How can I diagnose or treat exhaustion without seeing a doctor?
June 9, 2012 9:04 PM   Subscribe

How can I diagnose or treat exhaustion without seeing a doctor?

Here's where I'm at: I spent the past week reforming my habits in order to diagnose what certainly feels like abnormal exhaustion-- namely waking up tired and ready for sleep at eight or nine at night.

I gave up all forms of unhealthy snacking, I went on a diet of basic meats, veggies and grains, eggs, turkey bacon, yogurt, granola, nothing processed, started exercising, I gave up caffeine which I was assuming would be the big one-- still feeling mostly the same. I realize this stuff takes time but I can't shake the feeling that there's some other underlying culprit.

My weight apparently fluctuates 3 or 4 pounds throughout the day and I often feel (and look) bloated if that helps.

I'm not really asking for a diagnosis (though suggestions are welcome) but rather for some further steps to diagnose and treat this sort of thing.

posted by dr handsome to Health & Fitness (25 answers total) 4 users marked this as a favorite
Do you mind sharing with us why you insist on not seeing a doctor? It might help us better answer your question.
posted by ocherdraco at 9:13 PM on June 9, 2012 [1 favorite]

Many people with exhaustion find that they actually need a CPAP machine and their exhaustion goes away.

There's a lot of reasons for exhaustion and it can be more than just something causing you to *become* exhausted, but rather, can be something that prevents you from getting a good rest.
posted by shepd at 9:14 PM on June 9, 2012 [1 favorite]

Really, you should go see a doctor and have some bloodwork done. But that's in a perfect world where everyone has insurance and/or money.

Some other things to try: If you're having thyroid trouble, taking your temperature before you get out of bed in the morning for several days can be useful data point.

It's also possible you have some sort of food allergy or sensitivity, in which case an elimination diet might help. If you can't do a total elimination, then at least eliminating the top 8 allergens should provide you some useful information.

Note also that diabetes can cause fatigue -- from levels too high or too low. I'm not aware of a great way to measure blood sugar without sticking your finger. Do you have a friend with a blood glucose monitor who might lend you a lancet and a strip?
posted by Andrhia at 9:16 PM on June 9, 2012

Response by poster: Sorry, I totally meant to answer the question about not seeing a doctor: it's purely based on the lack of both money and health insurance.

And to answer the question about going to bed early: that doesn't -at all- help me with waking up exhausted and going to bed that early is unthinkable for most people with a regular job.

The allergy thing's helpful and has been on my mind and sleep apnea might very well be something for me to keep an eye on even if I don't, like, wake up in the middle of the night.

I was wondering if some form of acid reflux could truly be the cause of sleep apnea?
posted by dr handsome at 9:27 PM on June 9, 2012

The change in diet might be causing the bloating, depending on how radically different it is from your previous diet... Not a professional opinion, just a thought, since it's only been a week.

(Also revealed dr handsome is, in fact, not a doctor... or not a medical one at least)
posted by jorlyfish at 9:28 PM on June 9, 2012

Response by poster: The bloating thing's been a long ongoing problem-- totally not related to cutting back on my diet. But helpful answer!
posted by dr handsome at 9:32 PM on June 9, 2012

When I saw my doctor he recommended I take 2-5 mg of melatonin half an hour before sleepy time.

He didn't see any point in doing other testing when the obvious thing (not sleeping soundly) was easily treated. It helped my body get back in rhythm and after taking it for several months, I didn't need it anymore. He also gave me a big long list of pre sleep dos and donts.
posted by DoubleLune at 9:33 PM on June 9, 2012 [1 favorite]

How is your mood? Is there any chance there might be some depression or anxiety at work here?

Is a multivitamin a part of your new eating plan?

Bloating: I hate to be one of those annoying low-carb proselytizers, but it's helped me immensely. I notice a huge difference in bloat and energy levels on days when I dial up the carbs (esp. wheat products).
posted by quivering_fantods at 9:38 PM on June 9, 2012 [2 favorites]

Best answer: You should get tested to rule out iron (or vitamin B12) deficiency anemia. Are your nail beds, inner eyelids, or tongue especially pale? Sudden dizziness, rapid heart rate, bruise easily? Something to watch out for, at any rate.

