Is this my new normal? Because it's shit!

[CakeKiller]

I'm 49, been on HRT for nearly 3 years now as I started peri at around 42. Estradot 75, plus cyclical Utrogestan that I had to up to 3 tablets instead of 2 due to breakthrough bleeding.

I was doing ok but in the past few months I just feel exhausted and achy all the time. I've had blood tests which showed normal iron but low ferritin so I've been taking supplements for that alongside my usual multivitamin and vitamin d spray. And even though I get enough sleep, I'm always knackered.

I have a reasonably healthy, mainly veggie diet and used to exercise 6 days a week, 10k steps every day but this year that seems to have all gone out the window. I still try to do my workouts but last year I hurt my back and this year my neck and it seems that everytime I get back on track, something happens to put me off again.

I've been piling on the weight around my middle too, even though to look at me you wouldn't think i was overweight, and my blood test showed elevated cholesterol so I'm trying to get that down. My diet was decent to begin with but this means I've got to give up loads of the foods I like, which makes me feel even more miserable!

It's really starting to get to me and all I want to do is lie in bed all day. Is this normal? Is it what getting older is like? I expected to feel like this at around 65, not 49! Has anyone experienced this and found anything that helped??

just a thought - could this be plantar fasciitis?

@Holdonforsummer sort of. It's previously diagnosed insertional tendinitis, which radiates up into my calf and down into the side of my heel. But also my feet joints ache in both feet. So my toes and balls of my feet ache. So I'm like an old lady every time I stand up at the moment!

I just fixed my knees and hips and now it's feet! I do full protein, physio, water, vitamins and HRT. not sure what's left!!

*achilles insertional tendinitis diagnosed with MRI and by private consultant.

Good question. I don't eat very much meat these days but I do eat a lot of legumes and I eat eggs a few times a week.

Did you test active B12? Apparently that is a better indicator. I was only a couple of points below the healthy range and felt much more energetic after just two injections.

in terms of exercise I’ve found that creatine really helps with energy, motivation, and recovery.

you might have to adapt your workouts as you get older and listen to your body. You won’t be able to continue at the same intensity as before.

I’ve listened to a couple of podcasts recently (I can’t remember which ones) which were interviews with elite athletes now in their 50’s and they all say they just can’t do what they used to and all have really pared back their exercise because the previous intensity is no good for their older bodies.

@CakeKiller maybe look at all the amino acids you need in a non meat diet in order to get complete proteins.

Apparently Hemp is very good. There's an episode of the Food Doctor podcast that covers this.

I very much agree. I am 50, definitely in peri, but when my ferritin is low (like a year and a half ago, when it was 9, and again now), it makes me feel much worse than "just" the hormone fluctuations. Continue supplementing and get the levels rechecked in three months or so, it takes a while to fill up those iron reserves.

Thanks for the suggestion of creatine, I'll give that a try. I was wondering if protein powder would help too, but it can be quite expensive.

I wasn't even doing stuff like crossfit or running marathons before - just your bog standard Les Mills classes with cardio and weights!

Re ferritin, I've been on the supplements nearly 3 months now so I think I need to have another blood test to check my levels. My stomach couldn't tolerate 2 tablets a day so I've only been taking one.

Do you take any supplememts? I'm 50 and not on any HRT and take collagen and alternate magnesium tablets with Wellwoman. I've done weights for most of my life. After a knee injury this year I've actually spent less time in the gym and doing more swimming and yoga, and have taken up open water swimming. Knee is almost back to normal, I still do weights and cardio but am mindful of not overdoing it.

I had all sorts of hotmonal crap going on in my 30s and 40s. Took the combined pill up to age 35 then had the copper coil for four years, in which time I got endometriosis and bilateral endometriomas and PCOS at 39. Had laporosopic surgery then went on desogestrel until age 47 when I was getting low oestrogen symptoms. Went back on combined pill for two years then stopped that a year ago to see if my periods had stopped naturally, which they have. Since then I've had nothing at all and feel pretty good. No endometriosis symptoms in ten years.

With medical advice, might it be worth having a pause taking hormones and seeing where you're at naturally? I'm not anti HRT by any means and may take it myself but just wanted to see how I felt without taking anything first and pause and reflect. For me pretty good and better 49+ than I felt in my mid 30s - 48. Also could other things being going on in your life which are not helping? I've also felt healthier 43+ than the previous ten years as DDs were older, I changed to a much less stressful job and found a regular yoga class I enjoyed.

