Why am I exhausted ALL the time! Update Post 98

[Imzadi]

Do you know you shouldn't take iron or calcium supplements within 4 hours of taking thyroid meds?

 

[ronandannette]

To me the most obvious question is "have you passed menopause"? For me, during the process the only major symptom I had was something they called "crashing fatigue" and it was alarming. Eventually, the severe spells abated but I never have returned to my previous level of energy or stamina, either physically or mentally.

 

[Pea-n-Me]

I’m tired. Maybe it’s my job, or maybe I’m just getting old. I don’t know. I’ve scheduled a doctor’s appointment for my annual physical in mid April. I want to make a list of possible reasons for my exhaustion that I need to get checked out.

This is my list so far:
Check iron - I’ve had low iron in the past and have been on daily slow release iron pills for the past 10 years.
Check thyroid - I’ve been hypothyroid for the past 23 years and take daily meds. Maybe they need adjusting.
Sleep study - I had multiple knee surgeries over the past 2 years, and the anesthesiologist mentioned that I’m at risk for sleep apnea.
Heart monitor - I have an irregular heartbeat like my dad does. His eventually turned into A-Fib. I want to get this checked.

Is there any other medical thing I should get checked?

Some backstory - I’m a 56 year old middle school teacher. I know all teachers are tired after the last two years. I’m thinking of quitting and finding another type of job. My 7th and 8th graders are ok but the 6th graders are a handful. Dealing with them wipes me out. Plus with teaching classes you are “on” all day. There is no sitting quietly in your cubicle and getting your work done. I have to do all the grading, lesson planning, and paperwork after working a full day in the classroom. But I want to make sure there is not a physical reason for my exhaustion before I bail on teaching.

My heath is good (although I need to lose some weight), but I’ve had a rough couple of years with surgeries. I had double knee replacement in July 2020 due to bone on bone and terrible arthritis in both knees. It was very difficult; however, I was doing ok until Jan 2021 when I got a mild case of covid. Then in Feb 2021, my surgeon discovered my right knee implant and tibia bone were infected. I missed 6 months of work, had 2 additional surgeries, 3 hospitalizations (one because I had a terrible reaction to the IV antibiotic I was on), 8 weeks with a picc line and IV antibiotics. It was an ordeal. I did the knee replacements so I could move without pain and get my active life back. But now I’m too tired after work to live it!

Can you pinpoint when the fatigue started?

 

[flipflopmom]

You’ve gotten great medical suggestions here, but as a teacher, I just wanted to chime in that every single one of my fellow teachers in the building says the same thing. Doesn’t matter their age, home responsibility (little kids, etc), other life circumstances, we are completely and totally exhausted. Some blame decision fatigue, some fatigue of changes, some that it takes soo much more to keep kids engaged right now, some being in the political hotspot for the last year, bearing so many burdens; there have been many reasons given and I think they’re all valid. Not that it really helps, just wanted to let you know that you are not alone. Hoping you can get some relief soon!

 

[Kathryn Merteuil]

Is it possible you have had Covid again? I had what I thought was a "mild" case of Covid (until the test was positive I thought I had a slight cold) earlier this year. Following that, I was fatigued for over a month. I was so tired I did not think I could ever catch up on my rest. I was seriously dragging. Then the weirdest thing happened, I woke up one morning and felt like I was back to normal again.

 

[mrodgers]

Exercise and diet is really the first thing to check with everything. My doctor wants me to eat special foods and give me all kinds of pharmaceuticals when I know for a fact that if I only eat meals and don't snack, my glucose levels and weight drop like a rock and when I get off work and go for an hour bicycle ride, my cholesterol, glucose, blood pressure, everything comes down to near perfect levels. And on top of that, I feel great.

I'd been off the bicycle for exercise for a few years and I know it's time for me to get back onto it again and to fix the diet again. I do that and I know I won't have to take the recommended to me 4 pills a day.

 

[Moliphino]

Depression/anxiety can cause a lot of fatigue, too. The past couple years have been rough for most people, but I think teachers have had it tougher than a lot of professions.

 

[lesliekatya]

Maybe get checked for an autoimmune disease. I found out I had one that might explain my fatigue.

 

[PollyannaMom]

No advice that hasn't already been given, but just wanted to say good for you for making an appointment and going in prepared with specific questions!

 

[China Expat]

Definitely check thyroid levels!

