Each hormone deficiency is associated with a distinct kind of fatigue. I had them all.

thingsvarious

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Hello,
I am a medical student in my last year. For a few years I have been replacing all of my major hormones (see here) and I have been both high and low in many different constellations. From all this I learned 2 things.
  1. Each hormone deficiency can cause chronic fatigue.
  2. Each hormone deficiency is associated with a distinct kind of fatigue.

Often chronic fatigue has gone on for years and wreaks havoc on every domain of our inner and outer life. It is often gradual and we often don´t remember when it started.

There are many things that can cause chronic fatigue:
  • sleep problems (e.g. insomnia, sleep apnea)
  • gut problems (e.g. leaky gut, SMBO, food intolerance, food allergy)
  • coffee addiction
  • inflammation (e.g. autoimmune issues)
  • nutrient deficiencies (iron, magnesium, selenium, zinc, B12)

I am certain, in many (but not all cases) chronic fatigue is due to hormone deficiency.

And if hormones are to blame, we can have perfect gut health, no inflammation, impeccable nutrient status, sleep&eat&exercise&repeat all we want but our fatigue won´t get much better.
I wrote a summary about the kinds of fatigue for different hormone deficiencies.

After years of studying, researching, experimenting, testing I did a writeup about some stuff I have learned along the way.

For a brief overview how the different kinds of fatigues for different hormone deficiencies feel like, I wrote a summary of it. Read here: Each hormone deficiency is associated with a distinct kind of fatigue.

I hope you find value in it.
 

heapsreal

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Hello,
I am a medical student in my last year. For a few years I have been replacing all of my major hormones (see here) and I have been both high and low in many different constellations. From all this I learned 2 things.
  1. Each hormone deficiency can cause chronic fatigue.
  2. Each hormone deficiency is associated with a distinct kind of fatigue.

Often chronic fatigue has gone on for years and wreaks havoc on every domain of our inner and outer life. It is often gradual and we often don´t remember when it started.

There are many things that can cause chronic fatigue:
  • sleep problems (e.g. insomnia, sleep apnea)
  • gut problems (e.g. leaky gut, SMBO, food intolerance, food allergy)
  • coffee addiction
  • inflammation (e.g. autoimmune issues)
  • nutrient deficiencies (iron, magnesium, selenium, zinc, B12)

I am certain, in many (but not all cases) chronic fatigue is due to hormone deficiency.

And if hormones are to blame, we can have perfect gut health, no inflammation, impeccable nutrient status, sleep&eat&exercise&repeat all we want but our fatigue won´t get much better.
I wrote a summary about the kinds of fatigue for different hormone deficiencies.

After years of studying, researching, experimenting, testing I did a writeup about some stuff I have learned along the way.

For a brief overview how the different kinds of fatigues for different hormone deficiencies feel like, I wrote a summary of it. Read here: Each hormone deficiency is associated with a distinct kind of fatigue.

I hope you find value in it.
I think hrt can help but it depends on the root cause or close to the root cause. For me without antivirals hrt doesnt do much but on antivirals and then add hrt i then notice a significant difference. Vasopressin and other fluid and sodium retaining hormones are often forgotten and can help alot with pots/oi issues also.
 
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Can you elaborate more on your diet? I don't think paleo diets are ideal for all. I have one of the MTHFR genetic defects and notice a difference when I consume a lot of green leafy vegetables. Maybe I misunderstand how Paleo diets work, but I believe the emphasis is on fats and proteins.
 

thingsvarious

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I don´t think MTHFR matters much. Yes, I am on a paleo-like diet although I try not to overthink. All I do is keeping carbs rather on the low side.
 

Judee

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I am certain, in many (but not all cases) chronic fatigue is due to hormone deficiency.
Trust me, you are not the only doctor who has thought that.

However, I think you are making the same mistake that so many of the doctors we have encountered are making. You are equating "chronic fatigue" with ME/CFS. They are not the same. "Chronic fatigue" can be rectified by improving diet, getting caught up on rest, exercising, reducing stress factors, correcting hormonal imbalances and nutritional deficiencies caused by not doing those things in the first place.

ME/CFS is not fixed by doing those things. That's the point. It makes me sad that we are still encountering this confusion. It means our disease will continue to be marginalized because the fixes you prescribe don't work so the default will then be that it's all in our heads or blame the patient for non-compliance even when they are doing everything you tell them to.

I also think you are setting yourself up for frustrations as a physician when your patients do not get better when you think they should be.

