Persistent Fatigue

[shree]

Hello everyone,

 

Despite maintaining a generally healthy lifestyle and ensuring a good night's sleep, I find myself constantly battling with a lack of energy and weak legs. This persistent fatigue affects my daily activities, and I can't seem to shake it off, even after resting well.

I've recently had a comprehensive set of blood tests done, covering thyroid function, diabetes, kidney health, iron metabolism, liver function, and more. The results came back largely within normal ranges, which, while reassuring, leaves me without a clear path forward in addressing my symptoms.

Despite these generally normal results, my energy levels are far from normal, and the weakness in my legs is concerning. I've considered potential factors such as diet, lifestyle, and even the possibility of an underlying condition not evident in the bloodwork.

 

Additionally, during my quest to understand the root cause of my symptoms, I underwent an ultrasound examination of my entire abdominal area. The results were largely reassuring, with no significant issues detected. The doctor noted that while my pancreas could appear "slightly better," there was nothing in the findings that should directly contribute to the level of fatigue and leg weakness I'm experiencing.

 

Has anyone here experienced something similar? Could there be something I'm overlooking, or a specific aspect of my health that requires a deeper investigation? I'm open to any suggestions, advice, or recommendations for further steps I might take to understand and hopefully resolve these persistent symptoms.

 

Thank you all in advance for your time and any guidance you can offer.

 

 

Here's a overview of my bloodwork:

 

Parameter                                         Normal Value           27.03.2024
------------------------------------------------------------------------------------------------
Thyroid
- TSH basal (LIA) [mIU/l]                         0.30-3.6 mIU/l         2.4
- FT4 (free T4)                                   0.89-1.76 ng/dl        1.19
- FT3 (free T3) [pmol/l]                          3.50-6.50 pmol/l       5.59

Diabetes / Kidney
- HbA1c (FCC) [mmol/mol]                          29.0-41.0 mmol/mol     34.0
- Creatinine [mg/dl]                              0.70-1.30 mg/dl        0.88
- eGFR (MDRD for 1.73 m^2 surface area) [ml/min]  90-140 ml/min          106

Iron Metabolism
- Iron [μmol/l]                                   11.6-31.3 μmol/l       13.1
- Ferritin [μg/l]                                 22-322 μg/l            75

Hematology
- Hematocrit [%]                                  40-53 %                45
- Hemoglobin [g/dl]                               13.5-17.8 g/dl         15.3
- Red Blood Cells [T/l]                           4.40-5.90 T/l          5.24
- Platelets [G/l]                                 146-328 G/l            200
- MCV [fl]                                        80-96 fl               86
- MCH [pg]                                        28-33 pg               29
- MCHC [g/dl]                                     33-36 g/dl             34
- Neutrophils (Segmented) [%]                     40.0-75.0 %            44.2
- Lymphocytes [%]                                 17.0-47.0 %            42.6

Ions
- Sodium [mmol/l]                                 136-145 mmol/l         140
- Potassium [mmol/l]                              3.5-5.1 mmol/l         4.3
- ESR (Erythrocyte Sedimentation Rate) [mm/h]     <15 mm/h               2

Liver
- γ-GT [U/l]                                      -                      51
- GOT (AST) [U/l]                                 -                      22
- GPT (ALT) [U/l]                                 -                      [+] 84
- Alkaline Phosphatase [U/l]                      46-116 U/l             94
- Bilirubin (total) [mg/dl]                       0.3-1.2 mg/dl          0.5

Pancreas
- Lipase [U/l]                                    12-53 U/l              28

Other
- Neutrophils, absolute [G/l]                     1.80-6.20 G/l          2.33
- Lymphocytes, absolute [G/l]                     1.10-3.20 G/l          2.25
- Monocytes, absolute [G/l]                       0.25-0.85 G/l          0.43
- Eosinophils, absolute [G/l]                     0.03-0.44 G/l          0.24
- Basophils, absolute [G/l]                       0.01-0.08 G/l          0.03
- PTT (Partial Thromboplastin Time) [Seconds]     22.0-34.0 Seconds      32.5

 

 

[Leo Gura]

Chronic fatigue can have 100 possible causes. You will have to do a lot research and experimentation to troubleshoot them one by one. There's no one obvious solution or cause.

