Why am I so tired?
March 28, 2011 8:16 AM   Subscribe

What is wrong with me? Why am I so tired?

I am so tired.

First off, yes I saw a doctor. In my city it is nearly impossible to get a PCP. After daily calls to multiple offices for 3 months, I finally got into see one. I told him my symptoms. He did a bunch of blood tests. There was nothing. He said good luck. Before you answer "Find another doctor" please believe me that it is very hard to find one and although I'll keep calling around, it isn't something that is going to help me in the short term.

So, my symptoms, which started about 6-9 months ago:

- I am incredibly tired all the time. I go to bed at 8 or 9pm, wake up a few times during the night to breastfeed, and sleep until 6:30am. I fall asleep breastfeeding my kid (in a dark room), and on the occasion that I try to stay up to leave his bed, I am so exhausted that I cannot force myself to get up. On the very rare occasion that I do get up and leave the room, I am so tired that I can just make it to use the bathroom, get a glass of water, before needing to lay down again.
- When I wake up I need to psych myself up to get out of bed, telling myself "you'll get up, pee, undress, shower, brush teeth..."
- I take a multivitamin, a B vitamin, and fish oil - none of which have helped.
- I have a new fulltime job, a 2 year old, and a parttime job that takes up most of my weekend. Without question I am getting no "relaxation time" but there is no way around that. I am very stressed out right now. (And I don't have any time to exercise given my work schedule, my commute, my child, and my 2nd job.)
- I am breastfeeding my 2 year old, but only at night. I will probably be weaning him somewhat soon, but I haven't yet because I have no energy in the evenings to put him to bed any other way than breastfeeding.
- I have lost ~15 lbs. from my normal weight since reaching my "normal" weight after the birth of my baby. I eat a ton, yet I am thinner than when I was a teenager.
- During the day I am in a bit of a fog.
- I feel constantly dehydrated, despite drinking ~60 oz. of water a day.
- My mother was diagnosed with an autoimmune disease last year, so I asked to be tested for that. Everything turned up negative.

As I said, I told all of this to my new PCP. He did some blood test. I got the results in the mail and a phone call saying everything is normal and that I should try to rest/relax.

WTF is wrong with me? I realize that it is entirely likely that I am just stressed out to the max.

And, of course, you are not my doctor.
posted by anonymous to Health & Fitness (38 answers total) 11 users marked this as a favorite
I have a new fulltime job, a 2 year old, and a parttime job that takes up most of my weekend. I am breastfeeding my 2 year old.

Just READING that makes me tired.
posted by roomthreeseventeen at 8:18 AM on March 28, 2011 [52 favorites]

'being tired all the time' is kind of a notoriously difficult thing to diagnose, from what I understand. There's probably thousands of things that could be the cause of it, from depression to an infection, to toxic mold, to dietary deficiencies. I went through a terrible phase a few years ago where i literally would get exhausted walking up two flights of stairs, and I'd have to stop my car on the way home from work to take a nap a few days a week.

Turns out that the building had recently replaced a bunch of filters in their AC system and kicked up a bunch of toxic mold. After a few months, everything cleared up and I was back to normal.

Personally, I'd focus on the weight loss aspect of it with your doctor, since that's a real physical symptom and should be easier to find the cause of.
posted by empath at 8:22 AM on March 28, 2011

This is SUCH assvice, I do not have babies, I am not a doctor, but I wonder if your body- the weight loss, the dehydration, the sheer exhaustion- is trying to tell you it's time to wean your baby. It kind of sounds like he's bigger now and so hungry that you can't eat and drink enough to get in enough calories and nutrients for you both, even with him only breastfeeding at night. Mamas needs uninterrupted sleep eventually, too, especially mamas with two jobs.
posted by Snarl Furillo at 8:24 AM on March 28, 2011 [12 favorites]

Maybe see a nutritionist? I've been reading that the reason why so many of us are tired all day is that the standard American diet makes us malnourished.
posted by any major dude at 8:26 AM on March 28, 2011

What my doctor told me "you are a mother." You have a huge amount on your plate, and it will exhaust you. You may also have some depression like I did. You are at an overwelming place in your life, and need to take care of yourself better.

