Help with some lab results - fatigue, no libido, lethargy and brain fog

[Empiremag]

Hey folks. Over the last 6-9 months I’ve found myself super fatigued, really low energy, no sex drive at all and have a general brain fog most of the time. I’ve got some test results back but don’t know what to make of them after seeing my GP. She wasn’t a lot of help and basically said not to worry about anything. I’d love a little advice about what you think might be going on.

The readers digest from the results that I can see is:

Low iodine
Low Vitamin D (it’s summer here if that makes a difference?)
High SHGB

I’m reasonably active and healthy. I do 2 strength training sessions each week, 3 gym classes for fitness and ride a bike once a week for about 35km’s. I don’t eat crap. I eat mainly veggies, chicken, eggs and avocado 90% of the time. I will add in a protein shake and creatine most days and have a protein bar on most of the days I workout. I don’t drink much, maybe once a week I’ll have a bottle of wine but I’ve even pulled back on that lately as well. The only weird thing I do is I’ve taken 100mg of Modafinil 4-5 times a week for the past few years. I’ve stopped taking that in the past week thinking that may be contributing?

Anyone have any insights into what might be going on or what I could do to fix it? Let me know if there’s more info that’s needed!

Test results are attached.

[melDorado]

Title sounds like depression to me?

[Empiremag]

Title sounds like depression to me?

I felt like that might be it to start with but I've had depression in the past and this doesn't feel the same. When I felt depressed I had all sorts of negative thoughts in my head and felt more like my motivation was zero. There was definitely fatigue and lethargy but it felt different if that makes sense.

[melDorado]

Do you still enjoy other pleasurable stuff apart from sex? If so, you're probably good

[Empiremag]

Do you still enjoy other pleasurable stuff apart from sex? If so, you're probably good

Yeah I'm still enjoying cycling and hitting the gym. Footy training starts up again this week and I'm excited by that so I think I'm good.

[blue9steel]

I don’t eat crap. I eat mainly veggies, chicken, eggs and avocado 90% of the time. I will add in a protein shake and creatine most days and have a protein bar on most of the days I workout.

I am not a doctor. That said, what's your daily fat intake and current bodyweight?

[Empiremag]

I am not a doctor. That said, what's your daily fat intake and current bodyweight?

Current body weight is around 78Kg's or around 172 pounds. That's right around my footy playing weight so I'm not trying to lose any fat. Focussing on fitness and strength at the moment.

I don't track my macro's but my fat intake is mainly from nuts and avocados. I eat a couple of handfuls of Almonds most days and half to a full avocado. The rest of my food is lots of veggies, lots of eggs (probably 4-8 a day depending on the day) and the protein shake and bar when I need something quick.

Do you think higher fat intake would be useful?

[blue9steel]

Do you think higher fat intake would be useful?

Without knowing your current intake it's hard to say, but many of the symptoms could be caused by persistent low fat intake. You need a minimum of 0.4g/lb per day to maintain health and at least some of that needs to be saturated fat. I recommend you read the relevant stickies.

[1Fuzzy1]

Without knowing your current intake it's hard to say, but many of the symptoms could be caused by persistent low fat intake. You need a minimum of 0.4g/lb per day to maintain health and at least some of that needs to be saturated fat. I recommend you read the relevant stickies.

This.

I had similar issues op and I increased good fats & vitamin D. Also when back to a slight calorie surplus from a deficit...if you are cutting increase your cals for awhile and make sure you are getting enough sleep.

[Empiremag]

Without knowing your current intake it's hard to say, but many of the symptoms could be caused by persistent low fat intake. You need a minimum of 0.4g/lb per day to maintain health and at least some of that needs to be saturated fat. I recommend you read the relevant stickies.

Thanks a bunch! Will check them out again and increase the fat intake.

[Empiremag]

This.

I had similar issues op and I increased good fats & vitamin D. Also when back to a slight calorie surplus from a deficit...if you are cutting increase your cals for awhile and make sure you are getting enough sleep.

That's good to know. I was cutting during this but am not anymore so am in a surplus now but I'll focus a bit more on my macros and see how I go. Sleep is sporadic at the moment but I've been putting a focus on it for months now. I seem to wake up a fair amount during the night but am getting to sleep ok and getting 7-8 hours each night (interuppted but trying my best to focus on quality sleep where I can).

I've invested in an Ourra ring to get a little more insight into my sleep patterns so that will be interesting to see.

[rolli007]

it's because of physical overwork

[rolli007]

or you used too much protein

[Empiremag]

it's because of physical overwork

Really? I've been fairly consistent with my workouts over the years and stick to a 5/3/1 two day split routine with limited assistance work. That has never really fatigued me and doesn't appear to be too taxing. I've never felt like this before and take deload weeks every few weeks as per the program. I'd be happy to scale it back if that's what people think though!

[Empiremag]

or you used too much protein

I've never really considered this part before but higher fat and carb intake seems to be coming up as a thread here so I'll make a point to focus on that for sure. Thanks for the feedback!

[Iceman1800]

or you used too much protein

stupid post

[Empiremag]

stupid post

That’s not an issue in this instance? I don’t feel like I’m overdoing the protein but maybe lacking some fat and carbs?

[Iceman1800]

That’s not an issue in this instance? I don’t feel like I’m overdoing the protein but maybe lacking some fat and carbs?

