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Lifelong Mental Fatigue

fatigue help tired mental fatigue insomnia stress daydreaming

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#1 Hologram

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Posted 20 March 2012 - 12:27 AM


Hello, everyone. I've come here to talk about a few things that have been plaguing me for most of my life, all the way into my current adolescence. To put it simple, I'm always tired both mentally and physically, I would be able to cope if it were only physical. So where should I begin? My earliest memory of this is when I was at a young age of four, only walking, nonetheless this was enough to drain me of whatever energy I had. What disturbs me most, is I seem to be in a constant state of daydreaming, thinking, imagining. It's not too unpleasant but as soon as I bring myself out of that state and into the real world I become quite stressed as my strength begins to ebb. I seem to always be in a sort of dazed state, the only thing that can motivate me is putting undue stress upon myself, I literally feel the heart palpitations, I cause myself. For something as trivial as focusing on a test. Along with that, comes the physical fatigue, it's always been difficult for me to keep up with my peers, even though nowadays, I exercise regularly(HIIT style), I've gained muscle mass but if let's say I'm doing pullups, I can do a certain amount(more than the average fellow, maybe) but there's not a chance I'd be able to recover for the next set to do, my arms would start shaking and if I was lucky I might make half of what I did before. Moving on, my diet is balanced, I don't micromanage but from an observer's glance it seems fairly agreeable. I never seem to be well rested also, even if I take melatonin or a sleeping pill, actually I do feel rested but I feel even more drowsy than before. It's a bit difficult to explain.

-I've been through a sleep study but nothing has turned up unfortunately, I was getting enough REM and everything.
-I've had my cortisol tested and it was normal,
-I've been tested for anemia,
-Extensive allergy test
-hypothyroidism
-I'm currently in the process of attempting to obtain an MRI.
-I had an EKG as well.

This is a thread I'm using as a resource for the various tests, I'm looking to for answers. But I would really appreciate some extra input,

I've also done various things to improve my overall health. I:
-meditate
-exercise
-eat healthier
-engage in more mentally stimulating activities
-etc. Yes, I etcetera.

Let it be known that, I do have various psychological issues such as: anxiety(pretty much on pstd level), depression, low self esteem, rapidly fluctuating emotions, etc. My anxiety causes constant tightenings of my muscles, spasms if you will, perhaps one of the factors contributing to my early fatigue during exercise. One more thing, this may or may not be interlinked with the rest of these problems, I appear to have stomach troubles as well. With, something akin to acid reflux happening minus the acidity,(there is a constant flow of mucus, or some sort of thick liquid coming up my throat, it impedes my ability to speak at times, it's so bad...) I thought I may have low hcl but I tried taking apple cider vinegar but I tasted it coming right up, not very pleasant. Antiacids and fruit(both alkaline) seem to make my stomach upset,(especially if it's empty) so I'm trying probiotics right now and have seen nothing too significant happen.

Speaking of probiotics here's a list of the supplements I'm taking:

-5g of fish oil a day
-Trader Joe's men's multivitamin
-magnesium supplement
-vitamin e 1000iu a day
-vitamin d 2000iu a day
-uridine(the shit coming up my throat hampers the sub-lingual absorption of this however)
Okay, that covers most of the info, if you have any specific questions feel free to ask. I'm bouncing around a few possibilities, Celiacs Disease, some hormonal problem(I don't recall if I've had a full hormone test), iron overload maybe, or perhaps in a worst case scenario it's something unique to my biochemistry.

Thank you anyone who takes the time, to offer their help, it makes a world of difference.

*Whisper* does anyone think creatine might help, it's supposed to allow you to work out longer and harder and I'm wondering if it do the same for me in everyday life *whisper*.

#2 Hologram

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Posted 20 March 2012 - 12:04 PM

Note: Try and look at this from a clinical standpoint, I realize that some of my symptoms may be a bit 'odd' but this is one of the more intelligent places I've come across, so I have the faint hope that someone knows something, I do not and can help pinpoint exactly what is causing some of these issues.

Edited by Cerberus, 20 March 2012 - 12:06 PM.


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#3 Raptor87

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Posted 20 March 2012 - 06:39 PM

It was like reading my autobiography! But I do have troubles with my sleep.

But for everything else except the acid reflux, ( I am one of those with constipation/diarrhoea). Well I can relate! I also sense that my muscles are very stiff and weak at the same time, it is like there is some sort of loss of connection there. I walk weirdly, my posture sucks and I have balance issues, social phobia, depression, anxiety and so on.