Les Mills classes are one size fits all and have hardly any stretching or recovery. I ended up with plantar fasciitis after taking up Body Attack in 2016. Definitely change your exercise and get some advice from a mature personal trainer if you can.

It’s taken almost a year for ferrous fumerate 210mgx2 daily to raise my ferritin from 7 to around 70 which my GP says is the minimum ok level for a woman regardless of what the guidelines say. I take it at night to minimise any issues. I take other supplements too but this one thing has made the biggest difference to how I feel on a daily basis.

Slight complication with my ferritin level is that last year it was low but my overall iron levels were too high, so i was told I couldn't take ferrous fumerate! This year when I had my bloods, my iron was back to normal but ferritin down to 27 and I was able to take the FF.

Sounds like an increase in oestrogen and the addition of testosterone would help. I had testosterone added 6 months ago and it really made all the difference. Increased libido, loads of energy and cognitive benefits too. I haven't noticed any increase in hair loss or other negative side effects. My testosterone levels were at the lower end of the spectrum before I started. I'm 43 now and feel better than I did in my 30's. My diet is clean, although I do allow myself some UPFs, and I exercise every day which is beneficial for all sorts of reasons.

I'm not a medic, but anecdotally I notice women I know who don't eat red meat seem to suffer more with things like iron deficiency. I know a properly balanced vegetarian diet should be adequate, but I suspect some people don't absorb iron well from non meat sources.

You may well gave done, but just in case, have you had your thyroid checked? An underactive thyroid causes fatigue and mood changes and is associated with low iron/vitamin levels. The Venn diagram of overlap between meno and early thyroid symptoms is practically a circle so there are some theories that it is underdiagnised in women.

If you are supplementing iron you want to try taking it every other day as daily increases hepacidin which blocks its absorption. I have had a ferritin of 30 for years and feel fine with it but recently my TSAT dropped from 30% to 13% and I felt awful (TSAT is a measure of the transport of iron so what is actually available to the body).

Do you have any blood results from when you have felt well in the past? I think comparing to a personal baseline is always helpful as some people are naturally higher or lower on some markers. I would definitely check b12 though as it is generally low in those who don't eat meat.

I’m thinking of Thriva but their FAQ say you can’t use their test if on hrt as you don’t have regular levels in the blood due to daily or techs daily application of oestrogen.
Anyone know more about timing for a reliable blood test?

I feel similar OP but am older than you, early 50s.
My ferritin is also low - was just 17 which in my health board counted as normal as the scale starts at 15! So have been taking iron tablets 3x week for a year or so to top up. That has made a difference. I was vegetarian for about 7 years coinciding with peri and menopause and in hindsight I don’t think it helped. I can’t eat much meat, gone off it, but try to have some once a week or so as it helps with iron and protein.

Agree with pp that protein is another big one - you didn’t mention dairy, are you eating yoghurt or cheese? Esp with weights, active women need more protein.

Also I am on HRT but recently found my estradiol levels are low (88) so I may not be absorbing it. im increasing the gel dose for 3 months then having another blood test. Can't take testosterone yet as the GP says my body would just convert it to oestrogen. We'll see.

In the meantime - sleep and recovery is a superpower. Leave a day between heavy workouts.

The Hit Play Not Pause podcast is good, it's aimed at active menopausal women.

Yes, full blood count a couple of months ago and thyroid is fine.

I think the revelation that my cholesterol level was a bit too high was the icing on the cake, pun intended! I already do almost everything they advise doing to reduce it and my sole indulgence was butter on my toast as I hate margarine or any other spreads.

My GP advised to take one tablet every 2 days, on an empty stomach with vitamin C, which I took as a tablet. Your body can only absorb so much

I take Ferrograd-C, which has vitamin C already incorporated but maybe I'll try alternative days from now.

I think there’s no harm in massively increasing your protein intake to at least a gram per kg of body weight daily.

I’m no longer veggie but I don’t like eating meat or fish all that much. I eat a lot of Fage 0% yogurt, Nakd or Trek protein bars, PB peanut butter powder and nutritional yeast, and eggs. I try to choose snacks etc for protein content. I get some protein within 30 mins of exercise - and drink water with electrolyte powder (it’s cheap).

The PB powder isn’t as high protein as others but it’s not full of crap and tastes nice - whey powder might be better but I don’t like it much. I genuinely feel that my body has enough fuel to run on now. You could give it a try. Trying to exercise when under fuelled is horrible.

My ferritin only started going up (from 11 to 45 so not huge but great for me) when I started taking on alternate days, with vitamin C and an hour before drinking coffee.