If you can't afford a doctor's visit right now, one way to get tested for anemia is to offer to donate blood. If you're anemic, they won't let you donate, but at least you'll know--and if everything is fine, somebody gets a pint of blood. Win-win!
posted by doreur at 9:38 PM on June 9, 2012 [4 favorites]

Response by poster: Might need to start taking a multi-vitamin. Would the effects of that be noticeable in a weeks time? Because deliberately adding more vitamins to my body seems like a big step if I had some sort of vitamin deficiency, no?
posted by dr handsome at 9:45 PM on June 9, 2012

Do you have sinus issues? A sinus infection can cause pretty massive exhaustion, and it's not always the first culprit to come to mind if the infection is in the upper sinus (thus no stuff nose.)
posted by desuetude at 10:18 PM on June 9, 2012 [1 favorite]

After my son was born I came down with extreme anemia. I've been (safely) overloading on vitamins ever since. Best. Thing. Ever.

Give it a month to see a change.
posted by jbenben at 10:19 PM on June 9, 2012 [1 favorite]

Low protein can also cause exhaustion. If you're having trouble getting up in the morning, eat something protein-heavy before bed: cheese, meat, what have you. Also eat as soon as you get up in the morning. This can be a hard pattern to shift if it's unusual for you, but it truly does help with fatigue.

Food allergies can cause bloating, as can high salt, as can--interestingly--low potassium. The more salt you eat the less effective the potassium in your system will be. There's actually an ideal ratio, though I can't think what it is just now.

Fitday has articles on some of these issues, however. And, just in general, you might consider tracking your diet for a week or so, on a free nutrition-tracking site, like Fitday or Cron-o-meter. Both sites allow you to take easy notes on how you're feeling after a meal or throughout the day, which may start to illustrate a pattern if there's a food connection. It's also, in objective terms, kind of interesting to see just how well you think you're eating vs. how well standard nutrition judges your food choices.
posted by Violet Blue at 10:20 PM on June 9, 2012

When I was run down, a multi and a B vitamin complex always made a difference a lot sooner than a week. Taking a dropper of sublingual Liquid B complex from GNC makes it easy-- and my friend has nothing but good things to say about the transdermal B12 patch.

Part of my problem was being a vegetarian who never ate meat, so my doctor prescribed me OTC supplements and pan-seared beef liver (!) because the nutrients in real food are more bio-available. I hate to admit it, but it really delivers. If you can't bring yourself to eat beef, chicken liver is almost as effective. Eggs are super good for you, too.

These days, I eat salmon and blueberries as close to every single day as I can, along with either spinach or Brussels sprouts-- I'm full of energy, and I swear my skin looks as clear and rosy as it ever has. YMMV, but as someone who had the same sorts of symptoms, it works for me.
posted by doreur at 10:23 PM on June 9, 2012

Response by poster: Huh-- this is the last response I'll give for tonight:

I get massive amounts of protein in the morning, greek yogurt and protein granola and the meat should also help.

It's not a temporary thing so sinus infection seems unlikely. My nose is constantly stuffy but I'm pretty sure that's just a deviated septum.

Supplements seems like the most immediate thing to do-- gonna go get some multivitamins tomorrow.

The blood test thing sounds like a fantastic idea.

Thanks for all the help!
posted by dr handsome at 10:29 PM on June 9, 2012

I had this issue. I had full bloodwork done, and was found to have almost no vitamin D in my system, and was low in a couple others. I went on a high quality multivitamin, vitamin D, LOTS of omega 3's and probiotics. It took about six weeks to notice a difference, but I started to feel less exhausted and to heal better from exercise. Eventually I added a great meal replacement chock full of protein, vitamins, greens and such (Vega brand), and some greens. Six months later I'm a new person, I cannot believe the difference. I don't care what anyone says about not needing vitamin supplementation if you eat a normal healthy diet. I was depleted in some nutrients and was poorly absorbing others. The heavy duty regimen made a huge difference in my well being.
posted by tatiana131 at 11:14 PM on June 9, 2012

That sounds like me when my thyroid is wonky. It is very cheap to treat (generic is $4/mo) and the tests are straight forward blood draws. Cheap all around, as far as healthcare goes. At some point you might just need to get that tested. For some reason I put it off for years. And so, I felt like crap for years, no matter what I did. Now, I feel great. Once you've played around with all of the easy variables, it is probably time to see someone.