I think that this is all due to problems in the CNS and also amygdala. I am overly sensitive to my body and sensation and suffer from depression, I think this is because of the amygdala. And as you say, I tend to daydream. When I am able to switch of the daydreaming I become very sensitive to my surrounding, movement and surrounding structures intensifies and my heart starts beating heavily. For the muscle weakness and so on, I think this is some kind of problem I have got from either a braininjury, either from when I was conceived or that I suffer from something genetic. Its like having a weak attack of cataplexy all of the time, why I think it has something to do with the CNS. And I stiffen up just to keep the muscles up, it´s like my muscles don´t have the sense of pressure that it should have.

The only thing that has helped is actually modafinil. But the sideeffects from Modafinil and that the drug varies in it´s effect and it makes one suffer from anxiety once it wears off is utter hell. Sometimes I take it and the effects are very positive, but sometimes I only sense the bad effects. But it is weird how my body and perception transforms just by that drug. It´s almost like feeling normal for a few hours, even though I am suffering from side- effects.

If you ever find an answer to your problems, please let me know!
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#4 Hologram

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Posted 21 March 2012 - 02:26 AM

It was like reading my autobiography! But I do have troubles with my sleep.

But for everything else except the acid reflux, ( I am one of those with constipation/diarrhoea). Well I can relate! I also sense that my muscles are very stiff and weak at the same time, it is like there is some sort of loss of connection there. I walk weirdly, my posture sucks and I have balance issues, social phobia, depression, anxiety and so on.

I think that this is all due to problems in the CNS and also amygdala. I am overly sensitive to my body and sensation and suffer from depression, I think this is because of the amygdala. And as you say, I tend to daydream. When I am able to switch of the daydreaming I become very sensitive to my surrounding, movement and surrounding structures intensifies and my heart starts beating heavily. For the muscle weakness and so on, I think this is some kind of problem I have got from either a braininjury, either from when I was conceived or that I suffer from something genetic. Its like having a weak attack of cataplexy all of the time, why I think it has something to do with the CNS. And I stiffen up just to keep the muscles up, it´s like my muscles don´t have the sense of pressure that it should have.

The only thing that has helped is actually modafinil. But the sideeffects from Modafinil and that the drug varies in it´s effect and it makes one suffer from anxiety once it wears off is utter hell. Sometimes I take it and the effects are very positive, but sometimes I only sense the bad effects. But it is weird how my body and perception transforms just by that drug. It´s almost like feeling normal for a few hours, even though I am suffering from side- effects.


Well, at least I know I'm not completely alone now. Our situations sound disturbingly similar... the muscle tenseness, sensitivity, depression, and the rest.


If you ever find an answer to your problems, please let me know!

Believe me if I come across any sort of answer, I'll be sure to inform you.

#5 Mr Black

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Posted 21 March 2012 - 11:53 AM

I can painfully relate to almost all of the symptoms mentioned. Never felt like I got any rest no matter how long I slept, always physically and mentally tired/dead, weird muscle/joint aches, couldn't think/reason/remember for shit (at one point I forgot how to spell my own name), emotional instability and severe depression, no motivation, no desire to be social, no pleasure in anything, anxiety, no confidence in my ability to do even simple tasks, nothing seemed very real.

I've discovered that, for me, it's sleep-related and has something to do with the catecholamines. I haven't tried Modafinil, but I wouldn't be surprised if it helped me like it helps Brainfogged, since it stimulates the release of DA and NE, in part.

What has helped me tremendously is simple l-tyrosine (non-essential amino, precursor to L-DOPA), 1.5g-2g daily. I almost didn't bother trying it since I normally get 4-6g tyr+phe daily through food; the WHO's recommendation for tyr+phe is only 25mg/kg, which is about 1.6g for me.

I can't really say if phenylalanine (precursor to tyrosine) or DLPA helped much. At the least, I needed more than 2g daily.. and since it was the same price as tyr, I go with tyr.

I do very well these days.. there's still something missing, but I might just need to up the tyrosine, or perhaps change my sleep schedule.

Anyway, hope you both figure out something that works for you.
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#6 Hologram

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Posted 21 March 2012 - 09:33 PM

L-Tyrosine, phenylaline and DLPA hmmm? I've heard a few good things about L-Tyrosine, maybe I'll see if it does anything for me.

