Constant lethargy but all bloods etc normal

[ShouldersBackChestOutChinUp]

So I always feel so sluggish and weary. Everything is such an effort.

I'd rather snuggle down for a three hour nap every day than do anything else.

I walk 5kms every day with dogs. Active with dcs in the summer holidays. At weekends, I often sneak off for a snooze and leave dh to play with dcs or ferry them about.

I long to be energetic and bouncy and have go get 'em energy. Blood tests and thyroid checks all come back normal.

I can't just be lazy, can I? I don't think I'm depressed. Am I just a sloth-like person?

How do you get your energy levels up?

Same, have felt exhausted for years. Had all bloods including thyroid and iron check, all normal. I get tired just having a shower. Dr recommended I take up HIT training 😂🙄

Hi NanaNelly,
Sorry, yes they did. It was 66 ng/ML. I don't know if that is low?

Same here. I'm wondering if it's B12. I'm "normal" at 350, but in Japan normal starts at 500!!

When was your boiler last serviced?
I'm thinking about carbon monoxide.

Hi, these figures are off an NHS site but different countries have different ranges just as some countries consider low blood pressure as a health concern whilst others don’t.

FERRITIN guide to interpretation:
Low: Less than 15 ug/L
Borderline: 16 – 40 ug/L
Normal: 41 – 400 ug/L
High: Greater than 400

I felt ghastly for ages and my extensive reading left me thinking that for a woman anything under 90 isn’t good.

would you be willing to try a ferritin supplement to see how you feel a month or so from now.

Do you sleep well? I'm one of those unlucky people who feel like this if I don't get 7.5-8 hours a night. Hate going to bed early but it works. Are you bored with life? Could be a symptom of depression or anxiety.

What counts as 'a little low' for b12? Anything under 500 can give you shocking fatigue.

Definitely up your B12. Injections are meant to be better than tablets and you can get them done privately if your GP won’t agree to them.

Did they run a ferritin test? It’s not standard as part of a full blood count. My teenage daughter was exhausted, faint etc for ages. Kept saying iron was ok, then they finally took her ferritin, and it was 8, very low. Since she’s been on supplements she’s so much better (and on the pill as since her periods began that’s when her iron issue began as her first period ended up with a blood transfusion as the bleeding wouldn’t stop)

Thank you for the replies!! Akite, Luggagerack and Goldenbag, my B12 was 101 which I was told was borderline. I will look into injections but I've been on supplements for ages so it's odd it's not come up. The ferritin looks like it falls in the normal range but I will definitely try a supplement NanaNelly, thank you! Smallestintheclass, I sleep like the dead but wake up exhausted already. I don't think I'm depressed, though having no energy is not helping my mood it's true. Mrsmoasty, that is a scary thought! We have a CO2 alarm in the house but I will move it closer to the boiler to be sure. We get the blasted thing serviced every year as we got that as part of the package when we upgraded a few years ago.

I keep trying to find some tricks and techniques to get past the tiredness but it's like hitting a wall. :-(

@dreamingbohemian would you mind sharing who you did your test with, please? This whole thread rings so true for me - exhausted all the time but blood tests came back clear.

@Thewolvesarerunningagain 101?!?! Jesus, I'm surprised you are able to function AT ALL. Mine was 103 when I was diagnosed with pernicious anaemia and I was 'lucky' that it was diagnosed very quickly because of how very low my levels were!!
unless that is your active b12, you are extremely deficient and you will need to push for treatment for that asap.

I ordered tests online from Monitor My Health, they also do Vit D tests I think? The thyroid test was £30. They send the kit to your house, you have to prick your fingers and bleed a bit into a tube, then you pop the kit back in the post to them. It took a couple days to get the results. Then I went to the GP when they came back abnormal, he sent me for a proper blood test which confirmed it.

Just thinking about Vitamin D, this deficiency can also cause a lot of the symptoms on here, my DH had this some years ago. It couldn't be corrected with regular supplements, he had to take a prescription dose.

Hi Akite
I'm not sure, it just says 'Serum B12'. Is that active B12? Thank you for the reply!

For my money, your thyroid is underactive, your B12 is very deficient and your ferritin is suboptimal.

I would return and ask for a blood test for pernicious anemia (it's called intrinsic factor) - this could explain your B12 being so low. If positive then you will need B12 injections as you will not be able to absorb it in your gut from your diet.

I would also ask for folate to be tested if it wasn't before as folate, ferritin and B12 all work together and you likely need to raise them all.
Improving B12 is likely to lower your ferritin but looking at those numbers B12 is the more urgent one!

I'd also ask for a full thyroid panel (TSH, T4, T3, antibody testing) though in my experience you will be unable to get a T3 test through a GP but push for what you can get! If you have antibodies to your thyroid (wouldn't surprise me with your collection of results) then you have autoimmune thyroid disease. It's VERY common for those with this problem to have a whole family of deficiencies incl B12, folate, ferritin, vit D and struggle to raise their levels so you really need to know what you're dealing with. Low levels of these things make your thyroid medication less effective so it's important to aim for optimal levels not just "normal".

