Background: I'm 30, I have 4 kids (10, 8, 5 & 18mo) My energy/moods have been pretty cyclical for as long as I can remember along with a history of clinical depression - i tend to take on a lot & then experience burn out I also have a generally sensitive body and IBS. I assumed mental health was a factor but also always suspected an underlying imbalance of some kind because I seem to metabolize differently at different times. For instance, I will usually be very sensitive to caffeine (if I drink a cup of regular coffee I'll immediately feel jittery & if I drink it after 1pm I'll have a hard time falling aslssp at night) But if I'm feeling really burnt out i get ito a point were i notice NO effects from caffeine.)
just over 2 years ago, when I got pregnant with my last baby, I had extreme fatigue, headaches that lasted up to a month, upset stomach, dizziness... I just felt horrible the entire pregnancy. I also gained 20lbs in the first trimester and only 5lbs the rest of the pregnancy which was odd... But I thought it was just a difficult pregnancy (she was a twin til about 8wks so i thought that might be a factor) I felt better after she was born. I did have this thought in the back of my mind that something wasn't right about how fast I lost the weight, though. It took 2-3 yrs after my previous pregnancies to get back into my smallest sizes of clothes, but 12 months after my daughter's birth I was buying SMALLER pants than I'd worn since I was a teenager... I worried that I wasn't absorbing enough from my food because the IBS was manifesting in pretty consistent diarhea, but I when I realized it could have been the change in diet having (mostly) given up cheese while BF my daughter, I wasn't concerned anymore. (I'm still BF, btw)
But over the last few months my fatigue has increased gradually so I can only compare it to the pregnancy (I'm not pregnant) as I don't recall ever feeling this crappy for this long any other time in my life. I know that stress was a factor in kicking this off... DH and I were arguing a lot when I started to feel burnt out and when I started feeling fatigued it was the kind where I was exhausted all day but not sleeping well at night, i felt anxious a lot and if I could nap I'd wake up feeling startled...
But things at home were getting better and the fatigue continued to progress. DH has a new job, isn't so stressed & is being very supportive & helpful. Normally that kind of emotional change would leave me feeling invigorated & I'd go into 'productive' mode... instead, I can sleep 10-12hrs at night and still feel exhausted. I nap any time i get the chance (usually from half an hour to 2hrs when baby naps & boys are at school) I'm also having body pains - they change & seem to cluster over a few days so it will sometimes feel like its joint pain, or organs, but the most consistent has been a general flu-like ache that is especially bad in my arms (could be because they are the only part of my body that doesn't get accessive rest because I'm carrying DD or lifting her on and off the bed with me) My arms feel like the muscles have been overworked, it hurts to do things like driving or changing my shirt, often it feels like there is a rubber band around my bicep or forearm, and my hands tingle or go numb especially overnight. my neck & shoulders knotted up and I'm having headaches (not as bad as when I was pregnant though)
I first saw my dr about the IBS, thinking that was causing fatigue, but then started journaling my food, sleep & symptoms and realized how truely horrible i was feeling... But my Dr started with stool testing, an abdomenal ultrasound and then followed up with more blood work. I've had tons of tests over the last 6 wks I'm going to try to summerize:
U/s followed up by CT scan(neck to pelvis) and MRI (focused on the liver) found: Enlarged Spleen, 2 benign cysts on my liver
Stool tests: all normal
Metabolic Panel: all normal
CBC: white cell count 3.7 (range 4.8-10.8) Low- everything else normal
Morning cortisol (blood): 16 (range 6-20) Normal
Urine test: all normal
C reactive protien: negative
TSH: 1.09 (range .4-4.94) Normal
ESR: 10 mm/hr (range 0-20) Normal
Lyme antibody: Negative
LDH: 125 (range 104-211)
EBV: positive for anitbodies, Negative for active infection
Negative for Celiac, CMV,
Normal Hepatic panel & periph blood smear
Ferritin: 68.8 (range 10-150) Normal
Iron: 163 (range 59-158) High
Tissue transglutaminase AB-IGA: Normal
Vit D: 20 (range 23-65) Low
Vit B12: 560 (range 211-946) normal
folate serum: >20 (range 4.4-31) normal
morning ACTH: 13 (range 10-60)
morning cortisol: 12.7 (range 6-20)
free T4: 1.3 (range .8-1.8)
TSH: 1.63 (range .47-5)
Iron: 86 (range 59-158)
TPO antibodies: 107.1 (range <9)
The endocrinologist I saw recommended I take Vit D 5000IU daily and perscribed Levothyroxine 25mg because of the TPO antibodies even though my thyroid levels looked okay. I started both of those last week.
I suspect adrenal issues but am waiting on ordering saliva tests & seeing a naturopathic Dr til after tax returns. We have good insurance that covers most of these tests but funds are too tight to pay up front for 'alternative' medicine right now. I've gone paleo for up to 3 weeks at a time over the past couple of years & never noticed feeling much better, so while I understand food elimination can take time & diet is something I'm willing to address, I really feel that I need either some help with my energy or at least a diagnosis to be motivated enough to take on something that difficult. Right now my appetite is wierd so sometimes I don't feel like eating at all & as a result indulge cravings. still I eat a lot better than the average american.
I'm trying to be patient and see if the Levo and/or Vit D help at all, but the achiness/ body pain has been worse this week and it is so hard to just wait when my body is screaming to me that something is WRONG. Not to mention I feel so bad about laying around in bed all the time & not doing things with my kids :( I feel like I need to continue to pursue answers because if I don't see any more improvement in the next month (that's how long the pharmacist said the levo would take to help) I don't want to have wasted all this time just laying around if I could be ruling out or confirming another problem. I called the endo about the increase in pain and she suggested following up with my family dr. But is there anything she can test/do? or will she just suggest chiro? (I've already seen my chiro)
I want as MUCH info as possible about what is going on in my body so I can come up with a plan of attack (and the motivation to follow through)
If you have any suggestions for other tests i could have done or things to ask my Dr about, or if you have any insight about my labs I'd appreciate it.
ETA: my drs keep suggesting I try antidepressants, but I have lots of experience with depression and this is different! I do feel frustrated/depressed about feeling so crappy, but I don't wake up in despair... I'm not enjoying regular activities because I am in pain and tired, it's not like when I'm depressed and don't want to be around people because I'm sulking -- I actually WANT to do things I just don't have the energy. just getting a bath & getting dressed drains me. I grocery shop every 2 weeks and each time it's harder to get through... Also I see a therapist so mental health is being addressed.