Anyone here is free to disagree with me but that's all I'm going to say about this on this thread.
 
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thingsvarious

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Trust me, you are not the only doctor who has thought that.

However, I think you are making the same mistake that so many of the doctors we have encountered are making. You are equating "chronic fatigue" with ME/CFS. They are not the same. "Chronic fatigue" can be rectified by improving diet, getting caught up on rest, exercising, reducing stress factors, correcting hormonal imbalances and nutritional deficiencies caused by not doing those things in the first place.

ME/CFS is not fixed by doing those things. That's the point. It makes me sad that we are still encountering this confusion. It means our disease will continue to be marginalized because the fixes you prescribe don't work so the default will then be that it's all in our heads or blame the patient for non-compliance even when they are doing everything you tell them to.

I also think you are setting yourself up for frustrations as a physician when your patients do not get better when you think they should be.

Anyone here is free to disagree with me but that's all I'm going to say about this on this thread.
You are certainly right. However I am NOT saying that all forms of CFS are due to hormone deficiencies, but many certainly are. And in many cases hormones are at least contributing to the fatigue (or could be used as a therapy).
 

thingsvarious

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You are certainly right. However I am NOT saying that all forms of CFS are due to hormone deficiencies, but many certainly are. And in many cases hormones are at least contributing to the fatigue (or could be used as a therapy).
Just as depression/fibromyalgia/anxiety/schizophrenia/autism are all just phenotypes so is CFS.
 
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Can you elaborate more on your diet? I don't think paleo diets are ideal for all. I have one of the MTHFR genetic defects and notice a difference when I consume a lot of green leafy vegetables. Maybe I misunderstand how Paleo diets work, but I believe the emphasis is on fats and proteins.
MTHFR is such a hype these years. One should read not too much into this..
 

Mary

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@thingsvarious - you write about "chronic fatigue" in your opening post here. Chronic fatigue is NOT ME/CFS (myalgic encephalomyelitis/chronic fatigue syndrome). Low thyroid, low potassium, anemia, low B12, digestive problems (the list is endless) all can cause "chronic fatigue" but none of these are ME/CFS.

I suggest you take a look at what the CDC says about it: Symptoms of ME/CFS | Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) | CDC

Here are some other links I think you should take a look at as well: Canadian Consensus Criteria - MEpedia (me-pedia.org)
International Consensus Criteria - MEpedia (me-pedia.org)

Many consider post-exertional malaise (PEM) to be the hallmark of ME/CFS - it's generally very severe fatigue and/or cognitive and sensory dysfunction, very often delayed by 24 hours or more after rather minimal exertion, it's incredibly disabling leaving most people bedridden for days or weeks and in most cases requires that one do nothing (literally) until it passes.

I've been anemic. Anemia has "chronic fatigue" as one of its symptoms. It has no relation to PEM. The fatigue of anemia does not go away with bedrest, and anemia never left me bedridden like PEM has done. Anemia does involve "chronic fatigue" - ME/CFS doesn't.

Most people here have run the gamut of doctors who know nothing about ME/CFS and encourage us to exercise or take anti-depressants when our blood work comes out "normal". There are thousands of studies showing real verifiable abnormalities in persons with ME/CFS. ME/CFS can't be mistaken for hormone deficiencies or for coffee addiction, etc.

I believe something has caused us to need abnormally large amount of various supplements - e.g. my overall energy and functioning has improved with large doses of various B vitamins (which I never needed before ME/CFS), as well as BCAAs and a few other amino acids and some other things. But I still have to ration my energy carefully or I crash (PEM). I do better with the desiccated thyroid my doctor has me take - but it hasn't cured my ME/CFS - I still crash.

You talk about "chronic fatigue" - but that is not PEM. The name "chronic fatigue syndrome" given to this illness by the CDC in the 1980's unfortunately has left untold suffering in its wake - almost no money allocated for research, incredible ignorance on the part of doctors, patients met with disbelief and contempt by the medical profession and society in general (one endocrinologist refused to look at research I had brought him, saying that there WAS no research about ME/CFS because it (ME/CFS) didn't exist and there never would be any research about it, because it didn't exist. This is how brainwashed the medical profession at large is.

Only now some of them are seeing COVID patients who aren't recovering, former athletes who are left bedridden when they try to do anything - this isn't a hormone deficiency/.

