Are these symptoms peri-menopause - or chronic fatigue syndrome?

[Walkingtheplank]

I am absolutely knackered. Constantly tired. Doesn't really matter how much sleep I have. I feel dizzy, can't focus or process work, have headaches, feel hungry frequently, am irritable, like I'm pre-menstrual. I've been like this for c.6 months. I'm also achey joint-wise. I feel decrepit

I started HRT c. 2 years ago. I went from anxious and not sleeping to feeling pretty good and sleeping OK within the week - but more recently I just feel awful.

My first GP wanted to prescribe me anti-depressants, but I declined as I'm not depressed, so she suggested blood tests which have largely come back OK although I have high bilirubin which I've known for years and it means I probably have Gilberts syndrome which is not a major issue apparently.

I had to see a different GP for next steps. He hadn't even read the notes despite the surgery asking me to to come in to discuss the results. The result of this conversation was a suggestion of chronic fatigue syndrome but he also wants to rule out liver issues. He wants more blood tests.

I feel that the fact that I'm a 51 year woman is being ignored.
I've been offered anti-depressants (like so many women) which I feel is just to numb what I'm thinking and to shut me up.
If the issue is chronic fatigue syndrome then there's no treatment for that so that's just giving me a diagnosis (that is mostly a diagnosis for women).

What do I do? I don't feel that either GP has heard what I've said - or am I just not hearing what they're saying and this is not hormonal?

Has anyone had similar and what was the best way forward?

In not a medic so maybe there is a good reason for this - but it seems odd they wouldn’t consider upping/changing your HRT dose. I would have thought that would be the most logical next step.

Very quickly, because I’m going to bed, but have you got a print out of the blood tests? There are lots of things that could be ‘normal’ 🙄 but can give these symptoms if they are the low end of normal. Some women feel better if optimal, ie towards the higher end of the labs reference range. You also need to see if thyroid has been checked.

lastly if HRT improved things for a couple of years, have you had a dose increase to see if that now helps? Pray it’s anything other than CFS/ME.

I did ask if we should review the HRT and the GP agreed it was always worth doing so - and then he totally ignored that topic.
He just kept saying he didn't know what the problem was.

look into hyperparathyroidism - it’s reasonably common in women your age and i think would explain all your symptoms, especially when you mentioned achy joints

there is a couple of threads on it on here as well. good luck, i’m in more or less the same boat 💐

I do have the test results as on the NHS app.
My Serum TSH level is 1.59 (normal range 0.27 - 4.2) - so I think that rules out thyroid issues.

Sounds like you need to up/adjust your HRT. Suggest you see a menopause specialist, or at least another GP as your current GP sounds clueless.

Doesn't necessarily sound like hyperparathyroidism (having had it myself with one of my parathyroid glands removed last year).

The glaringly obvious first step is to review your HRT.

I think it’s a good idea for your GP to order more blood tests. It’s good in my opinion that the GP isn’t viewing you as a walking uterus but deciding to run more tests to rule out other causes for your symptoms especially since you are already on HRT.

Also CFS isnt just a diagnosis that you’ve implied is just used to label and fob off women. It’s a real medical condition. Long covid is a type of CFS/ME. There are treatments for CFS/ME, but not any quick fixes.

And how does the GP do that without a blood test for hormone levels?

What HRT are you on Walking? There's been lots of women talking of symptoms coming back after a recent change in the packaging of oestrogel. I'll see if I can find the thread.

I'm not using a gel. I'm on Femoston 2/10

i am talking about parathyroid not thyroid, the blood test results to do with that are PTH and also calcium, phosphorus and vitamin d 🙂

PTH isn’t tested usually unless it’s flagged that your calcium levels are off

Ah ok. Still, HRT review seems obvious and place to start. Good luck getting it sorted.

this PDF explains it quite well 🙂if you look at the symptoms list you have a lot of them

https://www.hyperparathyroidmd.com/wp-content/uploads/2020/01/HPT-Worksheet.pdf

My menopause specialist managed it just fine. I didn't even see her face-to-face.

