PLEASE help. 24 years old, exhausted

Hi everyone

I want to apologize in advance if this post runs on or if I make some errors, I am feeling really foggy right now!

I am at my wit's end. I just turned 24 years old a couple weeks ago, and I'm a female. It seems like most women my age are out working full-time jobs, or at college, or going out with their friends and living their lives and full 16-18 hour days. My friends who are only a few years younger than me work sometimes 12 hour days at the coffee shop where we work and still have the energy when they get home to make dinner and invite friends over. I, on the other hand, have been dealing with SIGNIFICANT fatigue issues.

I had a metabolic panel and a complete blood count test done earlier this year due to my increasing levels of overwhelming exhaustion. It seemed like I would have days where I would work six hours, come home, maybe work out for an hour, and then not do much else (too tired,) and then the next day I would be SLAMMED with physical fatigue, worst of all the complete mental fog, and my already existing depression was 10x worse. I had these tests done by my physician's assistant. The results came back "normal," and after reading on the internet that a lot of times the physician's use outdated lab values, I got a hard copy of the results for myself. I can't remember exactly right now what my overall lab values were, but my calcium level was .1 or .2 in excess (hypercalcemia,) and the only thyroid tests she had done were TSH and I believe T4 with reflex to T3 (this may be wrong...I don't have the results anymore since I gave them to my psychiatrist,) and they were "normal" too. So, since I was struggling with severe depression at the time and anxiety problems, I brushed my fatigue under the rug and just let myself be treated with almost every antidepressant on the market (I also struggled with anxiety and depression when I was in my teens and was treated successfully with Zoloft for 8 years, although fatigue was an issue then, too...could have been med side effects though,) none of which have been successful - all have made me more tired, more apathetic and lethargic, and needless to say my sex drive has died, which is distressing to a 24 year old girl.

Here it is, November, and after my fatigue problems not getting any better my psychiatrist told me I should see an endocrinologist and have my parathyroid tested. Well, the endo said I needed to have a referral from my PCP in order to get an appointment, so off to my PA again I went. This time she took my complaints more seriously since they have gotten worse - or, to me, at least...maybe it IS all in my head. Anywho, I complained to her of my dreadful mental fog, inability to concentrate or remember anything, I have trouble articulating sentences or explaining myself when I am put on the spot so I avoid talking about myself as much as possible...my exhaustion is horrific, my eyes just feel tired all the time, I FEEL as if I get cold very very easily, I'm lethargic, all I can do is lay in bed all day, I feel a million times worse after a day of activity (which to me is almost nothing since I am so exhausted.) I mean I am just TIRED. I don't feel happy, I feel that my quality of life is significantly impacted by my fatigue. I have NO sex drive. I don't care about anything anymore, even on days when I am not feeling "depressed." My mom was diagnosed hypothyroid when she was 22, and her mom is also hypothyroid, and my doctor finally noted my elevated calcium levels from my tests at the beginning of the year and decided to test me more in-depth, including another CBC, TSH, FT3, FT4, a lyme disease test (not sure which one,) a rocky mountain spotted fever test, PTH (my doctor DIDN'T TEST ME FOR THIS IN THE MORNING AND ALSO DIDN'T TELL ME TO FAST!) and some others that I can't remember right now.

I just called my PA to get the results. The nurse told me everything came back "normal." He didn't cite any specific tests or lab values or anything. I told him I would like a hard copy of the results for my own records and to show to my psychiatrist. I am on ONE medication, called Luvox, but I am only on 50 milligrams and it should NOT be causing this amount of fatigue.

I live with my mom and I can hardly work due to my amount of fatigue, anxiety and depression about not knowing when I will be "well" (if you can even call my "well" days well) and therefore cannot keep a consistent work schedule. My mom now thinks this is all in my head. I am starting to believe this is all in my head too, or at least part of me is. I mean, I am going BROKE. My mom is broke, she is a single mother with twins, my brother is hardly making the rent where he lives, and I feel like such a horrible lazy daughter because I can't seem to have the energy to do anything. I feel like at 24 my life is over. I thought that these last labs would help me get some answers but all they have done is put me even more in debt. I have no idea how I am going to pay off my bills. I don't even have the energy to exercise, let alone finish my bachelor's degree or work a full-time job.

I. Am. EXHAUSTED.

Someone, please help. I have absolutely NO ONE to talk to about my issues anymore. My mom thinks I need to push myself more and "build up my stamina". My dad thinks that I need to work more so I can take my mind off my fatigue. I have no close friends anymore because I just don't have it in me to keep close personal relationships and maintain them, and even if I did, it's not like most 24 year olds are understanding about medical issues (no offense to anyone who is around this age on this site! I think you might know what I am talking about though, hard to find someone to relate.) My physician's assistant probably now thinks this is all in my head too. I'm sure my psychiatrist will think the same even though he's put me unsuccessfully on literally every SSRI/SNRI that exists on the market today.

