To want to know why I feel so tired/ill all the time!!

I may have missed this but do you know your ferritin level? Your symptoms do sound like you need more iron, and much more than a supplement. Like people have said, get ferrous fumarate from the chemist, you don't need a prescription. But do find out your ferritin levels first. Your heavy bleeding has surely left you with an iron deficiency. I was also experiencing flooding, but not as regularly as you describe, and I became anaemic as a result.

Not RTFT but posting before I forget - Greek yoghurt contains tryptophan which can make you feel sleepy, it makes me feel like I need to go to bed. I know this might seem random but I noticed you say you might have it for breakfast and dinner…

No wonder you are tired. You’ve a very busy schedule, physical work on top of 20 k steps.
I found probiotics great and if you can get in ten min cat nap. I close my eyes for ten mins most days it gives me a boost.
Obviously take a health check too.

No but having caffeine close to taking iron will stop absorption. So for future just avoid caffeine, its best to take it first thing with vitamin c and then avoid caffeine for as long as possible but at least an hour.

With everything that’s happening are you feeling depressed? I was like you exhausted and I didn’t know I was depressed. I wish you all the best and hope you find the cause. 🙏

Honestly your doctors sound useless as it very much is a symptom.

Do you think you could afford a private appointment with a menopause specialist? I think I paid £300 for a one off appointment or they do around £100 a month and it includes all HRT at menopause care and they do online appointments. They can also recommend what is needed and then send it to your GP which is what I did.

I think its genuinely sounds like a huge combo of things. So you have the Neurodivergence will have an effect, then you are having heavy periods and low ferritin all affecting iron, you are potentially perimenopausal and you do huge amount. Most people would be exhausted with all this going on.

It can be hyperactivity of the brain - so if your brain is constantly thinking eighteen things at once, and you are trying to filter out the nonsense and focus on what is currently necessary, then that is exhausting - the equivalent of having to concentrate in an exam. All day every day. Shutting out the ADHD noise can be a really horrible, difficult thing. Imagine trying to have a serious conversation while workmen are drilling outside your house, two children are tugging on your clothes screaming 'Mummy! Muuuuuummmm!' a TV is blaring, your phone is ringing, there's a knock on the door, someone is playing a loud game on their computer, heavy metal music is being played at top volume by your next door neighbour, and your partner or boss is shouting angrily at you from two floors away, all while you try to make an important decision or have a a proper conversation with someone. That's what ADHD brain noise is like at its worst - and it can be like that for hours every day.

My god, that's heavy, darling - you must be so anaemic! 🤗 Are they not able to help you with that? Ever tried mefenamic acid (from GP)?

I thought adhd was linked to hyperactivity

You will feel noticeably better when your ferritin is up to around 75-100. I was you - I am 42 and last year got to a point when even walking up the stairs was difficult. Since then, I corrected my iron (and a couple of other deficiencies) quit alcohol and nicotine, focussed on eating a mainly whole food diet and exercise regularly and I have more energy than I have ever had in my life. So I also obviously don’t have Peri - as is the first thing that everyone suggests to every over 35 year old when they have literally any symptom.

4 litres a day is a crazy amount of water. It could seriously dilute essential electrolytes and symptoms include drowsiness and dizziness. Cut back to 2 litres a day.

If you dirnk that much, the thirst could be a symptom of diabetes - have you had your blood sugar levels checked?

One thing that causes extreme exhaustion is low Vitamin D. Did you end up spending more time indoors this summer, due to the very hot weather? It's worth taking a Vitamin D spray to see if it helps. Anothe common cause is low iron levels, and the NHS levels considered 'normal' are way below those of most western countries. As long as you don't already have high iron levels (which can also produce tiredness) it's worth taking a liquid or plant based iron supplement like Feroglobin or Floradix, as these don't have the constipation side effects that other iron supplements can cause.

Did you have flu or Covid? You could have post viral fatigue. It is crippling. I got it, as did a friend and her son, when we all came down with flu at the same time. It took us three years to fully recover, and only by stopping work and school for a few months to rest completely. It's one of the most horrible, frightening experiences I ever had. You have a very physical job, so it would be hard to recover quickly from this.

Maybe a silly suggestion - but have you checked the products you use when cleaning? Could some of them be toxic? can you simplify your routine and limit yourself to very safe products for the next few months?

I’m not saying that the lower calories are the full picture of why you’re tired by the way, hopefully it didn’t come across that way.
I also have had low ferritin and I can always tell when it’s dropped again. It’s like going from colour to black and white. And exercising 4 x per week plus 20k steps while having a low ferritin is probably stressing your body, making your weight loss so hard.

I think you need an intense period of trying to activate your parasympathetic nervous system. Looking after yourself truly 💗

Did they check all vitamins D, Iron, Thyroid?

I think most people need to take vitamins.

I take magnesium glycinate from Solgar
Menopace Vitabiotics
Omega from Onvits?
Vitamin D.

How is your gut? Do you take probiotics/kefir?

I would go back to another dr.

@EricTheHalfASleeveare you a GP by any chance? I could never get my ferritin above 30, even with over a year of high strength supplements. Had an infusion in January, and the difference has been amazing. I also used to suffer from recurrent UTIs, and since the infusion, I haven’t had a single one. Could be a coincidence, but I do wonder if my immune system has improved since the infusion.

I get that frustration. The question is - how quickly did you gain the weight? If it was immediate / short term it’s not likely to have been fat. The scales are one thing, but when you’re strength training the scale is only one metric. We need to measure, yes, but look at weekly trends not individual measurements. Sometimes it is even worth stopping weighing in and just going by how you feel. Energised and strong Vs tired and depleted.

If someone said to you, I promise that you will lose fat BUT the scale will definitely go up and not down, would you be happy with that? Theoretical question but it’s asking what your real goal is.

The question is are you aiming for low weight and frailty, or a static or even increased weight (probably temporarily) for better body composition and health? It’s a long game. I’ve struggled with this mental shift.

Have you had a scan of your gallbladder. My bloods took 2 days to 'peak' during a big flare up where I was hospitalised.

I forgot to say when you switch to the high dose iron, take it on alternate days. Not every day.

That's partly to ease any side effects on your digestion, but mainly because the high dose triggers the release of a hormone that then stops you absorbing more for 24-48 hours.

I did wonder OP. It’s explained a lot to me in terms of tiredness levels. Life is more exhausting if you are ND.

I would recommend trying to fit in a bit more genuine rest in to your day. You sounded so self critical ‘I then sit on my arse’ but you have two cleaning jobs! You are physically active for at least 4 hours and then everything else on top of that. Add in the loss of hormones when we go in to Peri…

Perimenopause has also been shown to be harder for those with neurodiversity.