I thought I'd pick you guys brains about thing I can look into or potential lifestyle changes. I am tired ALL the time. And I sleep FAR too much. My doctor is working on this with me - but I was wondering if you guys had any ideas of things I might be able to do to feel better or things to ask my doctor about.

I sleep about 10 hours a night and take a nap any afternoon I am home - sometimes that means 12-13 hours a day. I still feel tired ALL the time and this has been going on for much more than a year. I am always tired, and sometimes I have brain fog - and have to go home to nap and feel so tired sometimes the five minutes drive home from school (I am a graduate student) feels like a challenge.

Last october, I had a sleep study and do not have sleep apnea. My TSH (thyroid) levels were normal. My vitamin D is on the low end of normal. I have plenty of B12. Iron is normal too.

My mood is fine - I don't feel depressed and have been stable for a long time. I take prozac and wellbutrin. Wellbutrin was added about a year ago when I first started having these tiredness symptoms because we thought maybe I was having physical symptoms of depression even though I wasn't feeling depressed.

Also last October I had an appendectomy. I had a raging infection that they said could have been going on for a while - I thought I had found the answer - I was tired due to infection and would feel better after I healed from appendectomy but no such luck.

I eat very healthy - in fact, I worry less about weight loss and more about eating nourishing nutrient dense foods in a hop eto feel better. I take a long walk in the sunshine about 4 days a week. I could use exercising more I'm sure, but its difficult because I am tired all the time and can hardly keep up with life.

Ongoing chronic stress may be a potential issue - I am a 6th year phd student, chronically stressed about school and money things.

Anyway, any advice for ways to feel better: lifestyle changes, things that work for you, etc etc. Also any advice for things I should look into more with my doctor? I think we hit the big ones (thyroid, B12, D, Iron and sleep apnea).

Thanks for any input you have. I appreciate it.

You said you eat healthy. Can you be more specific?

Sure.

I do slide occassionally, and do have a "treat" meal about once a week, but generally I eat things like:

Breakfast: 4 eggs with two slices of nitrate free bacon and berries.
Plain Greek yogurt with cinammon and/or berries. Or a smoothie with protein powder, yogurt and fruit of some sort.
Always coffee with cream/stevia.
lunch/dinners: Salad with whatever veggies i have, chicken, feta cheese and oil and vinegar dressing. Or some sort of protein (chicken, grass fed steak, pork tenderloin) with veggies (often brussel sprouts cooked in coconut oil, but it varies). Or maybe spaghetti squash or eggplant with chicken and past sauce. Sometimes a sweet potato.

I do tend to eat "lower carb". I have about 2-3 servings of fruit/sweet potatoes a day. I do have higher carb about 1-2 meals a week.

Snacks vary, and I don't always have them - I more often have four small meals a day. If I do have snacks, it might be nuts, or cheese and sliced meat.

I should add that I do have insulin resistance and pre-diabetes. (fasting blood sugar 104 at last test).

Been tested for mononucleosis? That's the easy one that comes to mind.

Certainly less likely would be some sort of heart damage from the infection, as can happen with rheumatic fever.

One last idea - if you were taking powerhouse antibiotics to clear the infection, you could have disrupted your gut flora. Seems like that would show up in the nutrient checks you've already had.

Any chance of celiac disease? I saw a chart if symptoms on Pinterest today and some you mentioned were on there. Sounds like you are mostly grain free though.

At your weight and height I used to sleep a lot too.

Exercise would help a lot. Especially when you are less tired, like when you wake up.

But you may also feel less tired as your weight comes down.

I wake up between 5-5.30am now to work out.

Thanks ICUwishing and Shannonsnail. Good things to think about.

I have not been tested for mono - but thats probably a good idea. Could I have it for over a year though? Would it eventually go away on its own?

I should probably take probiotics - my gut health probably took a hit. I have them and am not consistent.