Not at all. Too much protein will only lead to excess calories. It would have zero effect on test levels and sex drive. Lack of fat is most likely the issue. Lack of carbs is irrelevant.

[Empiremag]

Not at all. Too much protein will only lead to excess calories. It would have zero effect on test levels and sex drive. Lack of fat is most likely the issue. Lack of carbs is irrelevant.

Ok that makes sense. I didn’t think carbs would be an issue given how long I’ve eaten low carbs but fat is interesting. I haven’t really placed a huge focus on that. I make sure to get enough protein and eat loads of veggies and just fill in with fat but I’ll put more of an emphasis on that now. Really appreciate the info!

[OldFartTom]

do you have sleep apnoea? or should I ask... do you know that you don't? (because you're asleep at the time you might not realise)

[Empiremag]

do you have sleep apnoea? or should I ask... do you know that you don't? (because you're asleep at the time you might not realise)

It's a good question and one that my GP raised as well. She's got me a referral to see a sleep specialist but I'm going to have to wait because it's a bit expensive for me right now. It's something I want to dive into though because it could be a problem.

[OldFartTom]

Whilst in no way a substitute for a real diagnosis from a qualified person, is there any sleep monitoring sensor or app or something that could at least indicate how likely this is

http://sleepeducation.org/essentials...nea/self-tests

Hope you work out whatever it is... Get well soon

[Empiremag]

Whilst in no way a substitute for a real diagnosis from a qualified person, is there any sleep monitoring sensor or app or something that could at least indicate how likely this is

Hope you work out whatever it is... Get well soon

Given the list there I'd say it's highly unlikely. My girlfriend has never said anything and I've asked her about it. I also don't really tick any of the boxes other than fatigue so I'd probably say I don't have an issue here. I do have a Garmin watch that I use that measures sleep and it doesn't seem to show any anomolies. I've got an Oura ring coming that will give me better insights over the watch as well but I'd be fairly confident saying that it's not sleep.

[keyboardworkout]

Your thyroid labs look good.

However,

High levels of SHBG can be related to:

Hepatitis

Hyperthyroidism

HIV

Anticonvulsants, or medicine used to treat seizures

[Empiremag]

Your thyroid labs look good.

However,

I'm guessing those would have shown up in the tests though right? I'm not on any medication at the moment and wasn't for a couple of weeks leading up to the blood tests.

[Dan101]

What does your total testosterone, e2 and prolactin levels look like? High SHBG likely means it has bound up all your testosterone. Low free test = all the symptoms of low testosterone.

You have also described the symptoms of a dopamine deficiency, which I have.

Happy to talk more when I get up tomorrow.

[litljay]

Low Iodine is your first clue.

https://www.everydayhealth.com/diet-...ne-deficiency/

What Are the Signs and Symptoms of Iodine Deficiency?
It’s important to recognize iodine deficiency signs so you can get prompt treatment. Below are some of the most common ones.

Enlarged Thyroid Gland (Goiter) Symptoms of a goiter include swelling of the neck where the thyroid is located; trouble swallowing or breathing; and choking (especially while lying down). (15) If you suspect a goiter, contact your doctor and request a physical assessment. If iodine deficiency is suspected, you can ask your doctor to run a 24-hour urine iodine test for a proper diagnosis. (16)

Hypothyroidism Symptoms of hypothyroidism include gaining weight unexpectedly, experiencing fatigue, feeling cold, having dry skin, and even suffering from depression. (17) If you think you may have hypothyroidism, consider getting your thyroid-stimulating hormone (TSH) levels checked.

Pregnancy-Related Problems Iodine deficiency in pregnancy can result in miscarriages, stillbirth, early deliveries, and, in cases of extreme deficiency, congenital defects in babies. Check your prenatal vitamin, as not all of them have supplemental iodine. Be sure yours has at least 220 mcg of iodine. (6)

I don't see a T3 or T4 test in there. increased SHBG is also an indicator of hypothyroidism.

Go back and see a Doc.

[Empiremag]

Low Iodine is your first clue.

I don't see a T3 or T4 test in there. increased SHBG is also an indicator of hypothyroidism.

Go back and see a Doc.

The current Doc I have been seeing is fairly clueless when it comes to this stuff and basically said it wasn't an issue so I'm going to have to try and find someone that knows a little more about it. Any ideas on how to find someone that would be better suited to this? Or is it a bit hit and miss? I'm in Australia if that helps. Appreciate the insights.

[Empiremag]

Hey Dan101, Not sure how to read the testosterone results but Free Test (VC) is 245pmol/L. S Testosterone is 20.9nmol/L. S Oestradiol says it's <70. Prolactin I'm not sure about but may be in the test results I posted in the original post. Is it called something else on a test like these?

I'd be interested to hear more if you have the time! Thanks again!

[Hadian]

The current Doc I have been seeing is fairly clueless when it comes to this stuff and basically said it wasn't an issue so I'm going to have to try and find someone that knows a little more about it. Any ideas on how to find someone that would be better suited to this? Or is it a bit hit and miss? I'm in Australia if that helps. Appreciate the insights.

An endocrinologist specializes in these sorts of things. I had thyroid issues myself, all of the same symptoms, especially the brain fog and fatigue. Vitamin D helped me as did iron, but these weren’t the main causes for my issue.