Fatigue

I have been suffering from fatigue for nearly 2 years.  I have had every test known to man and nothing shows up.  I thought it was because of the malabsorptive wls I had in 2002 so I had that revised hoping that I would absorp vitamins better and that would take care of the fatigue.  I have changed my diet and quit smoking in hopes of feeling better.  The only thing I haven't been able to do is exercise.  I just don't have the energy.  I try but I can't do it very long.  I am barely functioning.  Not finding anything physical I figured it was due to depression.  I have been put on a new antidepressant.  I do have some good days, not many.  I was doing better for a few days and thought things had turned around but the last 2 days I haven't had any energy.  I don't want to live like this for the rest of my life.  My labs have been fine and I take my supplements every day and get at least 80 grams of protein every day.

When you say your labs are fine... what's your B12?  Your iron?  Ferritin?  D?  

Sometimes docs say things are fine when they really aren't.

Are you getting enough sleep at night?  Any chance you have sleep apnea or something?

Kelly

What Kelly said...
Plus - you also need a full thyroid panel. Full not just TSH and T4.

It also may be hormones - how old are you? how is your "hormonal" history? maybe adrenal exhaustion? who knows.

My B12 was over 1600 at the last check. My D was 42, a little low but it had been under 10 at one point. I had a sleep study and no sleep apnea. They did a complete thyroid panel a few weeks ago and it was fine. I sleep about 8 to 10 hours at night. My ferritin was low last year and I had an iron infusion and now it's normal, as is my iron.
I am 52 so it could be menopause. I was having hot flashes but since my surgery I hardly have them. I had a hysterectomy so I don't get periods but I do have my ovaries.

How normal is normal? My ferritin was 11... my lab quoted 10- 200 as normal...  Well - I barley had any energy to get out of bed. 
What was thyroid? did they check the T3? free T3?
Just because the doc says it is normal - it does not mean it is "optimum for you"
i.e. my ferritin was 11... theoretically normal - but some people who have the ferritin below 50 - feel exhausted, drained, and will experience other low iron symptoms.. (google that).  
I started taking heme iron and within 2-4 weeks I could feel the difference.  And my ferritin only got up to 18... way to go for me... (first 6 months post op they were 112...)

Also- I am also in menopause... and when they tested me - not only estrogen was very low but also testosterone, and progesterone.  I am now on natural HRT,  and I am getting all three of them.   low testosterone in woman may manifest itself as low libido, low energy, fogginess, etc.

I also had very normal TSH and T4 - but my free T3 was really low.  The free T3 is responsible for the "energy kick".   The T4 is the non-active form of the thyroid hormones.

BTW: the natural HRT is very expensive IMO - but when i felt like I was "dying" from hot flashes, mental fogginess and feeling tired all the time - there is no price that I was willing to pay to feel like myself again, but talk to your Obgyn.  I have been on the hormones now for 2 months and I now start feeling better.  Not every day yet - but I can see the progress.  

I don't have the results but my doctor said my ferritin was very good, I think he said 60 but not sure.  He also said my thyroid was good.  I am seeing a new ob/gyn in Dec. and I will have him check me for menopause.  I was hoping to avoid hormones but if they will help I will try anything.  Thank you for all your help.

Call the doc and ask for all your test result. they can fax them to you, you cn pick them up or they can mail them. 
IMO - every time you have any labs drawn - make sure to get a copy of the results and keep that in your file.
As another person said - monitor your BS levels.   post op RNY - we do deal with Reactive hypo - and that may casue you to be tired. 
It may be combination of thyroids, iron, other vitamins, dehydrations, etc.   Onbe item - you would be Ok - but the combination of allof them - may be too much for your body.
BTW: you also mentioned 80 gr of proteins.  I used to try to get 80 gr per day. My Blood test show low normal protein levels. i was told to increase to a 100. Still low normal. Now I try to get 120-150 gr per day.     If i do not get enough, or get enough water + minerals - I feel really tired.

let us know what vitamins are you taking and how much.

BTW:  take 2 multi, B complex -50, biotin, D3 (10k per day), B12, calcium + magnesium, iron, probiotics, etc.     

I take 2 multivitamins, calcium w/mag and D and 10,000  vit D.  I was told I didn't need iron because I had the infusion and my levels are good.  I get about 100 oz of water a day so I know I am not dehydrated.  Also, I have very little malabsorption now since my revision.  
I am going to pursue the menopause thing since that is the only thing that I haven't had checked yet.
What kind of probiotics do you use?

Looks like you really cover it all.
I use the probiotics from Vitaminshoppe. They have the "10 probiotics" and I try to take 2-3 caps a day. good price - and i hope it is a good product - they put diffent bacteria to make sure we get them all..
http://www.vitaminshoppe.com/store/en/browse/sku_detail.jsp? id=VS-2164

If I were you I would get additional B. B-50. once a day. Then I would check my thyroids.
I felt extremely tired when my thyroid is low.
I sometimes run a test (in the morning). 
I take extra dosages of thyroid supporting supplements- and watch for reaction - "i.e. suddenly feeling warm, having more energy, feeling more nervous.."  
I do that once in a while.  
I take some form of iodine (I use natural seaweed extract ) 

or thyroid support pills by Gaia herbs - (I take 5 capsules on empty, together with extra B's and vit E with selenium)  If I feel warm all over     shortly after - I know that my my supplements converted the T4 into T3 or the my thyroid made more hormones...).
the Gaia soft gel caps has all what thyroid needs - and for conversion. 

http://www.luckyvitamin.com/p-32058-gaia-herbs-thyroid-suppo rt-liquid-phyto-caps-120-vegetarian-capsules

But - I would not waste the money yet - get a detailed thyroid panel (your Gyn can order that) if you do not have it yet.  BTW - as we get older - the thyroid has tendency to slow down... I know mine did... that and the darn soy protein I once took.  Almost destroyed my thyroid. it took me over a year of completely avoiding the soy to get my blood levels return to normal - mid range.
BTW, IMO - the TSH needs to be below 2... if it is more than that - some people (women in estrogen dominant stage - like in menopause - will get the symptomatic hypothyroid )
 and the T4 and T3 need to be at least in the middle of the normal range. 

I think there are a few avenues that you need to explore further: 

- thyroid
- iron
- HRT
- blood sugar levels
- blood pressure

BTW: my blood pressure was also really low- so i increased the salt intake (I use mineral salts - like dead sea salts, Himalayan salts, etc.) to get more minerals and to retain more water.   That also helped a lot.   It caused a water weight gain - but I do not care about 3 lbs as long as I feel better...