I just need some guidance. Is this Chronic Fatigue Syndrome? What do I do? Does anyone have any advice for me? I am so, so desperate. Is this all in my head? What is wrong with me????

-Very, very sad girl

Hi Judy2, thank you SO MUCH for replying.

I apologize for not including my symptoms in my initial post - I was just so emotional! My symptoms are confusing because half of me thinks they are "real" while my mother/some psychiatric physicians have tried to convince me that some of them are just symptoms of anxiety disorders and although they feel very real to me, they are not actually malignant in any way - in other words, "all in my head."

Here is a list to make my post more organized:

-Significant fatigue/constantly low energy. Easily drained of whatever energy I do have. It feels like I am a car running on empty. This leads to extreme lethargy.

-Mental fatigue/"brain fog". This includes very bad memory, poor comprehension unless I can take my time reading the material, and the inability to think as "critically" and "deeply" as I used to. This also includes concentration problems.

-Weakness. Climbing the stairs feels exactly like I am having to climb the stairs. It's a leaden feeling in my body. Also, in my arms - I helped my grandma hang her painting the other day and this 83-year-old woman had more upper-body strength than I did. Part of this may be from the anti-depressant I am on, as is some of the fatigue, but I had these problems before as well.

-"Day-after malaise." I feel very exhausted and my brain feels like it is malfunctioning/can't think straight for days after just one day of minor exertion.

-Depression/No motivation/Apathy. I have always been a "moody" and intense person (don't worry! I am nice!) but over the past year the depression has gotten to the point of suicidal thoughts and I was actually hospitalized for these thoughts in July of this year. I have been on literally every SSRI/SNRI for this depression but none have been effective or given me a full-response.

-Intolerance to cold/feeling cold frequently. It IS winter here, and there is always just the possibility that I am one of those people who gets cold easily, but I have found that I am more intolerant to cold than other people I know. I am constantly wrapped up in blankets. I have read there is a morning basal body temperature test for this you can do at home - have you tried this/known someone who tried it? Do you think it's something I should bother trying?
....Sometimes this coldness flips a switch and goes to the complete opposite side and I get boiling hot.

-I do have dry scalp pretty consistently and in fact today I had dry scalp skin falling off my hair at work. Once again, could just be that it's winter and the shampoo I use isn't moisturizing enough, though. I can't tell if my hair is thinning - I have never really studied it closely before, so I can't exactly compare. It's possible that my eyebrows are losing the outer thirds, and I feel like they have been looking thinner for a while.

-My skin is rough. It's bumpy, probably from being dried out, although it is also oily. The only reason I include this is because I have read dry skin is a possible symptom, although I don't know how much "dryness" is considered abnormal.

-I don't suffer from any weight gain like my mother and grandmother. My mom is overweight and has struggled with her weight for most of her life. I am 5'4. The heaviest I have ever been was 132 pounds; the lowest was 103 pounds when I contracted C. Difficile this March and lost a lot of weight. I am now around 110 pounds.

-I experience dizziness frequently, vertigo on occasion.

-Under my eyes feels CONSTANTLY tired and I just want to close them all day. I find it difficult to focus - not necessarily my vision but just my line of sight. It kind of feels like there is a blurry transparent wall between myself and the world and I have to really try hard to see past it.

-Depersonalization/derealization.

-Libido/feelings of attraction are absolutely gone.

-Ringing in my ears.

-My nails grow fine, but they look brittle and have very noticeable ridges.

-Sometimes I get swollen glands for a few days but no other symptoms of a cold. Could this just be allergies?

-Sometimes it is hard for me to breathe and I feel short of breath. I do have asthma, but the shortness of breath is different than the kind I experience with the asthma.

-When I walk upstairs, my heart starts beating really fast and hard towards the top. It's like my body is putting in so much effort just to walk up a flight of stairs.

-Confusion. It is very easy for me to get lost in situations in my head and this is very distressing to me as it causes significant anxiety when I feel I cannot think clearly.



That is a comprehensive list of my symptoms. I will definitely be posting my lab results when I receive the hard copy as it seems many on this forum know a lot more about these things than I. I will be picking them up on Monday or Tuesday next week. I know my TSH, Free T3 and Free T4 were tested although I think that was it concerning thyroid tests. I am punching myself right now for not requesting the thyroid antibody tests - although if I do have Hashimoto's, wouldn't my TSH/Free T3/Free T4 results come back abnormal?

Thanks so much again for the reply. I am sorry if I posted in an inappropriate section (thyroid disorders) but I did because at this point I am mostly considering a thyroid problem since a) I have a family history of hypothyroidism and b) it seems that it goes undiagnosed so frequently.


Also - don't know if this is important - but I do not take any vitamins or supplements.