Edited March 29 by Leo Gura

[Applegarden8]

Have you checked your colon? Colonoscopy for example? I did not see vitamin d here and you can also check macro/micronutrients. I know I have low vitamin D and it is associated with fatigue. Is your stomach occasionally inflamed? Maybe you could be allergic to something and under constant inflammation. What's ur blood pressure? Do you feel tired after eating? Do you feel tired after drinking coffee? Maybe quit coffee for some time.

Edited March 28 by Applegarden8

[yetineti]

Blood looks good; I’m assuming diet is decent as well.

Dumb question: do you work out? What’s your cardio look like?

Other than that, do you have any major stressors currently?

Edited March 29 by yetineti

[shree]

10 hours ago, Leo Gura said:

Chronic fatigue can have 100 possible causes. You will have to do a lot research and experimentation to troubleshoot them one by one. There's so one obvious solution or cause.

I already started implementing some principles from the Thyroid book on your reading list. But yes, this problem could have 100 causes.

[shree]

10 hours ago, Applegarden8 said:

Have you checked your colon? Colonoscopy for example? I did not see vitamin d here and you can also check macro/micronutrients. I know I have low vitamin D and it is associated with fatigue. Is your stomach occasionally inflamed? Maybe you could be allergic to something and under constant inflammation. What's ur blood pressure? Do you feel tired after eating? Do you feel tired after drinking coffee? Maybe quit coffee for some time.

-I just measured my blood pressure myself. It doesn't seem great. It was always normal, but as I see it, it is pretty high at the moment: 129/90 with a pulse of 67.

Maybe because I measured it early in the morning?

 

-I find it funny that Vitamin D is not listed in my bloodwork since I live in Germany. Good point, I will buy a self-test and then post it here.

 

-My stomach is inflamed when I eat milk products like cheese and yogurt. Could that be something?

 

-I feel almost always tired after eating; is this not supposed to be relatively normal?

 

-Coffee gives me a slight boost, not even worth mentioning. But I will observe my energy levels in the future after drinking coffee and post here if I see anything relevant.

I just know that caffeine makes me super aggressive when I do too much of it.

[shree]

4 hours ago, yetineti said:

Blood looks good; I’m assuming diet is decent as well.

Dumb question: do you work out? What’s your cardio look like?

Other than that, do you have any major stressors currently?

 

-Yeah, my diet could be slightly adjusted to be more balanced, but it is relatively good. I don't eat processed food nor sugars/soft drinks almost at all.

-I don't work out at the moment because everything got super exhausting. 3 years ago, I was able to do high amounts of sport, feeling unstoppable energy even though my diet was terrible compared to what I eat now.

-Stressors: Two small kids, working shifts, having a wife, lol.

I don't feel particularly stressed, other than the stress that I often got from the lack of energy to do anything meaningful.

[FourCrossedWands]

Do you have any autoimmune disease? Inflammation can cause chronic fatigue because the body uses a lot of energy trying to heal itself.

It can also be caused by:

Excessive drinking, masturbation, and screen time, vitamin deficiency, etc.

Edited March 29 by FourCrossedWands

[sholomar]

 Rotating shifts with an inconsistent bedtime takes a huge toll. I'm experimenting with working all nights with a fixed bedtime between 4:30 and 6:30 AM... I've made it so by closing 2 doors I can make my place pitch black any time of day. I realize that's not really feasible when you have a wife and 2 kids, but it amazes me how many people where I work who rotate shifts tell me they simply get by with 3-4 hours a sleep a night. That takes years off one's life potentially... messes up the nervous system in a big way. It stimulates the sympathetic nervous system and induces a state of chronic, low level stress in the body.  There's a reason divorce rates are so high where I work... when the body is stressed in that manner it affects the personality.

