26 year old man with 50 year old energy

[Rz2323]

Greetings,

So, in short, I am tired. A LOT. I hardly, almost never work out. I am not in bad shape, got a bit of a beer belly, probably skinny fat to average would be an accurate description of me. The last time I remember feeling good and being in shape consistently was when I was 17. I had close to a 6 pack and I was hitting up la boxing (ufc gym now) 3 times a week and working out a lot. I felt great. Around 18 or 19, I started to feel depressed and tired and lethargic for no reason. After sometime, it got worst and I ended up seeing a psychiatrist. Long story short, we have come up with the diagnosis of dysthymia, depressions ****tier cousin. Dysthymia is known as the 'tired' mental illness, as it's like a weaker depression, but all the time. One of the main effects of true clinical depression is tiredness, and which I deal with on a day in and day out basis. There has been one time during the last 7 years that I was fairly active and that was when I put myself in the ketogenic diet, which is very very difficult to maintain for me, as the side effects are really rough (feeling extremely irritable). Thus, I am left with feeling tired, miserable and ****ty most of the time because my physical energy is so low.

I am wondering what there is to do. I am wondering if it's truly a neurotransmitter issue with dysthymia, if there's hormones at play, if it has something to do with my gut (I know that sugar makes me feel a hell of a lot worst), or what. All I know is I need a solid 'mans man' sort of doctor to really help me out.

Currently I am on a couple meds, that do really help, I mean without tegretol for example, I wouldn't being able to get school work done, seriously, I have tried getting off it multiple times but every time I do my performance, least academic and productivity performance significantly decreases. The meds do really help, in some areas at least. Currently I am on
350 xr tegreotl daily, 100xr gabapentin 3xday, 25mg Zoloft, 4k vitamin d, 10k vitamin a, 2.5mg adrenal 2x day, and that's really it.

Before you say this is all the meds fault, I do remember around 18 or 19 starting to feeling a bit more lethargic. The last time I was truly in shape before medication was when I was 20 , for a brief couple months, I was in pretty good shape, but that didn't last too long. Ever since meds, there was a brief 3 month window where I was on keto and working out a bunch. but other then that I think working out is probably somewhat harder, but I really can't tell how much of it is meds or how much of it is my dysthymia. I just don't know, all I know, is that at 26, I should not have the energy of a 50 year old. I am attaching a couple lab reports for you guys as well for the most recently bloodwork I have done. Any and all help is truly appreciated. I AM committed to getting back into the kind of shape I was at when I was 20 or 17. I am 26, in my prime, and am truly 100% committed to being in the best shape of my life, not the worst.

(PS: I DIDN'T feel like pasting each of the specific metrics on here, so because the forum wouldn't allow me to put URL'S on here until I hit 50 posts, I simply took out the h in the beginning of the link. So just simply add h to the beginning of each link. )


July 2017 -ttps://patient.labcorp.com/patient/PatientWeb/Forms/PatientPortalCcrViewer.aspx?Id=2ca7932a-7ae1-4725-8130-02e21a866433&ReturnTo=visit

July 2017-ttps://patient.labcorp.com/patient/PatientWeb/Forms/PatientPortalCcrViewer.aspx?Id=23a699ac-9868-4d6b-81ea-cba3eb8c42b6&ReturnTo=visit


****comprehensive April 2017-ttps://patient.labcorp.com/patient/PatientWeb/ApplicationPages/CCRViewer.aspx

April 2017-ttps://patient.labcorp.com/patient/PatientWeb/ApplicationPages/CCRViewer.aspx (estrogen)


***comprehensive Dec 2016-ttps://patient.labcorp.com/patient/PatientWeb/ApplicationPages/CCRViewer.aspx


Hopefully someone will be able to decipher something from these labs. Thanks.

[JasonFit852]

Start with getting your sleep schedule on track (bed by 11 pm up by 7 am kinda thing), and make sure you get your diet on point (4-5 servings of fruits everyday, 25g fiber so lots of veggies, adequate protein, calories etc.)

Try that for a couple of weeks. If that doesn't work then see if it could be your quality of sleep? (possibly sleep apnea)

[Jonathan1138]

Of course I'm not entirely sure how all of that works, I'm no doctor, but as a bizarre example of how simple some things can be I went through about 9 months where I was extremely tired, I mean tired ALL of the time, all day long, no matter how much I slept. I was anything but depressed, I actually had a girlfriend at the time, I was excited about my career, I wasn't depressed. But here's the problem, every medical professional you meet wants to jump to stupid conclusions. One of the biggest things I've learned in life -- that only applies to me, so I'm not trying to generalize -- is that the vast majority of assumptions don't apply to me. I'm the outlier when it comes to most of my life experiences, so when I'm asking for advice I need the outlier doctor or the person who is just smart enough to figure it out without assuming I'm the 90%. I would tell these people, no, I'm telling you I'm not depressed, I'm a happy guy, I have an awesome life, but yeah this tiredness IS ruining it, it IS making me depressed, but depression isn't causing fatigue.

The first doctor was an idiot, didn't seem to help at all. The second doctor told me I was hypothyroid, so she put me on some light medication to help with the levels. That didn't seem to make any difference, that I could notice. I still felt tired. Finally I saw my dad's concierge doctor, a top-of-the-field type of guy, when I was visiting home. He immediately told me to throw away that medication, he didn't believe I was hypothyroid, and he wanted to see me in two weeks to test my levels again. Two weeks later, he said, "Your vitamin D levels are low. That's it. You are at 15 on a scale of 100, you need to be minimum 30 and you should be at 60." I lived in Los Angeles, so nobody could believe down there that a guy could have low Vitamin D levels living in a sunshine city like that. The problem is, that's a stupid assumption. I lived in a condo building, I'm a night owl, I don't even wake up until noon most days, and when I do, I was in the car driving to and from places, parking garages, meetings inside, whatever else. I started taking Vitamin D pills that cost like $10 for 90 days and now I've never had that problem again in my life. I take them pretty religiously because of how bad that situation became, so I'm acutely aware how important these vitamin balances can be. Who would have imagined being low on Vitamin D could be so energy-crushing? Wow.

I will say throughout my entire time being fatigued, I never gave up working out. I always did it anyway. Sometimes it was almost all of the energy I had for the day, but I made it happen, and I'm glad I did because I still think it helped me, at least in not missing a beat once I figured out what was up.

Also while it's important to get quality sleep, it's important to sleep when you feel like sleeping. If you're a night owl, it's not a personal preference, it's a chronotype. You cannot change it. You could more easily change your gender than you could change your chronotype. I cannot simply "go to bed" at 10 p.m., it doesn't work that way. My natural preference has always been to sleep around 4 or 5 a.m. and get up at noon or 1. It works great for me, I love it, and since I live my life on my terms, I make it happen. If you can't do that, and you have to get up early, the best thing you can do is try to endure, I guess, but you'll never feel as good as if you're on your natural sleep schedule. I had to deal with that throughout high school, but by college I made sure my classes were mostly noon or later, and as an adult I only get up for film shoots. I won't get up early for anything else.