Post Edited (RoGo) : 11/27/2013 8:23:12 PM (GMT-7)

Thank you very much Judy2. I pick up my lab results today and will post what they have found.

I'm just so confused. The nurse said "everything looked normal," and yet I feel absolutely terrible.

I wonder if this is a case of "normal lab values, but on the lower end of normal" hypothyroidism.

The brain fog is so horrible today...

I would think a trial on a very low dose of thyroid with close follow-up would be a good next step. Yes, some people can feel hypothyroid with test results just in the normal range.

A tip: I use my heart rate as a quick check on my thyroid status, as I find the other symptoms too subtle and sometimes my mind can distort them. My normal resting is in the low 60's (sitting, feet up, relaxed.) If it gets above about 72 when I'm not sick, I know something's out of whack and I check it regularly. When I was really hyper it got to 120; when I was really hypo it got into the upper 40's.

Hey Rogo,
I'm a new member here but I saw your post and thought I could offer some help. I currently have Graves Disease, my thyroid is finally stable for the first time in four years. I've had high levels and low levels so as you can imagine I've had all types of symptoms. I also developed a medically induced panic disorder which started because of my overactive thyroid symptoms.
I also discovered recently that even though my thyroid levels were perfect I was still suffering from hyper and hypo type symptoms but I'd had a recent blood test that stated I was fine. My Dr advised that I may have gluten sensitivity. There are scientists that believe there is a link between gluten allergies and thyroid disease. I've cut all gluten out of my diet for the past two weeks, within days I felt amazing, no brain fog, no dizziness or nausea, no anxiety and I wasn't fatigued, in saying that after the first week I started feeling some of the symptoms coming back but I did have some meals that contained gluten. Generally a Dr will tell you to cut gluten out for X amount of time and if you feel better introduce gluten back into your diet and if you feel the symptoms return then you likely have an allergy to gluten.
I hope this helps and that you're feeling better soon. :)

Rogo:
It seems to me that you are probably very hypothyroid. Most regular drs will not treat it if your blood work looks ok. If you go to a holistic dr you might get a lot more help. They go by symptoms and not blood work. The only problem is that they are expensive. You might have adrenal fatigue also. I dont know where you live, but holistic drs or natural drs are very common now. Also even chiropractors are doing a lot of that kind of medicine also. Good luck and hope you get some resolve soon. P.S. I had what I thought was chronic fatigue syndrome and it turned out I have Lyme disease. I also have hashimotos which some people believe that lyme can cause hashi. I had lyme testing from a lab in California called Igenix. It is the only lyme lab that is accurate.

Seksay69, thanks so much for the gluten-free diet advice. I definitely would like to give that a try, I have heard lots of wonderful things about living a lifestyle free of gluten from more than just a handful of people.

Judy2, I have a question - I just thought of this yesterday. My mom told me that for years whenever I would get check-ups (not going to the doctor for a specific illness like strep or the flu, just a regular check-up) my temperature has been consistently around 96.8. Also I have a history of random low-blood pressure. Not horribly low but definitely lower than normal. Doctors/my mom/nurses always chalked the low blood pressure and low temperature up to "my version of normal" but I started thinking, what if these have just been early signs of a thyroid problem? Do you have an opinion on that? As a nurse, I figured you might have some experience seeing patients with consistently low temps/blood pressure.

Aphysicalwreck, I am so sorry to hear that you have Lyme disease. I was tested for Lyme with this last round of bloodtests but they said it came back "negative." However, I hear that those tests are notoriously inaccurate. If a trial of thyroid hormone doesn't help me then I will definitely look more into Igenix testing - thanks so much for giving me some solid info!

Disturbed33, I am so, so sorry to hear that you have been suffering from this chronic illness. So your doctors have officially diagnosed you with CFS? If I have a trial of thyroid hormone and it doesn't help and I can rule out other vitamin deficiencies/illnesses like Lyme then I think my doctor will probably refer me to an internist or someone who specializes in CFS. There's a possibility I will have to go on disability as much as I'd prefer to just work like all the other "normal" 24-year-olds. It makes me very scared. Thank you so much for the advice.

Tomorrow is my psychiatrist appointment. My doctor has been very open to my suggestions so I am hoping he will prescribe Armour or a T4/T3 combination since my Free T3 is on the lower side of normal. I really hope it will help. I am also considering switching ADs since this one doesn't seem to be helping and makes me even more tired. Ugh...so many decisions to make.

So nervous for tomorrow, so tired, just wanna stay in bed all day. I want my mind back.

I am suffering from extreme fatigue right now too, so don't have much energy to write, but just wanted to let you know that you are not alone. I am 28 and started getting sick at 20, have had 8 years of disabling chronic illness. I feel like an 80 year old. It sucks. I really hope that your appointment goes well, bet of luck.

