Fatigue- is there anything I can do?

[SatsumaDog]

I’ll be 56 in July and I’m just exhausted all the time. I have tried everything I can think of (see below), but I just don’t seem to be able to shake it. Is this just how it is now or is there something else I can do? I’m fairly sure I’m now in menopause. I work full time in a fairly stressful job (home based), which realistically won’t change for at least another 4 years (2 kids to get through uni).

Any advice would be very welcome.

This is what I’m currently doing.

• 8/9h sleep per night (although I do wake up a couple of times)
• HRT (Evorel patches)
• Testosterone gel
• Exercise per wk (weights x5, cardio 120min)
• Walking -7-10k per day depending on work
• Diet- 140g protein at least- about 1600 calories (much more and I put on weight)
• BMI- 23 (a little heavy for me, so I’m looking to cut to around 22 over the next few months)
• Supplements- collagen, magnesium, omega 3, vitamin D, turmeric, creatine, monthly B12 injections
• Water- 3l
• No alcohol

Get your thyroid checked. Speak to the GP about underlying health causes. This level of tiredness isn't right

@SatsumaDog Humantra electrolytes have been life changing for me x

I was wondering about this. I had them checked about 6 months ago and they were fine, but definitely worth checking again. Thanks.

I’ve seen these advertised; I’ll give them a shot, thanks!

The fatigue is the worst symptom for me, sometimes if I push through and do stuff it lifts a bit. It feels so like you’re half sedated.

Oh yes I read another person mentioning electrolytes! Also creatine is one to look at. Some great research on it’s use during perimenopause and menopause for energy and cognition.

Yes, I agree. Strangely I feel pretty good during and just after exercise, but knackered the rest of the time.

I’ve been reading about this a lot recently. I have been taking 5g, but have increased to 15 recently. It does bother my stomach a bit
though, even when i split the doses.

I had this - generally sleeping OK but going through the day with eyeballs like lumps of lead and feeling if I put my head on the desk I'd be asleep in about 30 seconds.

I have started taking a B vitamin complex, (from Boots, I think) rather than just B12 on the advice of a GP friend who has Parkinsons so is well up on things that can help neurologically, and I've also started taking about 10g of creatine daily as it is supposed to be good for cognitive functions in older women as well as the gym benefits.

I'm definitely feeling less tired if I get a good night's sleep but still feel completely drained if I get the 4am menopause wake up call. I think it is the B vitamins that is doing it.

Do you know your levels op? Within range doesn't necessarily mean optimal...

I'm a bit surprised at the amount of protein you're eating.
The debate on protein has changed slightly, lately, and there is some kick-back against huge amounts. The guidance used to be 0.8 gms per kg of body weight per day, or up to 1gm per kgs.

So if you weighed 55 kilos that would be 55gms max

The other thing to consider is your HRT dose.
Evorel comes (I think) as estrogen only or a combined continuous patch- which are you using? How long for? Do you maybe need a review of the dose and type of progesterone in the patch?

The issue with patches is they can't be changed easily without a new prescription and the range of dose is quite limited compared to gel which you can change yourself from 25mgs to 100mgs.

That’s interesting about the protein,
I’ll definitely look into it. If you’re lifting very heavy, the advice I have had is 1g per pound body weight. That was from my lifting coach.

i wondered about the HRT dose. I’m on Evorel cont which I think only comes in one dose (50). I’ve been on it for around 5 years.

I don’t unfortunately, but was told they were normal. I guess they could have been on the lower end of the range though.

That’s interesting about the vitamin B complex. Definitely worth giving a try. I have recently increased creatine in the hope it may help, fingers crossed!

Definitely get Estrogen gel instead of patches. Much better.
You probably need to try doubling or tripling your Estrogen.

I’m going to make an appointment with my GP to review my HRT. I’ll certainly mention the gel to see if can increase oestrogen dose.

Is the gel better as you can control the dose? I’m struggling with the patches with wrinkling and irritation and therefore resurface of symptoms and not sure whether to ask to try gel.

With regard to protein, any excess will be filtered out by your kidneys but if you are having huge amounts it can cause kidney damage. I have always thought that unless you are training and lifting at a very high level then you can get enough protein from a good balanced diet.

I was advised by my GP to cut up Evorel patches to change the dose. I changed from Oestrogel ages ago as they changed the formula and didn't work as well anymore. There were lots of MN discussions about it at the time. @hedgheog I have heard that if you puff an ordinary asthma inhaler on your skin before applying the patch it can reduce irritation. I'm sure I read it on MN so it must be true!

I think it was because you also need Thiamin or Niacin, or one of those type of things. I get them from Boots - they are not expensive £3.90 for 180 tablets/6 months.

Walking 7k to 10k per day would tire me out. Perhaps you should allow yourself to gain a couple of kilos and eat a bit more. Iron check? Thyroid check? Ask for the results.

i don’t use any protein supplements, it’s all from food, but 1g per pound bodyweight is fairly standard. Unless you have kidney issues, then kidney damage isn’t really on the cards. I would say my diet is more balanced than most.

I have heard of people cutting up patches, so that’s another avenue to investigate. There’s just so many variables it’s like trying to hit a moving target!

The steps are just from what I do day to day as part of my normal activity, so I can’t really reduce that. But I think having some bloods done is definitely a good idea. Hopefully they’ll throw something up that can be addressed!

If you have the NHS app your results will be on there. Or phone and ask. You can feel like shite if your levels are even approaching the higher end of the range...

7000 steps is a normal day if not mobility impaired. I feel better on more steps but so hard to motivate my fatigued self.

How much vitamin D are you taking? I'd also ask about iron levels. Just thinking of the things that can make you feel tired.
While 8-9 hours of sleep sounds good if it's poor quality sleep this may not be helping either.