That means somehow finding time to relax, exercise, and eat well. I still struggle with this and my kids are now teens but it is really true. You really need to stop breastfeeding so you can get some more solid nights of sleep, and you are not being drained of nutrients/dehydrated (no pun intended). Your body is telling you it is too much to handle. It might be hard for a week or two getting them to sleep but the payoff will be big.
posted by maxg94 at 8:27 AM on March 28, 2011

I have a new fulltime job, a 2 year old, and a parttime job that takes up most of my weekend. I am breastfeeding my 2 year old.

THIS is why you're tired. This and stress.

Is there ANY one of those things (full time job, part time job, breastfeeding) you can let go of? At least over the next few months? I realize that you're probably taking on two jobs to cope with making ends meet, and I hope to GOD that I'm not coming across as critical of breastfeeding (in principle, it's not my business), but it just looks like you're trying to do three things when you only have energy for two, and that your own health is the cost. I had to make a similar choice when I was juggling a full-time day job and TWO completely different theater-related careers; after a couple years of that I noticed I was living in a state of chronic sleep deprivation, and the only way to fix it was to let one of those three things go. To this day I get people wondering why I gave up stage managing -- that's why. I can't afford to get rid of the day job, I didn't want to give up the writing -- so stage managing is what I had to give up.

And it looks like you've got the same thing. There are three things you really want to do, but you only have the energy for two, and your own health is being compromised as a result. I know it's a tough choice, but it's a choice you may need to make for your own sake.

In the meantime -- someone suggested magnesium supplements when I was having trouble sleeping last year. They did help me a lot -- but not in the sense that they helped me get TO sleep. What I noticed was that no matter how much or how little sleep I got, the magnesium made sure it was good QUALITY sleep. You may not be able to do much about how much sleep you can get, but maybe improving the qualitY OF that sleep would also help.

Good luck.
posted by EmpressCallipygos at 8:28 AM on March 28, 2011

I think you should listen to the doctor that you saw. He told you he couldn't find anything wrong in blood tests, but he still PRESCRIBED you a treatment, which was to REST and RELAX. Stress alone is capable of causing all of these things. You can't keep living like this.
posted by smokingmonkey at 8:31 AM on March 28, 2011 [5 favorites]

I have a new fulltime job, a 2 year old, and a parttime job that takes up most of my weekend. I am breastfeeding my 2 year old

I am male and don't have 2 year old, let alone breast feed, but having a fulltime job, let alone a new one, and part-time job on the weekend exhausts me. I can't imagine doing what you're doing and not being mindnumblingly tired and cranky. Something has to give with you.

One thing that did help was exercise, particularly swimming. It gave me more strength to deal with those long days, but of course, finding the energy to go swimming was hard at first. But worth it!
posted by Brandon Blatcher at 8:35 AM on March 28, 2011

Of course you're tired! If you're not willing to wean, I can only suggest that you eat a ton more protein, rather than carbs, and stop the nighttime feedings. Punctuated sleep isn't really restorative. Waking up a few times at night to feed a two year old strikes me as a pattern that's not helpful for either of you.
posted by Ideefixe at 8:39 AM on March 28, 2011 [1 favorite]

To may want to ask to get tested for sleep apnea if adding more downtime and better eating to your routine doesn't help.
posted by damn dirty ape at 8:46 AM on March 28, 2011 [2 favorites]

I work full-time and am the mother of a two year old. I am tired all the time. I am also nearly halfway through my second pregnancy, so I am extra tired nearly all the time.

BUT, and this is a big BUT, my vitamin d levels are also insanely low. Like, when I was tested for it the first time a year ago, my vitamin d was dangerously low --- contracting rickets low --- so my NP told me to take a 1,000 UI vitamin d supplement on a daily basis.

And about a month after starting it, I was not completely wiped out all the time. I was still tired because I work full time and have a two year old, but I was no longer at the I-can-barely-function-I'm-so-tired state any more.

A lot of doctors don't test for vitamin d levels, but if you live in a northern climate with little sun in the winter (New Englander from birth, here), that could very well be it. I'd definitely have your vitamin d levels checked if they haven't been. Odds are you're iron was checked, but that would be the other culprit for that type of exhaustion. It certainly wouldn't hurt to eat some extra iron rich foods for a few weeks and see if that doesn't help you feel a bit better.

Also, the weight loss could be due to both breastfeeding and running after a toddler. I know I lost 7 lbs over the summer without even trying simply due to keeping up with my son, and I know I don't always drink enough water. Try upping your water intake, too.

