Wiped out and falling asleep

[BBQHulaHoops]

I fell asleep this afternoon. It happens quite frequently. I did a short dog walk and an hour or so of gardening (weeding, clearing etc), a bit of housework, but by 3pm I was wiped out and was ovehelmed by the need to sleep.

I am on HRT and perimenopausal and I think too sedentary, but this has been happening for a couple of years now. Sometimes excercise or proper exertion makes me feel this way too, though other times not at all. It feels different from physical tiredness - almost like I have been given a drug. I get a taste in my mouth and a very particular feeling of exhaustion. It doesn't affect my sleep at night at all though.

Am I just very unfit? I am currently about a stone overweight, is it hormones, are naps normal? I did wonder if it was an allergic response, and I am trying to work out if I have felt this way when hayfever hasn't been an issue. Could it be a thyroid issue? I know everyone will say go to GP, but I have had my bloods done recently and nothing has been flagged as problematic. My blood pressure and and blood sugar are fine and on the lower rather than higher side.

I know no one can diagnose, but any clues or any suggestions as to how to work out what's happening.

Keep a sleep diary for 2 weeks, go to GP, push for referral to a sleep clinic. Conditions like sleep apnoea do not show on blood tests.

Have you been tested for Vitamin D or B12 deficiency? I've had both and was exhausted before they were treated. Having to have a nap at lunch etc. That's all been resolved since treating them

I had this. An overwhelming need to sleep, literally dropping off at my desk.

My ferritin was 9, incredibly low. Iron pills have helped a lot.

I'd speak to gp. I was like that when I developed hypothyroidism. I was quite young, it's more common around menopause

Low Ferritin, b12, folate and vit d can all also cause similar symptoms

I second checking iron levels.

I was napping in the afternoon, felt awful.

Ferritin was 13, normal according to NHS but actually very low. Needs to be much higher to function properly.

I had an iron infusion which really helped. I no longer need a lie down in the afternoon!

Sorry missed you've had bloods done

Sometimes "ok" isn't actually best for an individual. My folate was recently in range but really low and I had symptoms. You could try supplementing for a while (ferroglobin has all 4 iirc) and see if it helps

Ah thanks for this, it's so helpful.

I'd be surprised if it were iron, I have been tested for anemia and it never seems to be that. I take a daily Vit D 1000mg I think, and a B complex which covers RDA. But you are right@yellowpostitnoteabout the levels being within normal, but not necessarily right for me. Getting my GP to actually address this is another kettle of fish though. Possibly the best thing is to try and get hold of my most recent blood results - they never go through them - just say all within normal range.

As bloods are all ok it must be age/lifestyle related. Many women feel wiped out in peri and post meno.

You need to omit alcohol and caffeine so you are getting good quality sleep. Eat well, have plenty of physical activity to aid sleep and mood.

Have you thought about asking for testosterone? They won't give it for energy but if you say you have libido issues it is recommended in the NICE guidelines.

Do you dink enough? Hydration is key for energy so make sure you drink plenty of water.

If bloods ok it may be something to do with blood sugar levels

I can't take hrt due to breast cancer so had to tackle it all via health and lifestyle

I went upf free but I do think focusing more on protein in my diet had a significant impact, alongside resistance training. Finding that helped was accidental; I was following advice they now give (Liz o riordan et al) after cancer; 30 g of protein each meal and the recommended amount of exercise plus resistance training. I'm mostly vegetarian so it's nuts, seeds, tofu, beans, peas etc. I rarely get the afternoon dip now

Not really having any problems with sleep (if anything it's the opposite), don't really drink and only have one coffee a day!

Hydration I do try to keep up with, but not always as well as I should.

I have thought about testosterone, but I'd like to try and work out what's happening before I add more to the hormone mix.

Excercise is tricky because sometimes it helps and sometimes it just wipes me out for the day.

B12 deficiency worth looking into as not an area the NHS is well informed about at all.

Also you could be experiencing PEM - post exertional malaise. PEM is something to avoid. Key feature in ME and a subset of Long Covid sufferers who meet ME diagnosis.

