one year, like you did every test.... Try drinking PLENTY of LIQUIDS and check your paleo list for foods that replace your electrolites ( try gatorade for a month once a day with new vits ) AND go to FASCINO pharmacy and get a small can of O2 (oxygen) and inhale it..if you see any imporovement then get a big canister and inhale @40% for 15minutes a day then as needed,,, if the can does not help then i would look at your night breathing, but stay hydrated as these are signs of dehydration and oxygen deprived,,

then as you feel better start re-introducing your workout and vitamin routine if it appears again stop or take less,,, this is what i did it worked for me,,, but it may or may not be your problem

Thanks for your input.

I actually have already done both a full elimination diet recently which includes starting again at zero supplements and zero exercise and everything was reintroduced little by little. None of it helped much except I learned when I eat junk food that's very fatty I get bad acid reflux.

Have thought a lot about oxygen. I grew up with asthma and was in and out of hospital a lot in my early years. I then (like a genius) started smoking really heavily in my early teens into my mid twenties.

When I did my sleep study, my oxygen level dropped quite low (off the top of my head, 80 something percent).

Is it safe to buy and try inhaling oxygen? How much would the "small can" set me back? Does it have a mask or can I use my CPAP mask? - I appreciate your feedback!

[jimmiejackson]

From what he says, has already had a full blood panel which would always include fasting glucose.

OP - urine glucose is not an important test (and if you had a physical check-up that usually includes a urinalysis which would show glucose if present, which of course it seldom is). Any check-up package will have included fasting glucose but if you are in doubt easy enough to get one. Hb1ac is not necessary if fasting glucose has always been in normal level.

As mentioned I really think you need to pursue psychological causes. And stop the certizine and nooptropics. No meds but supplements.

Simply tell the therapist what you have said here..that you have a history of depression & so forth, previous substance abuse, and have been troubled for years by severe fatigue and mental fogginess for which a physical cause has not been found and which is getting worse.

That it is getting worse indicates that it is taking more and more effort to keep it all suppressed i.e. it is time for it to come out.

Vipassana meditation which another poster mentioned is also helpful but my instinct from what you describe is that you should get some pyschological therapy first before considering it. Vipassana does knock down the barriers between conscious and unconscious mind but if there is a lot of really troubling stuff piled up in the unconscious it is best to work through that with the support of an empathetic therapist first. You may otherwise be unable to tolerate the Vipassana.

I'm certainly going to look into psychological causes, I think regardless of whether it's the cause or not that there are some things that need to come out. I'm sure it will cost but I guess that's an investment I have to make.

Would like to rule out anything physical at the same time.

Getting a lot of great info here. I know Doctors can help more specifically but all of us have had experiences in "fixing" ourselves and this experience is very useful for me to read and think about different avenues.

[Sheryl]

I think from what you describe that you have already ruled out physical causes but if it makes you feel better you could get another full physical check-up, all of the main hospitals offer packages.

Need to be careful you don't fall down a rabbit hole of unnecessary tests and treatments...there are plenty of places, both mainstream and "alternative" medicine, that will take you for as much as you are worth and with nothing to show for it.

[MaeJoMTB]

Faddy diet = leads to = eating disorder = weak and listless.

Loads of people on 'health diets' like this.

Just eat normal food, forget the 'paleo' diet and supplements.

Try a couple of weeks eating what every other normal person eats.

If you're obsessed with Paleo, try the full Paleo life,

Forget the gym ..... walking/running/hiking outside, at least 1 hour everyday, like caveman.

You may have vitamin d deficiency from being inside all the time, caveman lives outside.

Gym is unhealthy and unnatural, caveman don't lift weights in an air-con gym.

No beer or alcohol, caveman doesn't drink fermented drinks .... just water (and blood?)

Paleo food, but no other part of your life paleo, how could that possibly work?

That just isn't logical or sensible.

Edited October 19, 2015 by MaeJoMTB

[t8769]

I use Paleo, I'm not weak or listless, I'm not obsessed or doing anything faddish.

I'm rather logic and sensible about my health. Love the gym - off there now.
I'm in better health than I've been in years.

OP have you been tested for Hemochromatosis?
This is a very common disease​ that, like AIDS, is often missed as its symptoms are diagnosed as other problems.
The warning sign is high iron levels - you can research it online. I think something like 7% of the population have it.

Not keen on Gatorade, that's a sugar mountain that can cause serious problems. You can get non-sugar electrolytes.

Also - thyroid tests can be tricky, sometimes you need 2 or 3. I had a bad thyroid but my first test was normal, as thyroid levels fluctuate and the day I happened to have the test it was normal.

Its great that you keep trying, I know how hard it can be.

Good luck!

​

Edited October 19, 2015 by t8769

[fang37]

All this worry/anguish may be doing more harm.

Solution?

The middle Road?

[fittobethaied]

Jimmiejackson, in one of your latter posts you finally mentioned that you had done HbA1c and fasting blood glucose tests and all were normal, so you have addressed the potential blood sugar issues. But, so far you haven't mentioned caffeine use...as in coffee, tea or other caffeinated beverages. I was a heavy coffee drinker for years and when I first came to Thailand 5 years ago I was drinking several packs of 3 in 1 coffee per day. Suddenly, I developed an intolerance to caffeine and began to read about caffeine toxicity and caffeine allergy. My symptoms were those of hypoglycemia. A person with hypoglycemia may feel weak, drowsy, confused, hungry, and dizzy. Paleness, headache, irritability, trembling, sweating, rapid heart beat, and a cold, clammy feeling are also signs of low blood sugar. As it turns out caffeine raises catecholamine levels and those reactions mimic hypoglycemia. The symptoms associated with hypoglycemia are sometimes mistaken for symptoms caused by conditions not related to blood sugar. For example, unusual stress and anxiety can cause excess production of catecholamines, resulting in symptoms similar to those caused by hypoglycemia but having no relation to blood sugar levels. So, I gave up on caffeine for several months, then I reintroduced the consumption of 1-2 cups of coffee per day, but never on an empty stomach. For awhile I felt energized once again, but it was short lived. Now, after I have even the first cup of coffee in the mornings I am ready to go right back to bed. And, it's not the sugar or the creamer...it's the caffeine.

Since coming to Thailand I too have become a bit of a hypochondriac, but only out of necessity. As has been mentioned, you are dealing with symptoms that are related to dozens of prospective causes. The typical Thai doctor in a government hospital will be clueless and will not be able to invest the time that is necessary to diagnose your problem. You may have better success at the private hospitals, but be prepared to pay for a litany of tests that may not even be necessary. They are more interested in treating symptoms than getting at root causes, but for the sake of earning their keep at the hospital they can "run you through the mill" in the interests of profits and their own job security. I have had much better success in researching, diagnosing and treating my own health issues. So, don't be intimidated by those who think you are foolish for dwelling so much on your illnesses. In Thailand you'd better understand your own body and be thoroughly researched and schooled before seeing any doctor here...and I speak from experience!

[OmarZaidMD]

Hi,

Most chronic illnesses respond to dietary changes, and fasting

Cut out sugar and change to honey;

Try the diet for your blood type;

• http://zaidpub.com/2011/12/29/food-is-the-best-medicineeat-right-for-your-blood-type-by-dr-omar/

See if you can get hold of the Ayuvedic tonic called Safi

• http://www.hamdard.com.pk/safi