Though I am glad you found yourself a solution, I hope I can manage to do the same.

#7 Logan

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Posted 22 March 2012 - 04:40 AM

I know others won't agree with this, but I think the OP's best bet is to try a low dose of an SSRI like Lexapro or Zoloft. There are several things these medications do besides simply inhibiting the reuptake of serotonin that contribute to therapeutic benefits-which include addressing fatigue, depression, anxiety, and congnitive function.
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#8 Logan

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Posted 22 March 2012 - 04:41 AM

Also, eliminate any grain with gluten, and for that matter, all grains.
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#9 Raptor87

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Posted 22 March 2012 - 04:54 PM

I´ve eliminated all grains and gluten and it hasn´t helped one bit! And it is not a good thing to do if one doesn´t have problems since the body stops producing lactase if it´s not necessary in the body so one can become allergic even if he wasn´t earlier from what I´ve heard recently.

The only thing SSRI´s did for me was that they made me sleep a lot more, they worsened my cognition and mental development! Not only that but instead of trying to deal with my problems they made me sit in it without reflecting over possible solutions.

That´s why I am thinking of trying deprenyl but I can´t buy any right now because I am low on cash.

#10 Hologram

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Posted 22 March 2012 - 08:33 PM

I'm planning on starting a gluten free diet within the next few days,

as for an antidepressant, I'm currently giving Stablon a trial run. Which supposedly holds almost none of the side effects of SSRIs.

And Brainfogged, a gluten free diet is something, I think is worth trying out. Just to rule out another possibility. Sorry to hear about your financial woes, didn't realize how much it went for, now I'm sorry I looked.

#11 hippocampus

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Posted 23 March 2012 - 08:15 AM

@brainfogged: what has lactase to do with gluten?

#12 Raptor87

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Posted 23 March 2012 - 10:59 AM

Missed to write dairy!

#13 Hologram

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Posted 24 March 2012 - 01:49 AM

Fyi, I am lactose intolerant, so lactose has already been removed from my diet.

Here's to bumping.

#14 splitastone

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Posted 24 March 2012 - 10:32 AM

1. Go see a therapist. If you do not connect (immediately) with the therapist, find another one that you connect with.

2. Less is more. I encourage you not to throw a bunch of supplements (or pills) at your problem. Stick to your multi (if you must take something) and eat whole food.

3. If you take drugs (including caffiene and alcohol) stop taking them.

4. Take a good inventory of your life and then start doing things differently. There is little chance you will feel better if everything is the same and you do all the same things. People get better when they change things (a lot of things). Get a new hairstyle, wear different clothes, read different books, listen to different music, move someplace new, do something new and different every day.

5. Lastly - take a break fom the internet if you spend a lot of time in front of the computer.

Hope this helps - When you start feeling better check in with us and let us know.
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#15 Hologram

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Posted 24 March 2012 - 06:04 PM

1. Go see a therapist. If you do not connect (immediately) with the therapist, find another one that you connect with.

2. Less is more. I encourage you not to throw a bunch of supplements (or pills) at your problem. Stick to your multi (if you must take something) and eat whole food.

3. If you take drugs (including caffiene and alcohol) stop taking them.

4. Take a good inventory of your life and then start doing things differently. There is little chance you will feel better if everything is the same and you do all the same things. People get better when they change things (a lot of things). Get a new hairstyle, wear different clothes, read different books, listen to different music, move someplace new, do something new and different every day.

5. Lastly - take a break fom the internet if you spend a lot of time in front of the computer.

Hope this helps - When you start feeling better check in with us and let us know.


You're absolutely right.

Thank you.
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#16 Hologram

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Posted 02 April 2012 - 02:19 AM

Seems, I couldn't follow your advice. Anyways, I got a tonsillectomy, the doc said my tonsils looked yellow and full of pus, I'm hoping this might help. As a blood test confirmed that I had had mono, multiple times in the past. So maybe I've been getting reinfected.

But computer usage is something I should definitely monitor when I get a handle on things.

#17 hippocampus

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Posted 04 April 2012 - 02:18 PM

self restraint or similar programs (google them) can help you with excessive (unproductive) computer use.
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#18 dolan_duck

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Posted 19 April 2012 - 01:09 AM

I suffer from very high fatigue as well. My alcohol intake certainly doesn't help. Unfortunately, I run in social circles where alcohol is a virtual must (I'm living in Germany).