I am not a doctor or otherwise a medical professional. But I am someone who can completely and utterly commiserate with you.
posted by zizzle at 8:48 AM on March 28, 2011 [1 favorite]

Sounds like you should be tired. Have you tried power napping? It only takes 15-30 minutes and doesn't require that you completely lose consciousness.
posted by justkevin at 8:54 AM on March 28, 2011

Crushing fatigue and constant thirst: The first thing I would try is gradually but massively increasing your caloric intake. It worked for me.
posted by zeek321 at 8:54 AM on March 28, 2011 [1 favorite]

Did the blood tests include a serum ferritin level? Was it less than 50 ng/mL? The reference ("OK"/normal) ranges for women used by labs can still be kind of low, and there have been studies that low serum ferritin can be associated with fatigue (and depression) in women, even if there is no anemia present.
posted by needs more cowbell at 9:00 AM on March 28, 2011 [1 favorite]

You have reason to be tired. It sounds like you're actually exhausted and emotionally depleted, too, though. Relaxation time is important not just so you get rest but so you connect with yourself and have some time that's free from demands on you from others.

I would also suggest that you might be somewhat depressed. Comments like "I am very stressed out right now," not wanting to get out of bed, and having a whole bunch of stress factors - job changes, recent family illness, having a baby - can trigger that. Blood tests won't surface that for you, so you might want to explore that with a doctor or therapist?

Is there someone in your life who can give you some childcare respite?
posted by Miko at 9:04 AM on March 28, 2011

In addition to Vitamin D, how was your iron level? Maybe take a good bio-available iron supplement in addition to your multivitamin.

FWIW, I went to see the doctor for severe fatigue last year. I was exhausted at the level of "collapse on the sofa every day and wonder if I'm secretly in the first trimester" exhaustion. After blood tests she put me on extra vitamin D, iron, and cytomel for a very borderline hypothyroid test result. It was "just barely normal", so sub-clinical. Those three together really, really helped within the space of a few weeks. So even if your tests didn't show you hypothyroid, if they were on the low end of normal, it might be worth following up on.

-- oops, x-posted with needs more cowbell
posted by instamatic at 9:04 AM on March 28, 2011

Are you married? If yes, your husband's (or wife's) next week is going to suck while he sleep trains your two-year-old to do without mom at night and go to bed without nursing. You're too tired to manage the week of hell it will take. Your husband can do it. After that he will sleep fine without getting up in the night or needing to nurse to go down. Spend a few days prepping him about how big boys sleep all night or whatever if you must.

Weaning will help with the exhaustion and dehydration because you'll get to keep more of your calories for you, won't be as dehydrated from nursing, and will get complete nights' sleep.

In fact, if you can swing it, go spend two nights at a nearby budget motel. Come home in the day, do your normal thing, go sleep the first two nights your 2-yo is without you at the motel so you can sleep alllllllllllll night.

The problem with little kids and sleep is that by the time you're so tired that sleep training becomes mandatory, you're must too tired to cope with sleep training.
posted by Eyebrows McGee at 9:05 AM on March 28, 2011 [14 favorites]

Nthing vitamin D, and try adding vitamin B12. I notice the difference from adding these two. And Cytomel has been a godsend to me!!!
posted by jgirl at 9:09 AM on March 28, 2011

The only way to be kind to yourself and your kid at this point is to get your kid to sleep through the night, or at the very least, go down without nursing. At this point, you're depriving your kid of a mom who's functional and alert, and you're depriving yourself of an acceptable life. Been there, done that.
posted by chesty_a_arthur at 9:10 AM on March 28, 2011 [2 favorites]

I read this as pretty basic lack of sleep. Your body generally performs best when you have 4-5 cycles of uninterrupted REM sleep. Even 3 cycles is decent. From the sounds of things you are probably getting one then woken up then another then woken up. Not ideal. And you will probably never feel rested until you are able to sleep for longer stretches.

