29 and exhausted... what could be wrong?

July 8, 2008 6:25 PM

I'm an otherwise healthy 29 year old male who easily gets exhausted and mentally foggy on a regular basis, sometimes seemingly without cause. Not normal-tired, but feeling as if I were 80 years old. It's been like this for at least a year and a half. I have an appointment to see a doctor (endocrinologist) in two weeks, but now that I've finally admitted to myself that I've got a problem... I'm antsy to start figuring out what it might be. Any ideas, hive mind? More details inside...

My symptoms are: slow, foggy thinking (almost like being drunk), low motivation, physical weakness/heaviness, emotional flatness, irritability, low interest in sex, low interest in much of anything, a general feeling of "drugginess"... feeling like an altered state.

Some days I have no symptoms at all. When I do have them, I usually start the day feeling fine, then the symptoms roll in all at once. Often around 3 or 4pm... lasting until the end of the day.

When I have my symptoms, caffeine seems to make them worse (especially mental fog). Alcohol, oddly, seems to make them better.

I took finasteride (Propecia) for 4 years (for hairloss), but quit 1 year ago, thinking it might be the cause of my problems. I initially felt better, but then went back to my symptoms, though only 1/2 as severe. This may be the cause or just made an existing problem worse. Either way, I'm more curious about what might have happened, rather than the reason.

Thanks, everybody.

posted by anonymous to health & fitness (31 comments total)

Congestive heart failure? Thyroid problem? Arrhythmia? Circulatory problems?
posted by orthogonality at 6:30 PM on July 8, 2008

When was your last HIV test?
posted by OmieWise at 6:31 PM on July 8, 2008

Hypothyroidism.
posted by hal_c_on at 6:38 PM on July 8, 2008

It could be a lot of things, and I think that guessing at this will just make you more worried.

I won't guess at anything medical, because I have no experience with that. However, I feel comfortable saying that you might be depressed.
posted by sondrialiac at 6:41 PM on July 8, 2008

I sometimes feel like that if I suffer a drop in blood sugar. Is there diabetes in your family? How's your diet?
posted by mikeand1 at 6:48 PM on July 8, 2008

My friend had symptoms like that when she was young and they were solved with a pacemaker. However, I think hers were actually more severe; she'd come home from school and just sleep for hours.
posted by crinklebat at 6:51 PM on July 8, 2008

Sleep apnea?
posted by trevyn at 6:53 PM on July 8, 2008

That sounds very similar to toxic mold exposure symptoms my friend had...great health otherwise, but then periods of mental fogginess, low motivation, overall weakness - even down to alcohol making him feel better. On days when he was away from the mold, he felt perfectly fine. but when he hit it, it could take 6 hours until he felt better. Have you kept track of what room you are in just before it happens? do you feel completely fine if you go out of town and away from your normal routine for several days?

I hate playing MeFi doctor, but I'm passing it on because it might take awhile before your doctor suggests it as a possible cause.
posted by ghostmanonsecond at 7:01 PM on July 8, 2008 [1 favorite]

When I have my symptoms, caffeine seems to make them worse (especially mental fog). Alcohol, oddly, seems to make them better.

That's highly relevant, and should be mentioned to the endocrinologist. Also try eating meals consisting mostly of one type of food (bread, potatoes, pasta, fruit, meat, etc) and note how you feel an hour or two later, if there's any difference. Do the same with drink if you can, specifically milk, fruit juices, and sugary drinks. It could be any of a wide variety of things, but good data always helps.
posted by aeschenkarnos at 7:03 PM on July 8, 2008 [1 favorite]

Seconding sleep apnea or possibly some sort of metabolic syndrome. Does eating sugar affect your mental fog? Does it bring it on?
posted by linuxgrl at 7:09 PM on July 8, 2008

Get a full metabolic workup at your endocrinologist. Make sure to get tested for thyroid function and parathyroid levels.
posted by moof at 7:18 PM on July 8, 2008

What is your diet like? Sounds like me after a large meal of bread and potatoes....sugar crasssssh. I have to be careful with carbs.
posted by melissam at 7:18 PM on July 8, 2008

Projecting wildly out of my own situation here, but how well are you sleeping? Your symptoms sound like what I experienced before I got treated for a (severe) case of obstructive sleep apnea -- keep in mind that it may affect those who aren't overweight and those who don't snore. It's progressive, and can lead to a truly dismal array of other health issues -- stroke, heart damage, depression, and auto accidents. The good news is, it's very treatable, and success rates are improving all the time.