I really hope you learn to listen to members here and not make the same mistakes made by most of your colleagues.
 

gbells

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@thingsvarious - you write about "chronic fatigue" in your opening post here. Chronic fatigue is NOT ME/CFS (myalgic encephalomyelitis/chronic fatigue syndrome).
He definitely thinks ME is due to hormone deficiency.

See his article.

The symptoms of “Chronic Fatigue Syndrome (CFS)” are often due to unrecognized hormone deficiency.
Good luck finding funding for this.

Funny how no other physician who has treated ME patients has considered it before. :rolleyes:
 
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gbells

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"often" --> I will change it and remove the word "syndrome" to make it more clear. Thanks.
I just don't understand why you think hormone deficiencies cause ME. You obviously don't have ME yourself or you would know this doesn't work. I have never heard of a ME patient being cured via this route.
 

thingsvarious

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I just don't understand why you think hormone deficiencies cause ME. You obviously don't have ME yourself or you would know this doesn't work. I have never heard of a ME patient being cured via this route.
Again, this is my opinion . And I think there is nothing necessarily wrong with it

"
The symptoms of “Chronic Fatigue Syndrome (CFS)” are often due to unrecognized hormone deficiency.
CFS is not “one single disease” with a specific etiology, but rather a phenotype. This is similar to the way depression, schizophrenia, fibromyalgia, autism, ect. are defined. They are all catch-all terms encompassing a similar complex of symptoms that happen to satisfy a certain set of (observable) criteria.

There are many different possible causes and different patients often have an individual constellation of factors leading to their fatigue. In many cases the root causes are viral infections, cytokine-related issues, autoimmune abberances, ect.. If this is the case neither the use of hormones (nor stimulants) will help much. They can be useful for symptom relief (but not cure) if (ab)used at high dosages.

However, in many cases the phenotype of CFS is produced by (multiple) hormone deficiencies (and can be corrected with HRT). In fact, quite often (multiple) hormonal deficiencies are in fact at the root cause, much more commonly than most of us would assume. This means, a subsection of patients that think they have CFS, actually have unrecognized hormone deficiencies, which are treatable. (In other cases, hormone deficiencies certainly are comorbid.)

It turns out that many patients (though certainly not all) with either fibromyalgia and CFS have a deficiency in T3 or in cortisol or both. Therefore, in many cases, the phenotype of CFS or fibromyalgia is produced by (multiple) hormone deficiencies (and can be corrected with HRT). Furthermore, often both of these conditions are “comorbid”. For causing/treating fibromyalgia T3 seems to be a little more important than cortisol, whereas for CFS cortisol seems to be a little more important.

Note: So why do doctors not recognize hormone deficiencies? Well, for one, we doctors are heavily undertrained in endocrinology. Second, the specializations and subspecializations in medicine have left us with doctors that are often blind to everything out of their narrow domain. They often miss obvious signs of hormone deficiencies, resulting in great suffering. Third, lab values are often normal.In fact, many of chronically fatigued individuals with hormone deficiencies at the root cause do not fall below the medical reference range and thus often fly under the radar of the current medical system of doctors who just look at values that are flagged. Their values come back “normal”. However, normal for someone 30 years their senior. The problem is often at the level of the hypothalamus, leading to multiple borderline hormone deficiencies, which are not recognized by the mainstream medical community."
"
 

gbells

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1. You don't have ME and haven't treated it successfully yourself.
2. You've never successfully treated a real ME patient using this.
 

thingsvarious

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1. You don't have ME and haven't treated it successfully yourself.
2. You've never successfully treated a real ME patient using this.
I don´t want to argue with you.
I have had crushing fatigue for years, however likely not what you understand my "Me". I did have multiple clients with crushing fatigue who got back to normal pretty quickly once their thyroid and adrenals were restored. I am not saying they had ME the way you mean it. Read again what I wrote. Never do I say that ME/CFS is due to multiple hormone deficiencies.
 

gbells

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I don´t want to argue with you.
I have had crushing fatigue for years, however likely not what you understand my "Me". I did have multiple clients with crushing fatigue who got back to normal pretty quickly once their thyroid and adrenals were restored. I am not saying they had ME the way you mean it. Read again what I wrote. Never do I say that ME/CFS is due to multiple hormone deficiencies.
Well this forum is for ME patients so posting here implying a cure when you don't just raises their hopes for no reason. You're in med school, write an article.
 

thingsvarious

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Well this forum is for ME patients so posting here implying a cure when you don't just raises their hopes for no reason. You're in med school, write an article.
Even on this forum there are many people who had lots of success with thyroid and adrenal replacement.