Also, not a doctor, but thats my opinion.
posted by WickedPissah at 9:38 AM on March 28, 2011

Unexplained weight loss, fatigue, and thirst are CLASSIC diabetes symptoms. Go somewhere else to get your blood sugar tested right away -- just go to one of those walk-in urgent care places. A lot of city or county healthcare agencies will also offer blood sugar tests for free. If those results are abnormal, then go find an endocrinologist and don't bother with a PCP unless you have to for insurance.
posted by yarly at 9:48 AM on March 28, 2011 [14 favorites]

IANAD. Fatigue and weight loss - have the doctor take a look at your thyroid. A visit to an endocrinologist may be helpful to take a look at your various hormone levels.
posted by VikingSword at 9:48 AM on March 28, 2011

I missed the "thirst" symptom. Yes, this might also be diabetes. Do you have a constant need to pee as well?
posted by VikingSword at 9:53 AM on March 28, 2011

Planned Parenthood also tests blood sugar as part of it's services. I know you are frustrated, but persist with your doctor. Sometimes you need to be the squeaky wheel.

What tests did your doctor run? that would be helpful information.
posted by annsunny at 9:57 AM on March 28, 2011

In lieu of a nutritionist : there is software that is a little daunting,
but incredible once you are used to it called NUTS : http://nut.sourceforge.net/
and what he learned developing the software http://nut.sourceforge.net/nutnotes.html

I now see they have a GUI ! - before it was CLI only

To track your food - and compare the food with the highest amounts of (x) whatever.

That said - the developer once wrote - if he could only take two supplements it would be chromium picolinate (deals with sugar levels) and vitamin B12 ( sub-lingual )

I am so not a doctor - I am almost the opposite of a doctor
posted by epjr at 10:15 AM on March 28, 2011 [1 favorite]

I feel constantly dehydrated, despite drinking ~60 oz. of water a day.

Besides diabetes, this is a red flag symptom of primary aldosteronism, which I was recently diagnosed with. For a PA diagnosis, you would likely have other symptoms including headaches and hypertension. The diagnostic test for this is a blood test for aldosterone and renin levels. Most PCPs don't do this routinely because in med school they are told it's rare. If you happen to have any of the other symptoms of PA, it's worth mentioning to your PCP.
posted by chez shoes at 10:16 AM on March 28, 2011

I don't know how to say this gently, but the idea of getting up and out of bed several times a night to nurse a two year old sounds crazy to me. Think about it - you've been getting up several times a night for over TWO YEARS, of course you're tired. It's not good for you, and it's not good for your toddler, who also needs consolidated sleep and the skills to achieve it himself. How you stop it is up to you, but I would probably wean cold turkey since you're not nursing at all during the day. I would give him a few days notice and talk up big boys not nursing and getting special *whatevers,* then the day you've decided to stop, get him a fancy new cup for his warm cow's milk, maybe a special new bedtime book, and after your bedtime routine, put him in bed. You may need to return him to bed lots of times (or listen to lots of crying if he's in a crib), but once he's asleep, I suspect the night waking won't be quite as much trouble. If he wakes wanting to nurse, I would just explain (briefly!) that big boys don't nurse and you love him and will see him in the morning. And repeat. And repeat. I would be surprised if it takes more than a few nights for him to be sleeping and you to be feeling much, much better.

And on top of that, of course, it sounds like you're working a lot, and I would imagine just stressed and run down and without much personal time. I do think that if you stop the night waking you'll be better able to deal with some of the other things though.
posted by robinpME at 10:29 AM on March 28, 2011 [5 favorites]

I rather suspect the blood tests the OP mentioned included blood glucose. I mean, I'm not ruling diabetes out; the symptoms are classic, and I know firsthand that one can get type 1 as an adult (not just type 2). But I suspect those who are suggesting that she's just exhausted and overworked have it right. And, not to pile on, but I agree that the toddler needs to be weaned and sleep through the night on his own.
posted by kestrel251 at 10:41 AM on March 28, 2011

It is okay to call up the doctor's office and ask them to mail you a copy of your tests for your own records. Then you know exactly what he tested you for, and if some of the suggestions in this thread have already been done. Also you'll have those results if you find another doctor, and be able to compare.

If you try various things and decide you still need another doctor's input, an internist may be more interested in hunting down a mysterious issue than a general doctor.

And FWIW, I was able to think a lot more clearly and got more energy when I was able to start sleeping through the night, after years of sleeping poorly. Just reading what you do makes me feel wiped out, but if you can get to sleeping through the night you could at least find out if that's the main problem.
posted by galadriel at 11:15 AM on March 28, 2011

"I have a new fulltime job, a 2 year old, and a parttime job that takes up most of my weekend."

