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UPDATE 8/29: So it's been around a month and a half since I posted this. Haven't had caffeine since this post, and due to the more stable energy levels that brings I feel a little better, though my energy levels still don't feel normal. My temperature is averaging 97.7, which is better than it's been though still well below my normal 98.6. My current COA is stay away from caffeine and go gluten/sugar-free and see where that leaves me in a couple months.


Let me just say first of all that I don't eat Paleo (although I'll give it a shot at some point). I'm asking this question here because after lurking a bit and being impressed by the community's enthusiasm for and knowledge of health, it seems I might find a reasonable answer here or at least get pointed in the right direction (already tried three doctors so far with no luck).

My problems started about a year ago (I'm now a 24-year-old male FWIW). I started having fairly severe (to me) pain and discomfort from my forearms down, especially in my hands (including carpal bossing in my right hand). The only major lifestyle change I could pinpoint was that I had started drinking coffee six months prior and had gotten up to a three cup/day habit; I also noticed that the numbness was worse depending on my coffee intake. After trying to quit a few times I tried switching to tea, but the problems persisted (just less severe because of less caffeine). Anyway, I didn't consume any caffeine at all for all of May and fell into a brain fog the whole month with no light in sight. I did notice, peculiarly, that I felt like my normal pre-coffee self for about the first fifteen to forty-five minutes after waking up each day, but went downhill after that. Cortisol?

So, with grad school looming, I caved and tried tea again for a week, then went a week or two off, then these past two weeks coffee and tea. What I've noticed is that even though I feel more awake and my cognition is in some sense improved, I feel more disoriented too now when I have either (esp. tea). To my medically-uneducated self it feels like the caffeine's stimulant properties are being overpowered by whatever negative effect it's having on my health. To top it all off I've noticed lately that my body temp. is pretty low (yesterday it was down to 96) and I've always been a solid 98.6er. I don't check my temp. frequently so it may have been like this for a few months, I dunno, but either way it's bizarre for me.

Any help? Guidance? Things I should ask a doctor about? The two things I keep coming across are hypothyroidism and adrenal fatigue, but RE the former I am quite the ectomorph (5'11", 120 lbs.), my TSH was normal at a recent check-up, and most of the physical symptoms don't seem to fit.

Now that I have an honest-to-God symptom (low body temp.) instead of vague I'm-tired/I-can't-focus complaints I'm pretty intent on cutting out the caffeine, because at the very least it doesn't seem to be helping.

TL;DR: 24-y/o thin guy; brain fog, but fairly alert first thing in the morning; low body temp.; maybe caffeine-related.

Thanks.

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I'm sure people will touch on the cortisol issue momentarily, but the phrase "with grad school looming" made me think.. are you finding yourself under a lot more stress now than normal? It's just that caffeine isn't the only thing that can affect cortisol. Also, can you give us an idea of what do you eat (other than coffee) since you're not paleo? – A at Grain Free Diet Jul 13 at 21:00
Yes, we definately need to look at that diet. Can you give us about a week of what you are eating? Another thing that you might think about is trying a probiotic. You have have too few of the beneficial bugs living in your intestines. Just a thought and if it does not help then there is really no harm done. Just a suggestion to try. – SCUBABry Jul 13 at 21:15
BTW, this does not really sound caffiene related to me. Even three cups a day should not mess you up...unless you are alergic to something in the coffee. – SCUBABry Jul 13 at 21:16
Yes I'm under stress; finished undergrad 2009, got accepted into a good grad program (starts in Aug.) based on my undergrad work but stressed that I won't be able to hack it (esp. with all the on-off caffeine woes). I eat what seems to be the appropriately acronymed SAD, though a bit healthier than most. Daily apple and banana, frequent veggie wraps (read: wheat), rice almost daily, miso soup, pasta, pizza once a week, drink mostly water, sometimes OJ. I'm aware that Paleo may be the answer to my prayers, but I was hoping to know just what is wrong with me too, if it's at all clear. – Walter Jul 13 at 21:20
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Sounds like you just don't eat enough. At 5'11" 120, that is extremely light. Your body might be in a semi-starvation mode. My initial recommendation is to up your protein and quantity of food. Calorie Restriction diets do sometimes lower body temps a degree or so. – RaiseFitness Jul 13 at 22:55
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5 Answers

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Your symptoms do seem thyroid related at first glance. Never take TSH "normal" at its face value. There was a switch in what is considered normal ranges not too long ago and many labs have yet to update their forms with the new ranges. Ask for the actual number, and if it is 3.0 or over (used to be 6.0 or over), you are hypothyroid. Personally, I have to keep my TSH below 2.5 or I become symptomatic.