It's very possible that your thyroid is not functioning despite what your test results say.

Did you get your T levels tested? Maybe you have low testosterone. Of course, testosterone replacement therapy has it's definite drawbacks if they are low, but I heard there is another medication out there (can't recall the name that helps produce T without shrinking your gonads).

Also, have you tried a paleo diet? It couldn't hurt to go on it for

Last resort is always an SSRI like Zoloft.
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#19 hippocampus

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Posted 20 April 2012 - 10:39 AM

Alcohol is not a must. In my country (Slovenia) we also drink a lot of it, but I used to say my friends that my doctor really advised me not to drink alcohol because of my kidney problems (which is true, but I could also lie :) ) and everybody understood that.

#20 MalachiCrunch

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Posted 27 April 2012 - 02:41 PM

HI, im 33 and I had the fatigue problem going on since i can remember, i always felt something was wrong, mental fatigue brain fog and very vague symptoms looking like depression without any sadness...putting me in High stress situation or abusing stimulants where my only ways to get things done and feel somewhat alive, motivated and focus... in the past 2 years my quest for wellbeing intensified: i tried every supplements on the market and saw a lot of heath specialists... every time i came back to the doctors trying to explain how i felt, they test me for different conditions but results always came out negative, finally 2 months ago they put me on antidepressants and fond out recently i have a hereditary desease called Hemochromatosis: i absorbs too much dietary iron and it builds up in the body causing very vague but disturbing symptoms.. im happy i found out my problem and i hope you will too. it is not normal to feel like that and there must be a reason for it, keep searching and learning
(sorry for my writing english is not my 1st language...)
by the way have you tried GLUTAMINE and TYROSINE and RHODIOLA, these were my favorites supplement for energy and motivation.

Edited by MalachiCrunch, 27 April 2012 - 02:46 PM.

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#21 Hologram

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Posted 27 April 2012 - 06:38 PM

Sorry for the late replies guys, my life has been a bit chaotic lately.

self restraint or similar programs (google them) can help you with excessive (unproductive) computer use.


Okay, I'll give those a look, I way too often just idle on the computer. With no real goal in mind.

I suffer from very high fatigue as well. My alcohol intake certainly doesn't help. Unfortunately, I run in social circles where alcohol is a virtual must (I'm living in Germany).

It's very possible that your thyroid is not functioning despite what your test results say.

Did you get your T levels tested? Maybe you have low testosterone. Of course, testosterone replacement therapy has it's definite drawbacks if they are low, but I heard there is another medication out there (can't recall the name that helps produce T without shrinking your gonads).

Also, have you tried a paleo diet? It couldn't hurt to go on it for

Last resort is always an SSRI like Zoloft.

Getting my T levels checked might be a good idea and I'm sorry to hear about your fatigue. I'm right now, trying to migrate to a Paleo Diet but am finding it difficult to make the transition. Has it had any good effects on your own fatigue?

HI, im 33 and I had the fatigue problem going on since i can remember, i always felt something was wrong, mental fatigue brain fog and very vague symptoms looking like depression without any sadness...putting me in High stress situation or abusing stimulants where my only ways to get things done and feel somewhat alive, motivated and focus... in the past 2 years my quest for wellbeing intensified: i tried every supplements on the market and saw a lot of heath specialists... every time i came back to the doctors trying to explain how i felt, they test me for different conditions but results always came out negative, finally 2 months ago they put me on antidepressants and fond out recently i have a hereditary desease called Hemochromatosis: i absorbs too much dietary iron and it builds up in the body causing very vague but disturbing symptoms.. im happy i found out my problem and i hope you will too. it is not normal to feel like that and there must be a reason for it, keep searching and learning
(sorry for my writing english is not my 1st language...)
by the way have you tried GLUTAMINE and TYROSINE and RHODIOLA, these were my favorites supplement for energy and motivation.

It's a good thing you found out what was causing it. And yes, to the Tyrosine(it had some effects but I don't think I took it consistently enough to get the effects it's acclaimed for), I haven't tried Rhodiola nor Glutamine, however. You think they're worth a spin?

Edited by Cerberus, 27 April 2012 - 06:41 PM.