Yes I was wondering about impact of Covid, too - could it be that? If wipes me out for months from an energy pov.. and some of the viruses going around this Christmas we're pretty brutal, whether Covid or another virus, post viral fatigue can last for a couple of months for me.

Definitely ask for your detailed test results. As well as ranges it's worth double checking what they tested for - my surgery doesn't automatically check vitamin D for example. And the ranges may be off for you - I'm on a thyroid forum where it sounds like some people need more like 2000iu Vit D daily.

Sometimes it is just life and ageing. We are all full of energy in our 20s and 30s so once over 40 and beyond you really notice when get up and go drops off.

I would bet many people have a quick snooze in the afternoon if they aren't at work

I would (without sounding patronising) just have a structured day, so get up at say 7am regardless of if working. Do stuff to keep busy then have some down time in the afternoon listening to music or calming apps. If you nod off well, so what.

I know many people chase the answer to fatigue and there often isn't one. I've had low ferritin (9) then treated with an iv and now 250 and I can honestly say I feel the same. Ditto vit D etc.

Maybe it's the progesterone part of your hrt, some women are intolerant and it wipes them out. If it's uterogestan have you tried inserting vagjnally?

This is what I get with coeliac disease and I've had gluten

Thanks @Janiie, wise words I do go round and round on this trying to solve it. About to adjust Uterogestan and will be trying out taking it vaginally.

This all started with Covid - which I had a few rounds of and a very bad time the first time (which is 5 years ago next week - I can't quite believe it). I also had a massive histimine response at this time - which I read can be exacerbated by both covid and peri. I have been gardening again today and actually felt the tiredness coming on again so have taken an antihistamine. It's so hard to unpick though.

@BBQHulaHoops - would definitely agree with a PP on trying taking Utrogestan vaginally- so much better for me too, and another friend was recommended this by her specialist when struggling with effects of taking it orally.

Covid is an utter bastard. Totally wipes me out and I've had it three times.

I also just find life utterly relentless, work, domestic, children. Great and full in one sense but ridiculously tiring.

And we haven't had any real sun to recharge our batteries in UK before this weekend since probably sept/oct ? I'm just sitting on a bench in the garden drinking tea and ignoring the To Do List currently!

I think the 7am get up routine is a v good idea that someone posted above. I'm rubbish at doing it (esp in winter) but if I do - unless I'm actually ill - it generally helps with a lot of things.

The histamine from hayfever makes you sleepy. An antihistamine can only do so much when there is high pollen count or you are actively exposing yourself to it by gardening.

You might have a bit of long covid as well. Long covid is a type of CFS/ME where exercise causes a backlash that makes you more fatigued. It might be worthwhile to not push yourself, but pace yourself- ie dog walk OR gardening but not both back to back on same day.

Yes histamine intolerance and peri/meno is well documented so maybe focus on that. Lots of dietary advice for a low histamine diet online.

Utrogestan vaginally may well help, you don't need hcps permission so just give it a go see if it eases things and in the meantime take an antihistamine and low histamine diet.

Get your thyroid function and Vit D and Vit B12 checked out. Ask GP for a blood test.

The op has had bloods checked. They'll have done a full screen with someone presenting with unexplained chronic fatigue.

I would urge you to get the actual number of your ferretin levels. The NHS idea of what is normal is so far below what is optimal it's ridiculous.

Good luck with it all!

I don't know if it's useful to update, but I had a very good conversation with my gynaecologist today (new to me Dr) - she was incredibly clued up and basically said with a history of PMDD, issues on the pill and now on HRT she was pretty certain that I have got progesterone intolerance, she confirmed trying a few cycles of taking the Utrogestan vaginally and if that doesn't work she had a whole load of other things to try. So a) clever mumsnetters for spotting this b) I am an idiot and hadn't understood that the PMDD continues through peri ( and c) a Dr that listens, engages with your history and is thoughtful about solutions is a wonderful thing, I may love her. We did talk about poss other deficiencies but she didn't think I had enough other indicators apart from the tiredness.

Hate to say it, but this is similar to my Long Covid - disproportionate levels of tiredness from anything even gently physically demanding.

Other possibility is anaemia and low ferritin - get the numbers. Ferritin around 50 is a good result.