Disturbed, thank you so much for the well-wishes and the info about fluoride - that's really interesting. I do use a water filter - not sure if my shower filters water too.

Butterfly, I'm really sorry that you are going through this, too. I hope that you have been able to find at least some relief! It is really difficult to feel this way, have to cancel on friends who don't understand, etc. when you're only in your 20s. I hate feeling like I have to sleep most of the day, but the worst symptom for me is the brain fog, confusion, and depression :/ I feel like my brain is wasting away.

Everyone, I saw my psychiatrist, and he was understanding and sympathetic, although he didn't want to prescribe me Armour or any T3 meds because he felt doing so was out of his comfort zone. He told me that he has hypothyroidism too and so does his mother, and the fact that it runs in my family is a strong factor in the possibility of developing the condition myself.

He prescribed me 12.5 mcg of Levothyroxine for two weeks, then 25 mcg for two weeks, and then hopefully I will be seeing a specialist (that was what my psych wanted.) I have taken two days worth of the Levo and is it possible that I am actually feeling MORE tired, dizzy, and spacey? Or am I just imagining this?

Does anyone have any advice, experience, etc. with Levothyroxine, Armour, or Cytomel? If my Free t3 and Free t4 are low does that mean I need both t4 and t3 medication, or is it a possibility that my body will be able to convert the t4 itself? I'm sorry, all of this is confusing and overwhelming to me.

Judy2, you have brought so much comfort to me this afternoon. I think you are absolutely right and I am expecting the medicine to work already which is, of course, ludicrous, and then when my reality doesn't match up to my expectations my feelings of disappointment trick me into thinking I am having all these side effects, when really I am not experiencing anything different than normal. Thank you so much, I really needed to read that.

I am so so so foggy today. I keep finding reviews of levothyroxine online (probably should stop looking...) and I see all these complaints! People are talking about how it made them gain weight, feel more slow and made their memory/cognition worse, made them lose hair...ahhhh! Aren't those just symptoms of hypothyroidism, though? Wouldn't that just mean that they are not on an adequate dose of medication? Then they say that when they stop the levo, the symptoms go away! "Nocebo" effect, maybe?

Anyway, sorry for the rambling. Can't wait for this brain fog to go away...

I'd like to jump in, if I may. I was in the same condition that you were, about 2 years ago. All of my labs work, and I mean I went through the gamut of labs, and 2 specialists, that my endo, thank God for him, found out that I had adrenal failure. And found out that You can die from this! it took approximately 5 months, three doctors, and lab, after lab, after lab, to finally get me the correct diagnosis. I feel for you because I was in the same condition. I don't know about your labs and the T4, but I just know that my adrenal glands we're very dangerously low.

hope this helps.

Lmks

Just a thought...After I was diagnosed with Hashi's and had been on medication for a time, I continued to complain of extreme fatigue, brain fog, low sex drive, etc. My doctor, on impulse, suggested I be tested for the mthfr gene mutation, of which chronic fatigue and other diseases can be associated. Up to 40% of the population can have at least one of the gene mutations and not know it. Bingo! I had two gene mutations show up on the blood tests. (Not so good, however). After researching it, it made sense why I had so many chronic health conditions throughout my life. I now have to take methyl B12 since my body can't break it down from foods. I also had my adrenal glands tested and tests indicated they were very low functioning, another reason for the fatigue. My hormones were also way our of whack, so I'm taking biodentical hormone replacement, which has also helped a lot. Maybe look into any of these to see if it may be something to get tested for?? Again, just a thought. Your symptoms sure sound like mine were before I was diagnosed with Hashi's.

The reason i ask this is why did they put you on a med for thyroid. Your story is almost exactly like mine. If you think your having side effects from a med than you are. Its not in your head and you never get used to side effects either. Im not here to be a ball buster by any means but if you havnt been diagnosted with any medical condition Beware of meds because meds mask they dont cure. Im not against meds for illnesses that need treatment but being a heavy medication guy since 17 years old it can turn into a very dark road. I know when i couldnt get help and the doctors didnt believe me along with my own mother i thought meds were going to take care of me but they sent me to the emergency room multiple times from side effects alone. I hope you dont take my message the wrong way but i have been through it all with my chronic fatigue thats what i call it and we are both in our 20s so we are young yet. If it makes you feel any better i know how you feel yesterday just walking to the kitchen i was panting out of breath. I didnt even want to go to the bathroom because i became winded even moving. Then that night i was just watching tv before bed and my heart started pounding like i had just got done running a marathon and i was breathing like a dog. This sends me into panic attacks everytime but then it passes. Its very uncomfortable and scary. Im not even nervous when this happens, i know its just part of my chronic fatigue. Some days will be better than others with that. I sure hope you find closure on what your going through and if you have questions or need to relate im usually on here. Good luck.