#22 MalachiCrunch

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Posted 29 April 2012 - 12:30 PM

Yes! try rhodiola between 200 and 500mg on an empty stomach in the morning, at least 30 minutes before eating anything or it wont work. i tried differents products and they dont work all the same so buy from a reputable brand... must take some days off it sometimes cause it seems to buildup and energyse too much. it is IMO the best herbal supplement and the only one that did something for me...i think it act like a weak MAO and help raise dopamine and serotonine but also endorphines the result is a very good feeling. For glutamine i dont get that immediate reward from it but i dont know why it helps me in a lot of ways including muscle fatigue, recuperation after exercise, it keeps my muscles from being ''eaten'' between meals, also keep mental sharpness between meals i use between 5 and 10 grams/day and i like it!
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#23 gizmobrain

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Posted 26 May 2012 - 06:18 AM

Search the forum for the CILTEP stack.

Quercetin (or artichoke extract) + Forskohlii + your choice of a pro-dopamine supp.

It has pretty much changed my life.
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#24 stevep229

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Posted 26 May 2012 - 09:34 AM

I guess I am aboard this ship as well. Been in the same place as you for years, with many of the same symptoms, predominantly the mental fatigue, followed by the physical. With out writing an autobiography, after moving out and being independent from my family, previously discussed symptoms made living on my own, pursuing a career, and working a full time rather hard, and stressful. Like most GPs, my doc said i had anxiety/depression and started throwing SSRIs at me ( apparently they are the cure all, sleep too much=depression=SSRI, sleep too little= anxiety=SSRI, and anything in between. I really hate SSRIs, they are thrown at ppl like candy, with hopes it will mask whatever problem the individual has, and and let the GP get some more appointments in. They are playing with ppls minds and personalities...makes me sick...but i press on from my ranting). After some personal studying bc of my lost faith in many doctors, i found many of my symptoms/behavioral patterns to match up nearly perfect with those of "add-pi with sluggish cognitive tempo". I took my findings to well respected psychiatrist with a conservative view on add, yet open minded enough to actually listen to his patients thoughts. I know there is some debate that SCT should be considered an entirely different disorder from that of ADHD, but the medications for ADHD work very well for SCT, and usually at lower than average dosages. I left with an ADD-PI diagnosis, and accompanied SCT. An accurate diagnosis and 20mg of Adderall XR was life chaging. It is not a magic bullet or super drug of any sort, but it improved my cognitive function and quality of life drastically. I have been at this dose for 6 months, and i have no thoughts of having it increased. This helped me accomplish many of the things that were stated by past posters on this thread. Motivation for a better diet, was able to move up at work (and still moving), boosting self confidence and creating further ambition. It helped me to better organize my life to clear out alot of the external stresses, which in turn let me focus on the internal ones. Do to my desire to keep from increasing my dosage, i started researching and looking for OTC substances with low side effect profiles and low toxicity. I stumbled onto nootropics and this forum, lurked for a few months them joined. The information i have gathered here has significantly improved my quality of life and helped further reduce the symptoms of my disorder. After starting a nootropics regiment, my ability to function improved so much in the work place that my drive and work ethic was noted by upper managment, and im being asked to go through the interview process for management. At 24 ill be one of the youngest supervisor in our company (23$ an hr base pay, with benefits, retirement, regular raises, etc) 2 years ago i was a 3rd shift cashier at 7eleven, and the change of actively improving my self and pursuing a valid diagnosis made my life do a 180 turn. This was more for encouragement to the OP. Not to sound like my thinking is distorted by emotion but...there is ALWAYS a light at the end of the tunnel, but those that reach it are those that keep trying, and pushing, and moving forward....its late. Night.


It ended up being an autobiography anyway...smh...darn creative add mind...
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#25 Tom_

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Posted 19 May 2014 - 08:12 PM

There are plenty of posts and I'm not going to read them all.

 

Against my better judgement I have made some suggestions of supplements that may help with fatigue (if you don't read anything else read about sulbutiamine), they are at the bottom. I'm putting this hear because I don't expect you to read it fully as you may well disagree with it. I'd urge you to read it and hell I want you to do what it says but you should do what you think is best. However read it, at least give an opionion a chance ;)

 

I did get a general sense that a lot of them were recommending supplements and other non-evidence based treatments. I strongly advocate an evidence based approach to the problem. My advise would be drop all the probiotics, special diets and what ever else, unless they are clinically indicated...avoiding lactose due to being lactose intolerant for example. I'm pretty sure nobody will read past this paragraph now, haha.

