Eight months of eating strict gluten-free paleo after a celiac disease diagnosis, I still don't feel back to normal. Most days it feels like I'm living in molasses and my brain doesn't function well enough for my work. I do have days where I feel like normal, just enough to remind me that this fatigue thing is out of my norm, but then I sink back down into the fatigue. I had a followup appointment with my GP and she set me up with a gastroenterologist (for an endoscopy) and immunologist (for allergy testing), but in the meantime, I'd like to see if I can come up with some leads / suggestions / more info to give these specialists, because right now I feel like I have nothing for them. All I know is that I feel bad.
I've had TSH tested 3 times (2.2, 1.8, and 2.15 mIU/L), all within the normal range. I had Free T4 tested (1.2 ng/dL), also normal. And I just got results for TPO and TBG antibodies to check for Hashimoto's thyroiditis, and both were negative (under 20 IU/ml for anti-TBG, and 12 IU/ml for anti-TPO). So it seems highly unlikely that something is wrong with my thyroid.
I've twice had my blood nutrient panels done, and all the nutrients tested were in normal ranges, including ferritin. Sodium and potassium were low, but still in the normal range, and everything else was smack dab in the middle of their ranges.
So, I'm at a loss for what could be wrong. I ordered some cortisol saliva tests but haven't gotten those results back yet. Edit: cortisol levels were spot on where they ought to be.
What other causes of mental and physical fatigue are there?
What kinds of things should I ask/tell my gastroenterologist and immunologist?
Some background on me:
I went of hormonal birth control 8 months ago after being on it for 10 years. My cycle quickly adjusted to normal, but I do have bad cramps and pre-menstrual breast tenderness (which I didn't have as a teenager). Those have gone away since I started eating more seaweed and brazil nuts.
I typically get 8-9 hours of sleep a night, and I was using blackout curtains until the weather turned warm. In order to keep the room cool enough, until we put in the window AC units, we have the curtains open for airflow. So this past week I've gotten about 7 hours of sleep a night. I haven't adjusted too well to the time change for daylight savings time, but I'm lucky enough to have a job with flexible hours so I have just been going to work a couple hours later.
As for food, I was doing lowish carb paleo (per day 1 lb of fatty grassfed ground beef, half a cup of sauerkraut, a bunch of kale, an onion, a can of salmon, a couple cups of spinach and a tablespoon or two of coconut oil, and maybe half a cup of sweet or white potato, plus liver and bone broth once a week or so), but then I upped the carbs, selenium, and iodine and started to feel much better. Lately I've been eating a lot more fish (from a fish CSA), fish stock, chicken meat, chicken stock, and chicken liver, beef and goat stock, beef and lamb kidneys and livers, oranges, potatoes, seaweed, and brazil nuts. I have been eating more variety lately, but a typical day is 4 oz leftover salmon with 3 eggs and spirulina for breakfast, an orange, a grapefruit, and 4 brazil nuts for lunch, and then grilled haddock (plus the eyes!) and a potato for dinner. Or I might have ground beef and kale for breakfast, an orange, a banana, and 3-4 brazil nuts for lunch, and then seaweed soup with dulse, eggs, and shrimp cooked in fish stock, for dinner. I often have a natural calm before bed or an epsom salt bath, and about a week ago I started supplementing with vitamin D. Maybe once or twice a week I'll have some green or black tea. And I have cacao nibs or dark chocolate a few times a week, too.
I'm 5'3'' and weigh 160 lbs. When I first went paleo I went down to 150lbs, but then my weight crept back up. I've been too tired for exercise: I tried taking up rock climbing but got so tired it seemed dangerous. I do a lot of walking, over a dozen miles a week. And lately I've been doing a lot of sprinting (about 2 blocks, once or twice a day) to catch the bus. I'd like to get back into weightlifting, but I just don't have the energy/stamina lately.
Edit: B-vitamin bloodwork results
I got my bloodtest results for serum levels of MMA, folate, and B12.
MMA: 138 nmol/L
Folate: 16.8 ng/mL
B12: 603 pg/mL
At this point (and bolstered by VB's post) I'm going to contact a TCM doc.
I'll get results back from free T3 (blood spot) and hormone panel (saliva) in a couple weeks.