On reddit, case I could not comment on, that I have published here with considerable causes for chronic fatigue:
Are these symptoms connected or am I just insanely unlucky?
1) Most important question would be whether there is any chance of sleep apnea. Where I am, one of the Oxygen companies will rent overnight equipment to test for it. Poor sleep is also tied in with low testosterone levels (yes, women have that too). You need your free androgen index checked. If low, Testosterone gel 0.2-0.5 mls topically daily helps.
2)Chronic fatigue and diarrhea – Highly suspicious of gluten sensitivity ( either Celiac (diagnosable in some through blood work and biopsy if eating wheat) or non-celiac gluten sensitivity which I have which is poorly diagnosable.
About 50% of people with chronic diarrhea will have gluten sensitivity
Wahnschaffe, Ulrich, et al. “Predictors of clinical response to gluten-free diet in patients diagnosed with diarrhea-predominant irritable bowel syndrome.” Clinical Gastroenterology and Hepatology 5.7 (2007): 844-850.
https://www.cghjournal.org/article/S1542-3565(07)00329-1/fulltext
Seborrheic dermatitis and mouth sores and other rashes occur in gluten sensitivity:
Caproni, Marzia, et al. “Celiac disease and dermatologic manifestations: many skin clue to unfold gluten‐sensitive enteropathy.” Gastroenterology Research and Practice 2012.1 (2012): 952753.
https://onlinelibrary.wiley.com/doi/pdf/10.1155/2012/952753
I have non-celiac gluten sensitivity and it took many years to confirm it through eliminating gluten from diet and challenging on (bad by day 2).
Going off gluten may not make you better – you may need to eliminate FODMAP//fructose containing foods to feel any better
3) Some diarrhea might suggest not absorbing things well – please get your Iron/ferritin, B12 and Vitamin D3 levels checked.
4) seasonal allergies – not only did I have gluten sensitivity, I react to a variety of foods – sugars, coffee, tea cola, chocolate, tomatoes. You may need to go on an elimination diet of few foods for could of weeks and then try reintroduction to see which foods might contribute; Dr. Crook has a book on that meant for kids but easy reading:
Tracking Down Hidden Food Allergy: Crook, William G.
5) Your gut biome has become popular in recent press and found aberrant in Fibromylagia with probiotics helping Lactobacillus (Culturelle) and Bifidobacterium (Align) helping. (Walmart has an equate product that has both)
Roman, Pablo, et al. “Are probiotic treatments useful on fibromyalgia syndrome or chronic fatigue syndrome patients? A systematic review.” Beneficial microbes 9.4 (2018): 603-611.
Aslan Çİn, Nazlı Nur, et al. “Effect of prebiotic and probiotic supplementation on reduced pain in patients with fibromyalgia syndrome: A double-blind, placebo-controlled randomized clinical trial.” Psychology, Health & Medicine 29.3 (2024): 528-541.
Ruiz-Gonzalez, Cristofer, et al. “Cognitive and Emotional Effect of a Multi-species Probiotic Containing Lactobacillus rhamnosus and Bifidobacterium lactis in Healthy Older Adults: A Double‐Blind Randomized Placebo‐Controlled Crossover Trial.” Probiotics and antimicrobial proteins (2024): 1-13.
https://link.springer.com/content/pdf/10.1007/s12602-024-10315-2.pdf
6) There is a subgroup of fibromyalgic patient that do not handle folic acid/B12 well:
Methylenetetrahydrofolate reductase (MTHFR) gene:
Ahi, Emine Dundar, et al. “Association between fibromyalgia syndrome and MTHFR C677T genotype in Turkish patients.” Journal of Surgery and Medicine 4.3 (2020): 235-239.
https://dergipark.org.tr/en/download/article-file/1035316
You can get gene tested but won’t be cheap.
taking folic acid and methylecobalamate/B12 is treatment.
7) There is a very new discovery finding a subgroup of people with autoimmune disease that can have normal blood B12 levels but ZERO brain fluid B12 levels due to brain autoimmune condition that generates auto-antibodies to CD320 B12 uptake receptor:
Pluvinage, John V., et al. “Transcobalamin receptor antibodies in autoimmune vitamin B12 central deficiency.” Science translational medicine 16.753 (2024): eadl3758.
This is so new, I don’t think there are any protocols for handling this besides taking high doses of folic acid and methylcobalamin(the active form). [note: high dose B12 is carcinogenic for elderly male smokers]
I got chronic fatigue with long covid as it has now been shown that vaccinations give ZERO protection against long COVID as rates of long covid are same in vaccinated and unvaccinated groups. Just a thought.
8) Should be number one, but aerobic fitness and emotional support (seeing a counselor) are important.
newpainmuse 