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

What are you eating when it totals 1600 cals but has 140gms protein?
It seems a huge amount because although I'm active and life light weights I only get about 50gms a day which is bang on for my weight, as suggested in guidelines.

How much Vit D are you using? My specialist (gynae) suggested 2000iu a day.

TBH I was exhausted reading the amount of exercise you do!

Heavy weights 5 x a week- how long do you train for?
2 hours of cardio as well
And walking up to 5 miles a day most days

On top of a stressful full time job.

Oh yeah vitamin D is a good point.

If you think of it @SatsumaDog, women retired at 60 not so long ago. We should be winding down at our age, not going at it full pelt like you are.

Op I was thinking about this thread as I made tea.

You are eating 1600 calories a day, you're super focused on protein and supplements and exercise moderately to high levels - 7-10k steps a day plus 2 hours cardio a week plus weights 5 times a week.

Your job is stressful as well. All of this 'work' consumes far more calories than you're taking in, and you mention wanting to lose (what amounts to) maybe half a stone.

All of this points to somewhat disordered eating, which can absolutely lead to the deathly fatigue you're feeling. I would encourage you to speak frankly to your GP about your fatigue, your diet, your exercise.

Perhaps a potential advantage of getting a bit older would be allowing ourselves to do less.
The whole perimenopause/ menopause debate and all of the advice and support surrounding it could easily tip into maintaining a view that women shouldn't age .... Keep going, do everything, work harder, stay fit, stay slim etc.
Fuck that quite frankly.
Your life sounds very pressured OP. Instinctively if you were any age I would think you deserve a bit more rest and a bit less stress.
As other people have said too maybe less focus on diet and exercise would create space for you to just breath and be .

OP 50 is quite a low dose. My dose was 175 but was cut by my GP to 125 and I was feeling horrendous so have paid privately to increase it again. I felt debilitated. It only takes me a few days to feel better. I saw someone told you to use gel but everyone is different. I don’t absorb gel so you may have to try a few things until you find what suits you but definitely ask to increase your dose. I use Evorel patches and they are the best for me.

I worked in Primary Care for some time and, before diagnosing menopause, we always ran a range blood tests to exclude other issues that might cause similar symptoms like low iron, liver and kidney function, thyroid, vitamin D, etc and sugars if there is risk of diabetes. That should probably be your first step.

Please do not start adjusting your dose without discussing with GP or cutting patches, it's not easy to get a consistent dose and is not a licensed way to use them. Remember if you change to gel you would have to add progesterone to your regime, that can often cause side-effects, among them tiredness!

I agree with @QueenOfHiraeth that your first step here is a full blood test including:

Thyroid
Iron
Blood glucose
Vit D levels

@SatsumaDog There is something that raises a few questions.
First, if you train seriously (which you are) a BMI of 23 is not necessarily overweight because you could have a lot of muscle.

Have you had an analysis of your body fat/ muscle composition? If you feel you are slightly overweight, then something's not accurate with what you say you're eating.

On 1600 cals a day, mostly protein, and doing 7-10K steps, (2 hours a day?) 5 workouts of heavy lifting, 2 hours of cardio on top of that - you should be very lean.

If you think you have pounds to lose, something is wrong (thyroid perhaps) or you're underestimating the food, or over estimating your energy output.

Is something driving you to this amount of exercise?
How do you fit it into working full time?

For health, the walking alone would be enough, with 2 to 3 days when you lift weights.

It sounds a bit frantic to be honest and maybe you need to do less?

Have yoy had testosterone levels checked? It could still be low
I also take Mg L Threonate for brain function and my dsis takes lion's mane which helps her levels of alertness.
Good luck as being tired all the time is awful

If you’re waking up then you’re not getting the sleep you list really if you know what I mean, I’ll be honest magnesium doesn’t help me at all, I have a really harsh sleep, it’s like I’m forced into it and I have dreams and wake up feeling wrecked. If the gp doesn’t find anything I’d recommend trying dropping it and looking at what time you stop drinking especially caffeine at (including tea) and screens too. Recently I’ve stopped tea after the afternoon, stopped screens at 6 and I try not to drink water too late and I sleep in through. It’s not faesible for me to do this every night but the nights I do it I get a good sleep and feel rested

Are you taking folic acid to support the B12 injections? You need a folate level if at least 7 for the injections to be utilised. Even if you had a decent folate level to start with, it gets diminished quickly with B12 injections, especially if they gave you the loading doses first,

Best advice is to take 5mg folic acid daily for month to get your level up, then take 1 5mg tablet at least an hour before your monthly injection,

Low folate can also cause exhaustion so getting that level up and allowing the B12 to help could make a difference.

You might also need B12 injections more frequently. Getting them is another matter unless you’re prepared to buy your own!

I’m your age OP. Thinking back, my nan (who lived to her late 90s) was doing far less at our age. Part time job cleaning, housework, one evening old time dancing a week.

Maybe we’d be less tired if we tried to do a bit less.