None of this, of course, may have anything to do with your situation. Sondrialiac has an excellent point -- guessing's no good. Talk to your primary care physician. Good luck, and feel better soon.
posted by Kinbote at 7:20 PM on July 8, 2008

I have low blood pressure and sometimes have these symptoms if I don't eat enough. My doctor said to eat salty stuff before physical exertion, which seemed to help, but doesnt happen nearly as severely now that I eat more regularly and drink a ton of water. But, your symptoms sound more severe than mine were.
posted by drobot at 7:21 PM on July 8, 2008

I knew someone that used to have symptoms like yours, but they continued to worsen. When he saw his doctor, he discovered that he had an aggressive form of leukemia. The radiation treatment he had didn't work and he died less than 3 months later.

My fingers are crossed that you don't have anything like that, man.
posted by jozzas at 7:31 PM on July 8, 2008

I'm the same age and have had virtually the same symptoms. I baffled doctors for a couple years and was told the problems were everything from a misaligned rib to anxiety attacks. But now i'm fine. And let me tell you why.

Diet. and Exercise.

Turns out that sh*t actually works.

Seriously though. I was not overweight at all, but dropping 10 pounds by regular exercise and a good diet cleared everything right up. By "good diet" i don't mean any of that atkins, south beach, or whatever they sell books about. Just don't eat as much. And eat healthier. Oh, and drink water and take vitamins.
posted by pencroft at 7:33 PM on July 8, 2008 [1 favorite]

this sounds exactly like me. i have both hypothyroidism AND sleep apnea, and i'm sure both of them are contributing to the problem. i'd rule out hypothyroidism first -- if that's the problem, it can be fixed by taking a pill once a day. if it's sleep apnea, fixing it can be a bit more involved but it's still very manageable. good luck!
posted by djenigma at 7:38 PM on July 8, 2008

MSG sensitivity!

Do you feel drunk and weird after eating spicy sushi, canned soup, fast food, Chinese food, or Doritos? MSG is in soooo many processed foods. I had very similar symptoms, weird attacks of intense fatigue and mental loopiness. (Sometimes, if I ate something that was really high MSG like spicy sushi sauce, my skin would hurt. All of it. It was like having the flu but weirder.)

I totally cut MSG out of my diet, and along with regularizing my sleep schedule, I no longer have attacks of drunken-feeling tiredness unless I accidentally (or self-destructively) eat that shit.

Then again it could be your thyroid. You should totally see that specialist, but I just wanted to share.
posted by Tesseractive at 7:45 PM on July 8, 2008

lots of stuff here sounds worth checking out. i had similar issues, and, for me, it was my life-long food allergies finally catching up with me. four months ago, i cut out wheat, dairy, corn, and eggs from my diet. after horrific cravings for three days which stopped abruptly, i suddenly needed an hour less sleep each night and a decades-long lingering "malaise" that was getting worse and worse over the last couple years was gone. could be something else above or something not mentioned. if you make a list and starting ruling things out, you'll figure it out sooner rather than later. see a doc. (i'm 27.)
posted by zeek321 at 7:48 PM on July 8, 2008

Do you get enough sleep (8 hours+) and do you keep a regular schedule?
posted by OlderThanTOS at 7:53 PM on July 8, 2008

I get the seriously tired at 3 or 4 in the afternoon if I eat a big lunch. I've gotten around it by eating 2 smaller meals during the day (one at about 10:30 and another around 2:30), and not drinking more than one cup of coffee a day. Coffee can really mess up your blood sugar and can make you pretty tired after the initial lift. If you are getting enough sleep, you might want to look at your diet during the day.
posted by The Light Fantastic at 8:27 PM on July 8, 2008

My symptoms are: slow, foggy thinking (almost like being drunk), low motivation, physical weakness/heaviness, emotional flatness, irritability, low interest in sex, low interest in much of anything, a general feeling of "drugginess"... feeling like an altered state.

(IANADoctor)

The combination of brain fog and reduced libido seems characteristic of a low testosterone level, especially in light of your age. Most men experience a decline in androgen levels in their late twenties.

Also, you mention feeling OK in the mornings, when testosterone levels are at their highest.

You say that the symptoms improve when you drink alcohol. Acute administration of alcohol can raise testosterone levels.

(Please don't rely on the booze to feel better, though. Chronic administration of alcohol puts testosterone levels in the toilet. Come to think of it, you might want to kick the booze to the curb until your problem is solved.)