I would be aiming to have B12 AT LEAST 500, folate in high teens/20, ferritin 100+, TSH under 2, T4 upper third of the quoted reference range, vitamin D in the optimal range.

Do some reading and go in armed with info and be clear about the testing you want. Good luck!

No, serum B12 is not active B12, they are different 🙂

Yes, echo what TerminallyIndecisive says, your b12 level is urgent.
Did you have a full blood count done? sometimes that showing macrocytic anemia (enlarged red blood cells) in conjunction with low b12 is enough.
It's not always necessary to prove pernicious anemia with an intrinsic factor test, they are only (I think) round 60% accurate so a negative result doesn't mean you don't have it. At my surgery, barring a dietary cause (eg unless you are vegan or vegetarian) they test to exclude other digestive causes (crohns) and if you are clear on those they assume the cause is pernicious anaemia and treat accordingly. If your surgery are leaving you with a level of 101 though , you may have a battle. You can contact the pernicious anaemia society for support and help.

Hi Akite and TerminallyIndecisive,

Sorry if I seem to be drip feeding, I have the results but no idea what is relevant/ what they mean- just the summary and the figures. It looks like they did do an Intrinsic Factor AB Screening Test which was negative. Vit D3 was 55 and Serum Folate 5.1. Anaemia would explain a lot. I was in hospital for minor (unrelated) surgery earlier this year and they were stressing that they couldn't get my oxygen sat (finger clip thing) up over 95. Thank you so much for your advice! I will get onto my GP asap.

Oh bless you, it's total overload all this information when you haven't encountered any of it before, incredibly confusing!

If your Vitamin D has been measured in nmol/L then it's not terrible but would be good to raise it. The NHS bands for vitamin D on my latest test were:
severe deficiency: below 15nmol/L
deficiency: 15-30
Insufficiency: 30.1-50
Adequate: 50.1-220
risk of toxicity: over 220

Given it's the end of summer and you need your stored vitamin D to see you through the winter i would suggest getting a supplement. A combined D3/K2 is the best option and take it with some fat as it's fat soluble. Drops on buttered toast/yogurt/in olive oil for example. If it was me i would take 2000-4000iu a day but I'm not a medic, just someone who's spent a lot of time trying to sort my own numbers out!

Your folate will be quoted as just in range but is unhelpfully low especially given you urgently need B12 and to be able to put it to use. Talk to your GP about a 5mg folic acid daily supplement.

But please please get help for your B12. It's so important for your neurological health. Oral supplements may not help you if you have absorption issues. Do talk to them about a course of B12 injections to see if that improves your symptoms.

What nhs trust are you in? You should be able to find the reference range for b12 in your area. As an example, in north Bristol the lower limit of the range is 180. I'd be very very surprised if you are actually within the range, I think you are below it and they've just said you are borderline.
and Here's a link to the NICE guidelines on how you should be treated with b12 deficiency, regardless of the cause. I've been diagnosed for 7-8 years now, feel free to pm me if you want to.

180-1000 for B12 here in Gloucestershire too Akite. I can't believe OP's level would be in range anywhere!

Thanks for sharing all of this info everyone, I posted upthread as I'd been feeling the same and now just looking back over my test results some of them that are "normal" but at the lower end, may be why I have been feeling like this.

My ferritin is 20 (the range given was 10-420)
Vitamin D 55 (should be over 50)

My B12 looks ok at 482, and everything else middle ish of the reference range other than calcium a little under - which the doctor I spoke to also said wasn't an issue.

My TSH was 2.2, but that was the only thyroid test I had done - my mum and maternal grandma both developed thyroid issues around my age so I had kind of expected this to be the cause. Would it be worth paying for a more complete test?

Very frustrating that my doctor basically said there is nothing wrong with me and it's just normal life with kids making me feel tired.

@MistyQuigley you have iron deficiency. This can be with or without anaemia. Anaemia is when your Hb levels fall below range. Iron deficiency without anaemia is when your ferritin is low but Hb fine.
Have a look at the Cks NHS guidelines here. Part way down see the bit "in all people, serum ferritin of less than 30 confirms the diagnosis of iron deficiency".
And yes, ferritin of 20 is absolutely enough to make you feel like shit.
You need iron.
Read further on the link about dosage etc and go back to your GP. Also join the FB group "The iron Protocol" for support and loads of information.
Good luck, you don't have to put up with feeling like this!

@MistyQuigley you need a ferritin supplement. 20 is very low.

@TerminallyIndecisive gosh, thank you. I almost cried reading your reply! I feel a bit stupid that I just took my doctor's word for it and didn't even look into it any further. But this has given me a huge sense of relief that I might actually feel ok again and that it's not me just being incompetent at coping with normal life! These tests results are from a while ago so I might get my ferritin checked again so I know where I'm at as my starting point. I've honestly felt awful since my second child was born, and he's 3 in December!