 

[HerRoyalHighness]

I suppose I can jump in here with my thoughts, too. I, also, had issues with fatigue, depression, weight gain, sleep issues, PMS issues, etc etc etc. I also had chronic diarrhea. Started about 20-40 minutes after I would eat. It was not dairy. I was tested for various things over the years and it really got down to me trying Keto and I realized my diarrhea stopped. A new GI I found tested me for fructose intolerance, and low and behold, came back positive. I, seriously, had been dealing with it since the mid-1990s and I firmly believe it's because of the increase in sugar in processed foods in our diets. In the past year and a half I've lost over 60 pounds, my energy is through the roof, my joints don't ache, my cramps are way more manageable, very few headaches. I have not had a cheat day since last April, but will see about our upcoming trip. If you would like to look into it further, various youtube channels are Low Carb Down Under (there is a US version, too - LowCarbUSA - just find more material on the Australian one)...then you can search for those that appear in those as most have their own channels. Dr Jason Fung, Serious Keto (Steve), Dr Ken Berry (DrKenDBerryMD), Keto Twins, Diet Doctor, Dr Eric Berg (he's a chiropractor so a bit of back and forth on him but he does have some good material). Thomas DeLauer is intense. He has a biochemistry background. Again, very intense, but dang, he is very serious. There is a documentary called Fat Fiction (it's free somewhere...maybe youtube) that is a good place to start, too. YMMV.

 

[abdmom]

Could be asthma and allergies. I had sleep issues for decades before I was diagnosed with asthma. I never wheezed. It's taken another 5 years for me to figure that I'm allergic to tree nuts and that is a main trigger for my asthma.

 

[BayouQueen]

I get tired if my B-12 and Vitamin D levels get low. I think that is common as we age, because absorption becomes an issue.
Other than that, make sure you are up-to-date with your lady health screenings -- mammograms and PAP smears. Maybe those fell through the cracks as you dealt with the other surgeries.

 

[CGB]

You’ve gotten great medical suggestions here, but as a teacher, I just wanted to chime in that every single one of my fellow teachers in the building says the same thing. Doesn’t matter their age, home responsibility (little kids, etc), other life circumstances, we are completely and totally exhausted. Some blame decision fatigue, some fatigue of changes, some that it takes soo much more to keep kids engaged right now, some being in the political hotspot for the last year, bearing so many burdens; there have been many reasons given and I think they’re all valid. Not that it really helps, just wanted to let you know that you are not alone. Hoping you can get some relief soon!

Middle school teacher here too. I couldn't have said it better, flipflopmom.

 

[DeeBee3]

Sounds like you are on the right track. Have all the bloodwork done - sometimes you have to request Vitamin D because insurance won't cover a regular screening of it.

Sleep is probably a bit factor - you may think you are sleeping, but you may not be getting restorative sleep.

I have little kids and I'm constantly interrupted at night. I mean it might be once, but it disrupts the rest of the night.

 

[luvdmouse]

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I’m tired. Maybe it’s my job, or maybe I’m just getting old. I don’t know. I’ve scheduled a doctor’s appointment for my annual physical in mid April. I want to make a list of possible reasons for my exhaustion that I need to get checked out.

This is my list so far:
Check iron - I’ve had low iron in the past and have been on daily slow release iron pills for the past 10 years.
Check thyroid - I’ve been hypothyroid for the past 23 years and take daily meds. Maybe they need adjusting.
Sleep study - I had multiple knee surgeries over the past 2 years, and the anesthesiologist mentioned that I’m at risk for sleep apnea.
Heart monitor - I have an irregular heartbeat like my dad does. His eventually turned into A-Fib. I want to get this checked.

Is there any other medical thing I should get checked?

Some backstory - I’m a 56 year old middle school teacher. I know all teachers are tired after the last two years. I’m thinking of quitting and finding another type of job. My 7th and 8th graders are ok but the 6th graders are a handful. Dealing with them wipes me out. Plus with teaching classes you are “on” all day. There is no sitting quietly in your cubicle and getting your work done. I have to do all the grading, lesson planning, and paperwork after working a full day in the classroom. But I want to make sure there is not a physical reason for my exhaustion before I bail on teaching.