I should add that I also suffer from chronic fatigue (amongst other things) as a result of long Covid (proven by some rather expensive autonomic function tests on Harley St). I believe it's thought that approx 30% of middle aged female long Covid sufferers are actually struggling with (peri)menopause rather than long Covid. Given symptoms are non-specific, it makes sense to investigate all possibilities but this takes time - and often money. Since the OP is already taking HRT so must have been experiencing some symptoms, reviewing her HRT could potentially be a relatively quick fix whilst other investigations are underway, or she's on a waiting list. Of course her HRT might be fine but if it's not been reviewed since she started experiencing these symptoms, it should be looked at. It doesn't take a rocket scientist to figure that out.

I would get vit D, B12 and ferritin checked before changing your hrt.

Not sure if this is what you're referring to:
Serum calcium: 2.27 (normal = 2.2. - 2.6)
Serum adj calcium conc: 2.41 (normal = 2.2 - 2.6)

B12 and ferritin normal too. Don't have the Vit D numbers.

It might be worth approaching a private menopause specialist, having a battery of blood tests and potentially then if testosterone and sex binding hormone levels are low, trying that, as well as checking your oestrogen. (Hope I've got the terms all correct - I'm no medic.) Your symptoms sound similar to me a year ago and this was the solution prescribed to me. My GP said my testosterone levels 'were ok but a bit low' but they wouldn't prescribe testosterone unless I had 'low libido' as the nhs will only prescribe it for that. (FGS!). Private clinic said my testosterone was 'on the floor' and my hrt needed to be raised so gave me both.

Having complained that I'm tired, I'm going to bed now. Thank you everyone who made a contribution - I feel that I was heard. 😀

Exactly. I wouldn’t be comfortable changing my HRT around without blood tests. The risk of too much oestrogen or too little progesterone is cancer especially if the problem is actually testosterone.

B12 and ferritin normal too.

You still need the actual numbers in relation to the labs reference ranges. Ferritin can be marked ‘normal’ at 20 for my lab but normal range is up to 300 and healthy hair growth needs it to be at least 70+ iirc. Many women would feel better at levels of 100+ so ‘normal’ doesn’t really mean much.
Same with B12. Levels are set ridiculously low in this country. My local lab mark levels of 150 as normal but then do sate to consider treatment if symptomatic. Normal goes up to almost 1000 so its likely people will feel better at 900 than at 151.

Thank you to those who took the time to reply on Friday.

It seems I have to have a proper sit down with a GP because even when the results of the next blood tests are back, there are different ways to interpret them - not sure which of the 3 at the practice to go for. Just feel like I'm bouncing between them. I also don't know how we fit this into a 10 minute appointment.

Ended up falling asleep yesterday with my face in a pile of cushions on the sofa. DH had to straighten me out so at least my face was clear! I had a more planned snooze earlier today.

It's also been quite clear this week that my concentration is lost. I literally forget what I'm talking about mid-sentence., especially if something else happens e.g. telling DH something earlier and DS walked in the room behind me; I instantly forgot entirely what topic we were on. This happened several times today. It's very hard to do my job when I forget what I'm talking about.

I hope we can get to the bottom of this.

Do you take regular Vit D spray? We have had the shittiest winter and no spring. I feel like, with the odd day's exception, it's been grey since September last year. That means if you don;t take a supplement you are certainly Vit D deprived which has the symptoms of extreme fatigue, muscle weakness etc.
If you are peri meno with some heavy bleeds low iron is also a possibility. Taking these supplements would have an almost instant benefit - you'd feel better within about 3 days to a week, so easy to rule out.

So almost 2 months on, all my test results are back and show nothing. Well not entirely nothing as I have fatty infiltration on my liver, but nothing to help with the fact that I am beyond tired and not functioning. Dr is referring me to the chronic fatigue clinic in another area. No idea how much time that might take. At this rate I'll have lost my job before this is resolved. Except if it is chronic fatigue syndrome there is no resolution. I don't want to downplay anyone else's experience but to me CFS is a label given to women who are tired and the NHS is not capable of solving it. There is no way to test it or cure it. It is a label and then nothing. What's the point of that?

I've had a few hours to consider the 'non-news' I'm just so angry that the NHS won't help me anytime soon/ever. If my husband was this tired and incapable of functioning they'd find a solution not just give him a label.

Not sure what I want from this rant. Just really tired and emotional.

You are not wrong OP and thousands of people are in the same boat.
Its also very difficult to access any benefits, and research into this has been almost nothing over the past decades.
Are you still working?