I... yeah. There's yer problem. I would be questioning if you WEREN'T tired.

There is nothing wrong with you. You are simply operating at full speed, running on fumes, working at maximum capacity... pick your favorite metaphor.

Eat as well as you can. Food is the fuel that makes you go, and if you've been skimping on your nutrition (out of sheer exhaustion), it's going to make a big difference in your performance.

Take care of yourself as best you can. Remember that asking for help is not a failure or a sign of weakness.

Look at your finances. Take what you're earning from your part-time job, and subtract the cost of childcare (if applicable) from your take-home (i.e. after-tax) amount.

Then look at what's left and ask yourself if there are places in your budget you could cut, that would equal that amount. Get a cheaper car? Find a cheaper living situation? Only buy thrift store clothes? Cancel cable?

I'd rather see you cut some more corners and have the weekends free, than working yourself into an early grave.
posted by ErikaB at 12:40 PM on March 28, 2011 [1 favorite]

As a mother who breastfed back in the 1970s and as a grandmother of recently breastfed babies I urge you to wean your baby. You cannot afford to keep nursing, your body is depleted. Give him a bottle, tell him mommy milk is all gone. Actually, it's a miracle that you're still producing any. Your symptoms could also be situational depression caused by the stress in your life.

Are you a single parent or do you have a partner? If you do have a partner make him or her carry more of the weight in terms of money and childcare.

If you're alone you need to reach out to family and friends for support. I hope you start to feel better soon, please feel free to memail me if you need a supportive virtual auntie.
posted by mareli at 1:53 PM on March 28, 2011

I rather suspect the blood tests the OP mentioned included blood glucose.

Yeah, probably, but doesn't hurt to re-do the test.
posted by yarly at 2:42 PM on March 28, 2011

Anecdotal, so take this with the applicable grain of salt.
A very good friend of mine was in a similar position. For nearly two years, she was completely exhausted, despite sleeping as much as she could, and eating well. Her GP told her that she was a busy, working mother of two, and of course she was tired, it was to be expected.
She was unhappy with that diagnosis, and after a time, she began to explore different diagnoses and treatments. One day, it was suggested to her that she may have an allergy, was she ever tested? No, she hadn't been, those were not part of the normal exams her doctor had ever run. She went to an allergist, and discovered that she has a serious sensitivity to both eggs and wheat. It has been six weeks since she cut the two out of her diet, and her energy is returning to near-normal levels. YMMV.
posted by msali at 2:46 PM on March 28, 2011

Nthing the advice to check your blood sugar. How is your diet? Do you eat a lot of processed flour/sugar/fried foods?
posted by getawaysticks at 2:48 PM on March 28, 2011

Even if it isn't diabetes, I'd cut waaaaay back on the carbs and refined sugar. When my kids were small and I was sleep deprived, I'd eat sugar (the carby, baked goods kind) to give myself a boost. It was a never ending spiral. Cutting out simple carbs might normalize blood sugar if it's out of whack. If it's a wheat allergy, you win there too.

But the thirst and the weight loss, yeah, that sounds like diabetes.
posted by madred at 4:33 PM on March 28, 2011

Is there any chance that you could be pregnant again?

Has your Dr checked your:
B12 levels?
Iron levels?
Vitamin D levels?

Screened you for:
Glandular fever?
Ross river virus?

Referred you for a sleep apnoea check?
posted by Sockpuppets 'R' Us at 4:41 PM on March 28, 2011

Try adding a non-sedating anntihistamine to your daily arsenal. I get tired - like, fantasizing- about-sleep-dead-on-my-feet-fucking-godawful-fatigued when I don't take mine. I don't *feel* like I have allergies most of the time - no congestion, no itchiness, etc - but I am knock down drag out exhausted. OTC generic Zyrtec or Claritin, the non-decongestant kind, are cheap and effective.
posted by 8dot3 at 7:26 AM on March 29, 2011

8dot3, Claritin can have faint drowsy effects on some people, even though it's proclaimed non-drowsy. I went through a phase of thinking I was either really depressed or developing some mysterious chronic disease until I ran out of the Claritin I was taking daily. Suddenly the almost irresistible urge to climb into bed for hours mid-day went away. Just something to be aware of if you're already dealing with fatigue.
posted by needs more cowbell at 8:18 AM on April 4, 2011

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