Also, to try: Floradix
posted by munichmaiden at 11:18 PM on June 9, 2012

Honestly, I'd say you really need to pursue some kind of medical testing and evaluation. There are likely sliding scale clinics in your community that can help, though you may have to wait a while for an appointment and be more assertive about your needs. Fatigue has a pretty wide range of causes, some of which are serious and others less so. Serious sleep apnea can, over the long term, cause brain damage and is linked to cardiovascular problems. Similarly, you really do want to know immediately if you have uncontrolled diabetes or your kidneys are failing. A lot of other causes mentioned in this thread can be ruled out with pretty basic blood tests. A single standard multivitamin is probably unlikely to do much harm if you feel like trying it out, but actually measuring the nutrients in your body and seeing if you have significant deficiencies is really going to be a better approach then randomly playing around with mega-supplements.

Keep in mind that fatigue and hypersomnia can also have psychological causes. You might want to look at some of the myriad of online resources on anxiety and depression and see whether anything sounds particularly familiar.

Good sleep hygiene practices are ultimately useful whether there's an underlying medical cause or not.

If you need help figuring out how to get the care you need in a way you can afford, maybe ask that next week on AskMe and tell us where you are.
posted by zachlipton at 12:16 AM on June 10, 2012 [1 favorite]

I'm not trying to scare you, but just putting it out there that exhaustion like this can absolutely be the start of something you really need to see a doctor for.

My stepmother was recently diagnosed with leukemia - the only symptom of which had been a gradually increasing exhaustion. Now, not saying you have cancer - but rather that since you've been doing your best to treat the symptom, you really need to find out the root cause because your current plan isn't working out.

The US healthcare system is shitty, for sure, and I sympathize with not having insurance. But if your efforts to curb the exhaustion aren't working, it might be because it's a symptom of something else and not the root problem in and of itself. Going to a see a doctor now might very well be cheaper in the long run if you can nip a larger problem in the bud.
posted by sonika at 3:40 AM on June 10, 2012

I agree with zachlipton that there are affordable sources of health care. Try googling for "federally qualified health center," "FQHC," or "rural health center," depending on whether you're in a city or the country.

Also, if you're not getting any exercise, try just a little walking or biking or something like that. It can rev you up, even if you don't really feel like doing it.
posted by lakeroon at 4:01 AM on June 10, 2012

Multivitamin with iron, Vitamin D, B12, and fish oil = does a body good
posted by k8t at 6:02 AM on June 10, 2012

I forgot in my earlier answer... I also recently had symptoms like this, and this time it was anemia and iron deficiency. I didn't think of this because I went in after my hemoglobin was low trying to give blood, but I definitely had the exhaustion thing going on for about a month before diagnosis and a couple weeks after.

So in conclusion, nthing seeing a doctor. They will be able to narrow down your symptoms. My previous doctor (when I didn't have health insurance) was really understanding about my lack of insurance and kept visits as cheap as possible ($25-$50 for the visit, never ordered bloodwork but was spot-on in every diagnosis, knew where I could get antibiotics for free/lowest price, etc.). Depending on your income and the state you're in, you may qualify for state-sponsered insurance as well.
posted by DoubleLune at 7:08 AM on June 10, 2012

Nthing the doc.

Sleep apnea isn't waking up during the night, it's stopping breathing during the night. HUGE difference. Husbunny snored like a mo-fo, and stopped breathing. As his bedmate, I noticed it and a sleep study confirmed it, he's hooked up to a CPAP now and it's changed his life.

I have anemia and it's no joke. I'm limaceous most of the time, although I take vitamins, eat meat (when I used to eschew it) and lots and lots of leafy greens. I suspect an absorbtion problem because I still wanter around pale and tired. My cross to bear I guess.

You've done what you can on your own and it's time for bloodwork. Look for univeristy clinics, county health departments, etc for lower cost care. But hie thee to a doc.
posted by Ruthless Bunny at 8:38 AM on June 10, 2012

Another possibility: something in your environment is awry. Any chance you might have a natural gas leak in your place? How about mold?
posted by quivering_fantods at 11:52 AM on June 10, 2012

Response by poster: I just donated blood and my blood is "very healthy" which is reassuring. I know there's a paper I'll be getting back with more information but it's a step... and donated blood!

I have been taking the multi-vitamin on and off but now's the time to reinforce that habit and keep some sort of regular track of my sleep schedule, diet, etc.

The thing is, even if I'm a complete hypochondriac (which I'm not, I'm merely exhausted, concerned, and proactive) but even if I am this stuff will be a great start to a much healthier lifestyle!

Thanks for all the suggestions guys!
posted by dr handsome at 10:50 AM on August 26, 2012

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