Shannonsnail - I have had IBS most of my life - so I did get a blood panel a few years back for celiac that suggests I do not have it (although only way to know for sure involves a colonoscopy and sample). Although I don't eat a ton of wheat products, I do currently eat some gluten though - my cheat meals, in the soy sauce I use when I eat raw tuna as a meal, etc. So its not totally ruled out - but given the blood test it is unlikely. Of course, the blood test doesn't always get it right. Still given the symptoms are more recent (last couple of years), and I'm 33, Im guessing that is unlikely. Something to think about though. I was wondering if it could potentially be a food allergy of some sort.

The other thing that comes to mind is maybe I'm being too low carb? But its not like I don't have any carbs, I just minimize them and try to get them from non-processed sources.

Thanks for the ideas so far!

Ian - Totally agree that losing weight may fix some of this. And even though I don't have sleep apnea, I may still be having poor sleep due to being overweight.

Its hard though!! Being tired all the time doesn't make weight loss easy (not that this should be an excuse).

Wow, you eat nearly identical to me! The only difference is I take my coffee black and I don't use protein powder.

But knowing you are pre-diabetic, and as Ian said, your weight, that could really be making you feel tired. I've heard a lot of people who has issues with their blood sugar express they experience fatigue. There is a board for those dealing with diabetes, and while I'll understand that you are technically pre-diabetic, maybe posting the question about fatigue on that board might give it a better chance of it being read by others with less than ideal blood sugar.

I also agree with shannonsnail. A gluten intolerance can have many other symptoms besides gastric. I've read that fatigue, and even depression can be causes by a gluten sensitive person consuming gluten. You can always get tested or just eliminate it from your diet for several weeks and see how you feel. I'm not sure how long you need to be gluten free to feel better. It might be longer than several weeks, maybe a month?

With gluten intolerance, and I could be wrong about this, I thought most people had a more immediate reaction after eating gluten (e.g. you would get tired or sick almost immediately after eating something with gluten rather than a constant feeling of fatigue).

I would definitely ask to be tested for mono, as well as Lyme disease (do you spend time outside? live near a wooded area?)

I honestly think there is nothing worse than undiagnosed exhaustion. There are SO many possible causes. I wish you luck in finding the cause...and cure.

I gather that tiredness is a side-effect of Prozac. Could this be it?

I was tired much of the time when I was on antidepressants.

I have been on prozac since 2004ish .... but I was thinking and wondering the same thing . Maybe when I was younger it was easier to overcome the tiredness with natural energy.

Thanks everyone for your suggestions so far.

I would wonder whether there is some issue with your antidepressant medications causing long term issues. Antidepressants have been linked to GI symptoms, and if you were prescribed a proton pump inhibitor medication to take, you may be increasing your risk of magnesium deficiency (especially with your gut flora out of whack). Symptoms of magnesium deficiency and antidepressant use both can cause weakness, fatigue, and disturbances in blood sugar. If you aren't supplementing, I would recommend it. And I would question whether the continued use of the prescriptions is necessary. I took antidepressants for awhile, when I was in a really bad place after my mother died, and I was able to stop using them, and haven't needed them since. I might still be on them had it not been for the side effect I had of developing a tremor. Thankfully, that stopped when I stopped taking them. There is a lot to be discovered about these drugs, and while they may be a lifesaver for some, they may be causing untold problems for others. The brain is a very complex organ, and how these drugs affect neurotransmitter function is not completely known. Just a thought.

I agree about the antidepressants and would ultimately like to be off them. I tried to go off prozac once and it was a disaster. Given everything in my life right now, I'm scared to try at the moment.

You did just make me think about when I went on my blood pressure med (enalapril) and when the symptoms started. They may be closely related. I think the enalapril was a bit before , but I'm not sure - the fatigue slowly came on - wasn't sudden. I'm wondering if I should try switching lbood pressure meds? Can't hurt! I think I can at least give that a whirl.