 

Edited March 29 by sholomar

[Michael569]

Your lab results are fine

I think you're just exhausted from balancing career, personal life and family. Having 2 kids, a house to take care of, mortgage to pay, bills to cover and full time job to handle will easily leave you depleted even if your are a healthy savy person. It's just difficult to find enough personal time with so many dependencies. My heart goes out to you and anyone who can do that.

Is your sleep still disrupted or have your kiddies grown past the initial stage at this point?

Yeah, the answer is more likely finding a way to implement some "me time" and eating properly balanced portions to make sure your body has sufficient energy.

I don't have kids yet but i can imagine it will deplete my energy as well so i can sympathize.

Btw 129/90 is elevated so you might want to have that looked at. It could be also caused by long term sleep deprivation or if you gained some weight recently. That one is actually really important to keep under control, way more than anything else.

Also, curious, has your bodyweight shifted?

Edited March 30 by Michael569

[shree]

On 29/03/2024 at 11:42 AM, FourCrossedWands said:

Do you have any autoimmune disease? Inflammation can cause chronic fatigue because the body uses a lot of energy trying to heal itself.

It can also be caused by:

Excessive drinking, masturbation, and screen time, vitamin deficiency, etc.

I'm not aware of any autoimmune diseases in my case. Regarding inflammation, I'm curious about how one might identify it. I abstain from alcohol and moderate my habits, including masturbation. However, I've noticed excessive screen time tends to deplete my energy, acknowledging it's an area for improvement on my part. Regarding vitamin deficiency, that's an interesting point—perhaps it's something worth exploring further.

 

On 29/03/2024 at 7:46 PM, sholomar said:

 Rotating shifts with an inconsistent bedtime takes a huge toll. I'm experimenting with working all nights with a fixed bedtime between 4:30 and 6:30 AM... I've made it so by closing 2 doors I can make my place pitch black any time of day. I realize that's not really feasible when you have a wife and 2 kids, but it amazes me how many people where I work who rotate shifts tell me they simply get by with 3-4 hours a sleep a night. That takes years off one's life potentially... messes up the nervous system in a big way. It stimulates the sympathetic nervous system and induces a state of chronic, low level stress in the body.  There's a reason divorce rates are so high where I work... when the body is stressed in that manner it affects the personality.

 

Yes, I'm also struggling to understand how some people function with such detrimental lifestyle habits. I always make sure to sleep before my night shifts to prepare, and as soon as I get home, I make my room pitch black to maximize sleep quality. Nonetheless, even with these precautions, I find myself less functional upon waking, which is understandable given the circumstances.

 

On 30/03/2024 at 10:26 AM, Michael569 said:

Your lab results are fine

I think you're just exhausted from balancing career, personal life and family. Having 2 kids, a house to take care of, mortgage to pay, bills to cover and full time job to handle will easily leave you depleted even if your are a healthy savy person. It's just difficult to find enough personal time with so many dependencies. My heart goes out to you and anyone who can do that.

Is your sleep still disrupted or have your kiddies grown past the initial stage at this point?

Yeah, the answer is more likely finding a way to implement some "me time" and eating properly balanced portions to make sure your body has sufficient energy.

I don't have kids yet but i can imagine it will deplete my energy as well so i can sympathize.

Btw 129/90 is elevated so you might want to have that looked at. It could be also caused by long term sleep deprivation or if you gained some weight recently. That one is actually really important to keep under control, way more than anything else.

Also, curious, has your bodyweight shifted?

Yes, juggling all these responsibilities can be incredibly exhausting, and I've felt my exhaustion reaching extreme levels. My blood pressure did spike during my period on the keto diet, but it's normalizing now. Thank you for pointing that out. 

My body weight has been pretty stable for many years.