Another thought with your low body weight, low temp., and tingling/carpel tunnel issues in the forearms would be celiac disease and a resultant B-12 deficiency. Even though you eat meat, you might not be able to get the nutrients out of it because of damage to the villi in the small intestine. You could try some sub-lingual B-12 for a few weeks to see if your forearms feel better. And for a longer experiment drop the wheat and see if that makes a difference

Magnesium deficiency could also be at work here, especially if it gets worse with stress and caffeine consumption. Perhaps try some supplements like Natural Calm or Epsom Salt baths. Check out Dr. Carolyn Dean's work if you want more info on that (although, I have to warn you, even though I think she has many good ideas, she thinks just about EVERYTHING is caused by magnesium deficiency).

Last thought about a possible relationship to the caffeine, dehydration? The spinal column is mostly water and if you aren't well hydrated it gets shorter and the bones in your spine are more likely to rest on each other, rather than floating ever so slightly apart, and that can pinch the nerves that go down your arms.

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I second the B-12 recommendation and investigating celiac disease and non-celiac gluten sensitivity - both often overlooked sources of peripheral neuropathy. – arugula Aug 25 at 14:23
Thanks for the replies. As of my last physical in April my TSH is 1.5, which by every standard I've seen seems pretty normal. Also my B12 was above the reference range. Yes, I'm currently converting to gluten-free and mostly sugar-free, as my new roommate told me about his ex who (after lots of tests and thyroid meds) beat her hypothyroidism with a gluten-free (and sugar-free, I think) diet. I figure it's worth a shot. Maybe mag deficiency; I've been diligent about my multivitamin and fish oil supps and the former has magnesium. Kind of afraid to take another mag supp for fear of too much. – Walter Aug 29 at 22:54
How much magnesium is in your multi, and what form? Some forms, like oxalate, only a very small percentage is absorbed. Aiming for 300-400 milligrams of supplemental magnesium in addition to food sources seems to be a sweet spot for most. The only problem with trying to take more magnesium than you need would be diarrhea, and it stops as soon as you cut back. – Happy Now Aug 30 at 2:16
"Magnesium (from magnesium oxide, amino acid chelate, glycinate) ... 200mg 50%[DV]." The the separate magnesium capsules I have are 500mg, so that's why I was afraid to take those with the multi. Can I open the capsule and pour half the contents in with a glass of water or something? BTW, w/r/t to the caffeine/dehydration thing, maybe. Is that an issue for a chiro to deal with? I should say that at this point the hand/arm thing seems distinct from the energy stuff. – Walter Aug 31 at 17:25
Why did I type oxalate up there, I meant to type oxide? D'oh. So, only about 4% of magnesium oxide you ingest will get absorbed (and it is the cheapest source, so it is most likely the majority of what is in your multi), so adding the 500mg. of whatever other kind of magnesium you have won't be an overdose by any means. I've found that the chiropractor can help most when I'm already well hydrated. It is worth a shot now, but personally I have stingy bones that don't want to move if I'm low on water. If the chiro doesn't help with that, deep tissue massage or myofascial therapy could work. – Happy Now Aug 31 at 18:48
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JMHO, The numbness/pain in your arms in worrisome. It could be anything from a cervical problem to a heart problem, and I would see a doctor.

Your symptoms are really too general to pinpoint. You need to have some kind of diagnostic tests done in order to point you in the right direction.

Of course eating a healthful diet always helps and cannot hurt. Even if it just baby steps, like cutting out sugar or refined foods.

Best of luck to you.