My heath is good (although I need to lose some weight), but I’ve had a rough couple of years with surgeries. I had double knee replacement in July 2020 due to bone on bone and terrible arthritis in both knees. It was very difficult; however, I was doing ok until Jan 2021 when I got a mild case of covid. Then in Feb 2021, my surgeon discovered my right knee implant and tibia bone were infected. I missed 6 months of work, had 2 additional surgeries, 3 hospitalizations (one because I had a terrible reaction to the IV antibiotic I was on), 8 weeks with a picc line and IV antibiotics. It was an ordeal. I did the knee replacements so I could move without pain and get my active life back. But now I’m too tired after work to live it!

i feel like we could be friends! Middle school math and science teacher here… waiting to be told it’s time for knee replacements. Similar age. All these suggestions are so important to check out with your doctor. I had blood work done 6 months ago. Turned out I had very elevated inflammation in my body…. Not helping my exhaustion. Was diagnosed this fall with psoriatic arthritis, an auto immune disease. No one in my family has ever been diagnosed with it… but boy am I exhausted. I’m up in the morning, takes me a little longer to get moving, but by 4 pm I’m ready for a nap. Even walking through Target let alone Disney springs is exhausting. Good luck finding answers. Once you find answers, you can find solutions!

 

[RamblingMad]

Here's a pretty good list:

https://www.mayoclinic.org/symptoms/fatigue/basics/causes/sym-20050894

 

[Christine]

OP, you are correct to check all the things you've identified first.

Another poster mentioned the ferritin and that's the best thing to check for iron stores, not the typical iron tests done. I was ferritin deficient for years, pre-menopause, and exhausted all the time yet I was not anemic. That said, if you're 56, you may well like in menopause and then you have to be careful with even taking any iron after that.

With all that, if it comes back normal, you very well could be dealing with older adult fatigue due to sub-par eating and lack of some good exercise. Standing in a classroom getting 10,000 steps probably isn't doing it.

I had major foot reconstruction last year. Due to foot issues prior to surgery and for 8 months after, it had been a LONG time since I had done any meaningful exercise. I finally started gently exercising in December. I dropped most of the sugar out of my diet (I do still have some every day), cut my calories back, lost 12 pounds and I FEEL FREAKING FANTASTIC. I am 58 years old. Ruling everything out (as you will do) is wise but a lot of these feelings of poor health and fatigue really come down to sub-par eating habits and too much weight.

I go to the gym because I don't have the equipment at home. I do have a treadmill but I'm nervous about my foot and my balance so I don't use it. I started off in December by doing a 30 minutes Walk Away the Pounds video just to get my foot used to moving. Then I started at the gym with 12 minutes of rowing (easy on the joints), and then I either get on a stationary bike that's comfortable, but have graduated to an elliptical which is really giving me a good cardio workout. When done with that I pick about 4 different weight machines and try to build on the major muscle groups. In 3 months, the change in how I feel is amazing. All my joint pain is gone too.

 

[DLgal]

Sleep study should be your first step.

My husband has spent the last few years being chronically tired during the day. It got so bad he would fall asleep while driving briefly. He finally had a sleep study done (military medicine moves slowly) and he has severe apnea, with an average of 40 apnic episodes per hour. His body never gets into Delta wave sleep (the restful, regenerative type). He will get his CPAP next week.

The sleep doctor told him it is NOT normal for any adult his age (early 40s) to *need* a nap during the day and he *should* feel rested after 7 hours of sleep. While he can make it through the workday with lots of coffee, he naps every weekend, for several hours.

He had been medically worked up for everything else, and the sleep study was last on the list. It should have been first.

 

[Princesca]

Vitamin D and B12 levels are good to check. B12 and iron are tied together somehow; I think B12 levels might be essential to your body's ability to uptake iron or something to that effect. You can generally take a reasonable dose of both of these without any concern. I have a B12 spray I dose with once every 2-3 days. I take 4000 IUs of D3 a day. I get my levels tested annually.

I take daily thyroid replacement, and my uptake was not adequate on Synthroid alone. They had to add liothyronine for me to feel optimal. Consider asking about that if you haven't already. Also make sure you're taking your Synthroid on an empty stomach and waiting at least 30 min before eating anything, preferably closer to an hour. I have the best results taking my thyroid meds first thing in the morning when I wake up.

I had sleep apnea but lost some weight and it resolved. My signs of it when I did have it were: 1) irresistible sugar cravings in the afternoon, 2) being able to insta-nap in the afternoon (could fall asleep in minutes, anywhere), and 3) getting up to use the loo multiple times a night. I didn't really have to go - but apparently people with sleep apnea are waking up from hypoxia, and then their body is like 'oh hey, I'm awake, better go while I can'. So without apnea, you'd be sleeping most of the way through the night without needing to go.

I know it stinks to be tired all the time. Middle school is the worst age for behavior, too, in my experience, so no wonder you're exhausted, even just from that alone. Good luck with your results!