 

I also saw you were pushing for an MRI. Tell a radiologist where and what to look for and he can find a tumor the size of a grain of sand (well...a bit bigger), tell him you are looking for anything weird, unless you have a massive tumor or a lesion the size of the grand canyon he isn't going to find anything...not that I suspect there is anything to find with an MRI. So I think its a big waste of money.

 

Chronic fatigue syndrome or Fibromyalgia (if you forgot to mention pain as a symptom, otherwise not), possibly comorbid with the possibility of IBS is my best diagnosis, alongside obvious psychiatric involvement. However you have mentioned various speisifc psychiatric diagnoses of which you should benefit from treatment (and could be the entire problem) so it makes sense to me to treat them first...empirically. Psychotherapy (CBT) and antidepressant therapy has shown to effectiveness is all of the above disorders (although with some there is contradictory evidence or only for certain sub-types) You said you were trying Tianeptine, not my first choice but give it the time it deserves - 12-14 weeks and increase the dose at week 4-6 if you haven't noticed any effects and again at week 8-10 (as a side note, Tianeptines side effects are no better than SSRI's, just different). It should also improve sleep. Duloxetine or Milnacipran is probs the best place to go next. Addition of Mirtazapine or monotherapy after the SNRI's might be best. Mirtazapine has some weak evidence for use in CFS and being a potent 5-HT3 antagonist and an antidepressant could be useful in Fibromyaliga. Pregabalin is an option for anxiety and Fibromyalgia.

 

You said you had a polysomnogram and nothing came up. Polysomnograms don't rule out idiopathic hypersomnia and there aren't any approved EEG biomarker diagnostic guidelines for poor sleep structure and its not considered a sleep disorder despite evidence clearly showing it having an impact on functioning.

 

A three month trial of rigid and strict sleep hygiene and sleep restriction has been shown to reduce microawakenings and broken sleep archutecture. The idea is to start with 5-6 hours of sleep a night and increase over about two months to 8 hours. With small changes made every day or slightly larger ones each week. Sleep hygeine should also be kept to:

 

  • Avoid napping during the day. It can disturb the normal pattern of sleep and wakefulness.
  • Avoid stimulants such as caffeine, nicotine, and alcohol too close to bedtime. While alcohol is well known to speed the onset of sleep, it disrupts sleep in the second half as the body begins to metabolize the alcohol, causing arousal.
  • Exercise can promote good sleep. Vigorous exercise should be taken in the morning or late afternoon. A relaxing exercise, like yoga, can be done before bed to help initiate a restful night's sleep.
  • Food can be disruptive right before sleep.  Stay away from large meals close to bedtime. Also dietary changes can cause sleep problems, if someone is struggling with a sleep problem, it's not a good time to start experimenting with spicy dishes. And, remember, chocolate has caffeine.
  • Ensure adequate exposure to natural light. This is particularly important for older people who may not venture outside as frequently as children and adults. Light exposure helps maintain a healthy sleep-wake cycle.
  • Establish a regular relaxing bedtime routine. Try to avoid emotionally upsetting conversations and activities before trying to go to sleep. Don't dwell on, or bring your problems to bed.
  • Associate your bed with sleep. It's not a good idea to use your bed to watch TV, listen to the radio, or read
  • Make sure that the sleep environment is pleasant and relaxing. The bed should be comfortable, the room should not be too hot or cold, or too bright.

Bright light therapy/predawn therapy may also help with fatigue.

 

Idiopathic hypersomnia is much rarer and while sleep hygeine should be kept to the main treatment is psychostimulants. Due to the miriad of symptoms you are presenting with I suggest you don't use sleep hygine until everything else has been tried as it may worsen anxiety, disrupt sleep, worsen depression (although it can also improve it) etc...

 

You should also have a delightful battery of blood tests (some of which you have already had and some you have probs had and not mentioned/didn't realise the quack was testing you for). And for goodness sake make sure these are ordered by a doctor and not by some dodgy internet place.

 

I would be surprised if these hadn't been carried out and be rather annoyed at my doctor.

 

TFTs (thyroid function tests) to rule out hypothyroidism. I know you've had it done but it should be rechecked.

LFTs (liver function tests) to rule out chronic hepatitis

FBC (full blood count) ah hell, everyone loves FBC's, they can send you on the road to hundreds of things

BMP + Ca2+ (Basic metabolic panal/Cem-8, when including calsium) to check for kidney disease, indicators for parathyroid dsyfunction, indicator for hard to detect thyroid disorders and a shit ton of other stuff

 

These might not have been but are well worth having done

 

Hba1c and fasting glucose to check for Diabetes

B12 levels

 

These could be done once everything else comes back as normal.