My suggestion: try some intense weight training (no cardio, because that's been known to depress androgen levels as well) and take zinc supplements. Add some high-cholesterol foods like steak, eggs and ice cream to your diet.
posted by jason's_planet at 8:32 PM on July 8, 2008

OP: People are throwing out everything under the sun. There's a reason for that. The reason is that low motivation, irratibility, low libido, fatigue, weakness, etc are about as non-specific as you can get. The number of ailments (physical and psychological) that cause those symptoms is incredibly large.

You might as well throw darts at a medical encyclopedia without some lab results or something.
posted by Justinian at 8:37 PM on July 8, 2008 [2 favorites]

I had symptoms like that until I was diagnosed with an iron deficiency. Get thee to a vitamin counter, and wash those suckers down with plenty of orange juice. I felt better within a few days.

Also keep in mind that the body finds it difficult to digest iron, which means you should also eat lots of food high in iron. Beans especially are good, and will help combat iron's other potential problem - constipation.
posted by GardenGal at 8:41 PM on July 8, 2008 [1 favorite]

It could be a lot of things. For me it's usually hypoglycemia combined with stress. But one time when it was really bad it turned out to be severe vitamin B12 deficiency.

After the B12 deficiency was solved, I still get crashes on stressful days but there are some things I can do to help: cut down on caffeine earlier in the day, eat small frequent meals high in protein, get regular exercise - especially if I feel a crash coming on.
posted by rhiannon at 8:44 PM on July 8, 2008

I'm also going to suggest hypothyroidism. I have been treated for this for about ten years.

Of the symptoms you list, these are the ones that I have experienced and have been attributed to hypothryroidism: 1) slow, foggy thinking (almost like being drunk) - that's a very apt description; 2) low motivation; 3) physical weakness/heaviness - especially the feeling of heaviness; 4) emotional flatness - either a numbness or downright depression, a frequent symptom; 5) irritability; 6) low interest - in ANYTHING, yes. 7) general feeling of "drugginess"... feeling like an altered state. Okay, that's all of them. I think, possibly, as far as the timing, that might be one of those YMMV situations. I would have the symptoms constantly, every day. Maybe they would subside at night around a traditional 'bedtime' time. Caffeine would make my symptoms worse, as well, though, I can't remember alcohol improving them.

Since you've got an appointment with an endocrinologist, you're already following my only bit of advice. Of course, it could be something else, but I would at least have the endocrinologist test for hypothyroidism. You might already know this, but thyroid conditions are extremely common, and they can be treated and controlled, in many cases, with medication and the occasional blood test.
posted by Mael Oui at 9:04 PM on July 8, 2008

For many years I had serious fatigue, including brain fog and a feeling like my legs were made out of lead. I was eventually diagnosed with multiple sclerosis. Luckily I don't have a serious case of it. the fatigue, brain fog, and other related symptoms are totally controlled by Provigil, to the extent that it's not an issue.

One indication of MS-induced symptoms is that they are made worse by heat, and they abate when you cool off. So, literally, if you're feeling lousy and you take a five minute cold shower and get your head wet (remember, MS is a disease of the central nervous system --- it's all in your head) the symptoms vanish. You can even make them go away be entering a very well air conditioned room.

An MS diagnosis is made with the help of an MRI, usually by a neurologist. If that's what it is, there are good meds that you should get on, including Provigil for the fatigue-related symptoms. Make sure you see an MS specialist. Many neurologists focus on other things --- sleep issues, epilepsy, etc --- and there's enough going on in the MS world that you want someone who is focused on it.

Good luck!
posted by alms at 9:05 PM on July 8, 2008

I heard a doctor on npr a few weeks ago describe these symptoms as "Fish Fog". She was seeing a lot of patients who eat a ton of fish with what ended up being mercury poisoning. Long shot - but it you are a big fish eater - something to keep in mind as a possibility should you find everything else is normal.
posted by Wolfie at 9:06 PM on July 8, 2008

I think what you can take away from this thread is: there exists a metric fuckton of possible causes for the symptoms as you describe them, and so you no longer need to be concerned that these symptoms are better left ignored -- start keeping a diary that describes your physical locations, dietary habits, proximity to allergens and the amount/quality of sleep you're getting, and bring that to the doctor that you should most certainly visit.
posted by davejay at 9:59 PM on July 8, 2008 [2 favorites]

Add in the possibility that you aren't absorbing B-complex vitamins properly.
posted by IAmBroom at 8:17 AM on July 9, 2008

Get tested for Lyme. And contrary to what the doctor may say, you do not need to have the "bulls-eye" rash to be infected.
posted by LC at 2:39 PM on July 9, 2008