My husband is always exhausted. Is this normal?

[Wrenbirdwren]

I could really use some advice on whether I am being unreasonable about the level of exhaustion my husband is at.
Family set up. Me; 42. Freelance work that doesn't bring in much, but means I can do all school runs, no after school clubs, cover school holidays, no need for holiday clubs etc, manage mental load etc. I cook for myself and kids, housework etc. 2 kids, 5 and 11.
DH: 44, full time £90k job, 2 days communting, the rest from home. No evening hobbies. He is vegan, so cooks for himself.
I get up with the kids at 7 on school days and do breakfast, lunches, spellings, reading etc and get them off to school while he gets ready for work. He starts at 9. He takes an hour for lunch where he often eats and has a nap fpr 20 minutes. He finishes at 5, when he cooks for himself then gets smallest one to bed on some evenings. He goes to bed at 10. The little one still gets up in the night so we end up ferrying him back to be about 3 times. We take turns at this.
He is yawning constantly, big black shadows under his eyes. No energy or motivation. Waves of anxiety which he is getting therapy for, but to no real effect. On a weekend, he will go through the motions with the family but you can tell he just wants to be left alone. We will both have naps.
He gets time off every school holiday as I take the children to visit relatives for 4 days to a week. He is refeshed after this but a week later is exhausted again.
I don't know the solution. I'm quite low on stamina myself and need an awful lot of sleep, and get migraines around once a month so he covers for me then. I also get breaks when with relatives and at home when the kids are at school. I feel very guilty that he is so worn down. But,if I went back to work he would have to do more of the mental load and wouldn't cope. I'd like him to consider 4 days a week, so he could at least sleep on a day so it doesn't affect the weekends, but he's against that.
I'm concered it's long covid, or his diet, but he insists his vegan diet is healthy (he does it right, lits of lentils etc for protein), but he also has lits of food intolerances and IBS.
I must admit I'm ranting, he's excellent in so many ways, I just hate seeing him so tired and crabby and it's meaning we don't do as much as a family.

This is so spot on. Anyone who wants to get tested for T levels usually has to go private as like you say the NHS isn't good for this usually. The US tends to be more ahead with this stuff.

12 is also low, without doubt, regardless of whether it technically creeps into the low acceptable range. Noone testing knows what his natural levels are either. My husband's, for reference, are 27. If your husband tested as 12 this year it could be in the process of falling.

Does he snore? Is he over weight? Look at the Epworth sleepiness score and see if he ticks any of the risk factors for sleep apnea. Also get iron levels checked and vit b12.

Also get him checked for coeliacs disease

He did go private luckily and has had a lot of success with treatments, the trouble is the expense which isn't something we can sustain or get the NHS to pick up the slack with.

It's an absolute nightmare to navigate because I'd be willing to pay whatever it takes to help him stay healthy if money was not an issue, but we're both disabled, and have a disabled child too and the costs just keep racking up.

Haven't read all the replies @Wrenbirdwren but it could be his diet. But also, does he snore? My husband was like this and turned out he had sleep aponea.

Speak to the GP and get your DH to have a full work up done. And if he snores get him to refer to a sleep clinic.

I agree test for sleep apnea and celiac as well as the usual iron, b12 etc. Vit D is another important one, I feel like rubbish when my Vit D is low and it can really affect your immune system.

A nutritionist might be better than a GP when it comes to diet as they will be able to take the veganism & IBS into account.

With the 5 yr old I would put a mattress on the floor of your room and let them come in and sleep there if they don't disturb you. OR buy a bigger bed for child's room and take turns co-sleeping so that you both aren't being woken up overnight every night.

If he has bowel issues has he actually been diagnosed with IBS. Has he had FIT and calprotectin tests to rule out IBD?

If he’s vegan he’s likely deficient in B12 and most likely iron too. Get him some supplements but if he wants to get bloods at the doctors don’t start supplements yet.

I'd be wary that the IBS isn't actually IBD. Many IBD patients are misdiagnosed with IBS for a long time. I'm one of them. I also can't tolerate gluten and couldn't handle fermented foods. I can handle fermented foods now that I'm correctly diagnosed and have been able to alter things correctly.

My son has IBD as well and the exhaustion he had before diagnosis was extreme. Autoimmune conditions often involve a lot of exhaustion.

These tests don't mean there is no IBD if they are negative. A colonoscopy is needed to be sure of the large bowel. An MRI or ultrasound for the small bowel.

Agree with all the blood/sleep apnoea tests mentioned. Also worth getting an eye test if not up to date.

He should get his thyroid tested.

Agree with diet and bloods but also as someone who only started going out working neatly ft in the last two years and still doesn’t have close to what dh has in terms of constant emails, phone calls about meetings, firefighting etc, and the fact that if his job goes we’re effed, Id say it could honestly be just life too.

Being woken several times a night is no small thing, it’s unlikely either of you are ever completing a full sleep cycle. I feel far better after 6 hours of consecutive sleep than 8 very broken hours.

Its likely his diet. He needs to keep a meal/drink.plan for a month and get ut assessed by a professional nutritional therapist.

Fair point but it’s a start. I have IBD but for several years it was thought to be IBS and I did have positive results on both tests followed by a colonoscopy.

It's a good start, for sure. Relying on these tests delayed my diagnosis with IBD for a good few years.

The glaringly obvious issue here is he’s vegan. I’m assuming you have thought about this already?! He’s likely low in B12 for a start! Full blood panel needed

He’s been tested for coeliacs and is negative. Not sure about FIT test, I think he has had one. He is not overweight and does not snore. X

If he doesn't eat gluten then any coeliac blood test will come back negative. You have to be eating gluten at two meals a day, for six weeks, before the blood test.

Sorry if this is a cliché, but could he be neurodiverse? Anxiety, exhaustion & difficulty participating in family life - needing to be alone. Restrictive patterns of behaviour/sensory issues in his choice of vegan diet. Rejecting changes to routine such as dropping down to 4 days a week.

Being autistic in a world not built for you is incredibly exhausting.

You have my massive sympathies. I hear about this way too much. T replacement should definitely be on the NHS because all men go through the andropause. It's really not fair to not be able to get the support your husband needs.

I think the 3x a night getting woken is the biggest issue, some people once they are woken once can't get back to sleep. DH is like this, if he is woken at 2 then he is awake from then onwards.

You should probably get him off the vegan diet too and onto something with more energy. As great as it is for saving the animals it just doesn't work for some people.

The big dark circles and exhaustion are 100% inflammation from the IBS being triggered. My DH is the same. When he was like it all the time we didn't notice but now he has it mostly under control, the occasions he gets a trigger this is him for the next 24 hours. Totally exhausted. It's horrible. He needs to see a dietitian and proactively sort the IBS. It's really really misunderstood.

Your husband needs a check up at the doctors. Get his bloods done. I was just like him ..probably worse and l ended up being diagnosed with Hashimotos (Thyroid) and pernicious anemia. Few years of correct treatment and l have my life back. These things tend to sneak up on you and you get iller slowly but surely. He might also be needing iron. Please get him to the doctor.