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Well I'm a guy so I doubt it's a cervical problem, but I do have heart palpitations semi-frequently (though now that I think about it maybe not in the last week). The feeling is the cardiac equivalent of momentarily driving off the road and hitting that rough patch that's supposed to get your attention. I'm hoping this is unrelated to the other problems though (I've read heart palpitations, while distressing, are pretty common and usually benign). – Walter Aug 29 at 22:58
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I think the 23andMe SNP testing isn't too popular, probably due to the expense and the low likelihood of finding anything really useful, but I had similar symptoms (low temp, brain fog, fatigue, difficulty recovering from exercise, intolerance to caffeine, etc), and I found answers in my SNP analysis. For a set of general problems that could be caused by any number of things, I recommend doing a SNP analysis: even if it rules out some things (like methylation problems) that's helpful to know in the case of fatigue and brain fog. And it has been a lot more effective at uncovering my health problems than my set of specialist doctors (though I do recommend having a doctor on board to help order tests and such).

Through a SNP analysis I found out I have a problem with some genetic mutations in my methylation and oxidation pathways. I found a website detailing Amy Yasko's recommendations for treatment based on genetic mutations and it has made a huge difference. This was after a year of eating paleo to fix my gut.

Do you have any autoimmune disorders, fibromyalgia, chronic fatigue, or autism spectrum in your family? You might check out some chronic fatigue / methylation boards, such as phoenixrising.me and mthfr.net, to see if any of that jives with you.

My health went downhill a few months into grad school, and I'm just starting to turn it around now, a few years later. I was close to having to drop out. So it's great that you're tackling this now, rather than trying to ignore the problems, like I did at first.

Oh, and some thoughts about thyroid and caffeine. Everyone thought my problems were thyroid, but I've had a handful of bloodwork tests for thyroid and I come back totally fine. Same with cortisol. The caffeine thing could be that you're a slow metabolizer, SNP rs762551.

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I had never heard of SNP testing. It IS expensive, but I'll consider it for down the road if thyroid tests, gluten-free, etc. don't lead anywhere. As far as family history, anecdotally my mom "slowed down" in grad school (so, around my age) and I take after her a lot (both physically and mentally). She was always a good student but started struggling in grad school, and as an adult was not an energetic person (though a responsible provider and good mom). She passed of brain cancer several years ago. Maybe CFS... but I dunno. (cont'd) – Walter Aug 29 at 23:05
(cont'd) I'm kind of afraid of a CFS diagnosis because to me that's just a catchall for fatigue-inducing conditions we can't effectively treat yet. I'm afraid the only thing left for me at that point would be drugs. I've read Provigil is a good and relatively safe stimulant, and maybe down the road I might consider that, but I'm so convinced that something is whacked out in my body that treating my brain seems silly... like taking opiates for a broken arm instead of treating it. BTW, I'm glad you managed to continue school. I think I'll manage :) but things could be better. – Walter Aug 29 at 23:16
Yeah, I am unhappy/uncomfortable with diagnoses like fibromyalgia, chronic fatigue, and IBS, too. On the plus side, if you are leaning that direction, and it's because of a problem with methylation/oxidation, then there's a simple fix: support the methylation and oxidation pathways where they are broken. But yeah, check out the stuff medical insurance covers first: thyroid, celiac, etc. I pursued this other stuff when I was getting more and more run-down, and stopped being able to read papers, a year after being gluten free and paleo. – Sara S. Aug 30 at 0:06
How does one (or how do you personally) support these pathways? – Walter Aug 31 at 17:40
I have mutations that make me unable to methylate cyanocobalamin and folic acid to their usable forms, and a mutation in a pathway that recycles homocysteine to methionine (there are actually two different pathways there, and only one of mine is disrupted). So I take folate (or 5-MTHF) and methyl- or hydroxo-cobalamin, plus support for the other homocysteine-to-methionine pathway (TMG) and some other things. Basically, if you think this might be your problem but you can't get tested, you could try taking jarrow methyl-B12 lozenges (takes about an hour, between your lip and gum) and folate... – Sara S. Aug 31 at 18:29
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Check my post about it: http://paleohacks.com/questions/145928/paleo-for-1-year-left-with-a-health-puzzle For me, the problem of energy went away as soon as I started eating lots of carbs. I was stuck in hibernation for months.

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It might be a good idea to have your B12 levels checked. Apparently, that can lead to similar symptoms to yours.

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