 

Serology for anti-tTG antibodies for Coeliac disease

hydrogen breath test for froctose malabsorbtion

 

 

I can't see this being most of the autoimmune diease, if the problems presented that early in childhood the possible autoimmunes it could be would usually see you either dead or perfectly well by now.

 

There is a common saying in medicine. If you hear hoof beats assume its a horse not a zebra. Translated that means look for common diseases first, even if they have uncommon presentations. Then look for the waky 1 in a million diagnosis. Because hey, what is more likely something 1 in 10 people have, even if most have different symptoms or a disease that 1 in 100000 have?  That is partly why I've taken such interest in your psychiatric problems, the rest being they are already diagnosed all just need spesific treatment and psycho-somatic diseases can cause symptoms people would never expect to be 'psychological' but it does happen.

 

My last peice of advice. When fatigue is the main complaint research shows that only 8.7% of people will actually be diagnosed with a definate physical disease. So don't continue expecting a magic diagnosis that you will in all likely hood never recieve. Treat any disorder you find with an evidence based treatment, don't go looking for diagnoses that aren't accepted by the medical community (ex: adrenal fatigue), don't waste your money on treatments that don't have an evidence base until you have run out the the evidence based treatments (and then always use an evidence based and theoretical approach) and keep looking for ways to live with the symptoms and improve them (including treating the symptoms (again with an evidence based or at least theoretically sound treatment (cough MODAFINIL, cough)). I'm not saying you have no hope and even without a firm diagnosis you can make life perfectly liveable. With meds start low and go slow...your cluster of symptoms suggest you will probs experience more side effects than most. Stick with a drug until the side effects become utterly intolerable and I mean intolerable or they become dangerous until it has been given a fair trial. If you can't tolerate a normal dose go lower rather than drop it. Don't try psychostimulants (including Modafinil) until you have exhuasted everything else.

 

As a side note, I can't see anything wrong with drinking/tablets of up to 250mg caffeine a day but make sure the last dose is at least 6 hours before bed time.

 

Supplements:

First of all i'd suggest against using Selegiline unless it is in antidepressive dosages (see above), as there is no evidence of benifit for fatigue and it is a 'real' drug, with some potentially big bad, nasty side effects. Also theoretically It shouldn't be that stimulating.

 

Sulbutiamine is my best supplement recommendation and I'm only just against you trying it before other stuff. I wouldn't even be that mad if you choose to try it alongside an antidepressant, or before one. Its basically a b vit with a fatty acid chain added to it. It has been shown to reduce anthesia (brain based fatigue) and to reduce psycho-behavioual inhibition in depressed subjects. Dosage varies from 300-2grams a day. Generally in the litriture its not associated with tolerance but some people I know have claimed to develop tolerance. I also developed some tolerance to it but it settled into a middle faze where it worked well but not like it did for the first week or so. In other words, expect a hunny moon faze but it should work afterwards as well. I would recommend starting with 200-300mg twice a day, once in the morning and once in the afternoon. Increase the dose slowly by 100-300mg/week and try not to go past 1-1.5g as I'm guessing tolerance is more likely.

 

DLPA, prodrug for dopamine and noradrenaline, plain and simple - it increases them and they are both exciatory. There is some very weak evidence for use in depression and pain. I recommend this over L-Tryosine because some guy once told me it can depleate the sulpher reserves and I have never been bothered to look it up. L-dopa can have significant side effects and shizzle.

 

N-Acetly-cestine (NAC), there is some weak evidence its useful for a range of mental disorders and its an antioxidant (what more could you want? well a lot but hey if I was going to try anything it would be )

 

Multivitaim - none of those super dupar uber multivits, you can have to much of a vitamin as well as to little. Just a regular, its unlikely to do any harm and might reverse any defiencies you have.

 

St Johns wort - make sure you aren't taking any antidepressants while on this. Obviously for use as an antidepressant but is out done by antidepressants in all but the mild severeity.

 

Citiocholine/CDP-choline - may stabilizes neuronal membranes, increase thyroid and corticosteroid hormones, may increase dopamine and noradrenaline and is a choline source and possibly a few other things.

 

 


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