What could this be? EXTREME exhaustion.

[PuddingsAndPies]

I am constantly exhausted - I am currently being treated for depression, and am on 45mg mirtazipine (specifically to try to improve the quality of my sleep at night, in the hope of reducing this). Despite this, I am still hardly able to function. Even with 12+ hours sleep, I am exhausted & can't watch television or read without finding myself falling asleep. My GP sent me for blood tests last week, but I haven't heard back yet - I'm not sure what they were testing for, although diabetes was mentioned (I had to fast for 12 hours beforehand). I'm not sure that it is diabetes though, as I don't have the constant thirst, etc.

Thank you in advance for any suggestions!

[narmada]

Have these symptoms only started since you began mirtazapine? As a PP said it is massively sedating (which can be useful if you are agitated-depressed) and it causes huge weight gain.

I seem to remember being told that in rare cases it can also change blood counts.

The coloured patches.... aren't they symptomatic of diabetes? Mirtazapine can do odd things to your insulin levels....

[PuddingsAndPies]

Thank you for the list, Rockin!

& no, the mirtazapine was introduced to tackle some of the symptoms. The symptoms predate the meds.

[PuddingsAndPies]

Saw the doctor. I've never seen him before, & he was really rude - I went in with a list of symptoms I wanted to talk about, & he took it straight off me & turned it upside down, & left me to flounder a bit. He said that at 2.9 there's nothing to worry about, & said it was all just my depression, which I don't think it is. Eventually I ended up crying & said that whether or not it's a thyroid thing, I can't keep being this ill. Then he essentially said that I was too mentally weak to stand any further investigation because I was so tearful
After some debate, he decided that he was going to actually examine me, ask about my family history & talk about my symptoms properly, & I've ended up with a referral to an endocrinologist. But what an absolute nightmare that was.

[Kewcumber]

whats your weight like? Sleep apnoea?

Have they tested b12 and iron?

[PuddingsAndPies]

I'm not massive, but I've steadily been putting weight on & I'm the heaviest I've ever been. No sleep apnoea.

They haven't tested b12, though they tested for anaemia, which I apparently don't have, but I think there are other tests for iron? I'm not sure.

They tested kidney & liver function, & my blood glucose, all of which came back normal.

[mollymole]

Your GP has referred you to the endocrinologist - they should be able to give you much more help than the GP and are specialists in thyroid treatments so things are actually moving in the right direction for you.

[Kewcumber]

sleep apnoea more linked to neck size than overall weight. Some drugs deposit fat around the neck.

Yes you can have low iron but not be anaemic but IME is more often results in generally low/depressed/tired feeling rather than exhaustion.

[narmada]

Hey interesting you say that Kewcumber because I developed nighttime breathing issues on Mirtazapine - a bit apnoea-like. Got a fat neck on it too....

[Kewcumber]

I developed severe sleep apnoea on high dose steroids and haven't quite shifted it even though the weight has now gone from my neck - though it has improved dramatically and there is hope my airway may recover enough eventually to get off CPAP.

You can do an Epworth sleep questionnaire online to assess your level of sleepiness. I seem to recall that its the first thing the sleep clinic did with me.

[rockinhippy]

I'd also be asking if they did a kidney function test & ask about a celiac disease test - its unlikely this one was done with weight gain, but as I'm just finding out now as with kidney function problems it can actually be fluid retention rather than actual weight, but the weight could also be a red herring & be down to the ADs as already suggested

I've had similar problems for years, diagnosed as fibromyalgia & the hen M.E as I kept on pushing for answers - I too thought thyroid & thanks to great advice from RD above pushed for more in depth tests, but after restless etc they came back within normal range - my problem has now just been diagnosed as stage 3 Chronic Kidney Disease, not sure how the hell they missed that one as it was the first thing I asked about as I've a history of kidney trouble

That said I am currently doing a gluten (wheat, barley, rye) load to prepare for doing a home celiac test, as the more I read on that, it looks likely its the correct diagnosis for both myself & DD - left untreated it affects thyroid, kidneys & much much more - we have been tested, but were given no advice on loading up on gluten prior to testing, which is needed for an accurate result - the way eating so much gluten is making me feel I am convinced this test will be positive.

good luck getting answers

[rockinhippy]

Sorry just spotted your update & see you've had the kidney test done too - good luck with your endo appointment

[digerd]

Rockin
How can they misread/ignore your kidney function blood test results. Or was it the results that were wrong?
That's terrible.

[PuddingsAndPies]

Thank you for the advice on this before. Just as an update (& also as a record for myself), I have been sent blood forms for tests tomorrow. They will be testing:

Albumin
CRP
HbA1c
Calcium
ESR
Total CK
Full Blood Count

I'm not totally sure what they're looking for, but it should help rule things in / out.