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Fatigue - advice needed

C

CrazyCatLady2693

Member
Messages
24
Type of diabetes
Treatment type
Tablets (oral)
Hi, I am fairly new to my diagnosis of Type 2 Diabetes (September 2017) and have managed to lower my HbA1C to 38 through diet and Metformin and have also lost a little over 2 stone in that time. I am having awful problems with fatigue and lack of energy not relating to food (I mean I'm not lacking energy because I'm hungry, the periods of fatigue can last days or weeks). I just want to know if this is a 'normal' part of being diabetic?

For a bit of background info I have quite severe mental health issues but am being treated for that and am quite far on in my recovery. I also have underactive thyroid so take Levothyroxine for that and need B12 injections every 3 months because of a deficiency in that. My thyroid and sugar levels have both been checked recently and are fine. I've had fatigue relating to depression etc in the past but this doesn't feel like that did - it feels physical. Everyone keeps saying how well I'm doing with regards to my health and weight so I am confused what's causing me to struggle so much. It sometimes feels like there's so much going on with my mental and physical health I'm unable to figure out which symptoms are coming from where and what the best course of action is.

I've booked an appointment with my GP for a couple of week's time because the fatigue is disrupting my daily life. I am on disability benefits as I am currently unfit to work but even the basic chores around the house can leave me exhausted. Even if I sleep well I wake up feeling like I haven't slept. My whole body feels achey pretty much all the time. I've read through the symptoms of ME/CFS and experience nearly all of them but am worried about broaching the subject with my GP because I don't want to make a fuss about the fatigue if it falls under a diagnosis I already have.

I worry I'm overthinking the whole thing to be honest so if anyone in a similar position has any insight into fatigue relating to diabetes, underactive thyroid, B12 deficiency etc I'd really appreciate it. Or obviously anyone who has diabetes and chronic fatigue! Thank you in advance
 
I don't think fatigue is a common feature of T2 diabetes when well controlled, and it sounds as though yours is.

You aren't taking statins by any chance? I ask because Simvastatin reduced me to a zombie and I was having to lie down for a sleep in the middle of the day to keep going.
 
Hi @CrazyCatLady2693

You mention B12 Deficiency so are you having treatment for that currently? Are you being treated with injections? If so, how often do you have them? Have you had Folate, Ferritin and Vit D checked recently? Unless you have a particularly clued-up GP, they don't seem to be aware of the issues related to B12 deficiency, usually undertreat and also often under-treat hypothyroidism

In case you're not aware:
- Folate is essential for your body to utilize B12.
- Just because one has good levels of B12, it's not necessarily getting into the cells, so continuation of symptoms, so needs very high, frequent injections to help get into cells. Serum B12 testing is of no value as your levels will be skewed.
- Metformin, Proton Pump Inhibitors/ H2 blockers (ie Rantidine, Cemitidine) are just two types of medication that can cause absorption issues of vitamins, including B12
- Entenox (Gas & Air) can also wipe out active B12 in your system

So, if any of these ring any bells, it may be worth investigating further. PM me if you want any further info re B12 Def
 
As you say you are now on B12 injections 3 monthly they may dip significantly before the end of 3 months. Not easy as B12 jabs are unlikey to be increased sooner.

However you do need D3 tested and your ferritin levels..
 
Apologies, @CrazyCatLady2693
It was only after reading @donnellysdogs post that I realised I missed where you mentioned 3-monthly injections

Have you considered self-injecting in between your 3-monthly injections? Supplies aren't expensive to get and B12 isn't toxic so there shouldn't be any issue with taking too much.
 

Hi there CrayCatLady, I agree with the others, in terms of vitamins, and certainly with hypothyroidism you follate, ferritin, D and B12 are all important to allow your thyroid to function as well as it can. It would also be very worthwhile for you to know what your thyroid hormone levels are - especially as you may be aware, fatigue can be a symptom of hypothyroidism. Bearing in mind our natural production of thyroid hormones can vary week on week, month on month it isn't wise to discount your thyroid function from your fatigue issue.

Allegedly, many GPs only strive to reduce the TSH element into the NHS "normal" lab ranges, when for some people that's not enough. For them, they need to be well into ranges.

If you would like to do a bit more reading on thyroid issues, then Health Unlocked (https://healthunlocked.com/thyroiduk) could be a decent starting point.

Hopefully your GP will be receptive to you and do a bit of testing for you.

Good luck with it all. Extreme fatigue is no fun.
 
Thank you all so much for replying, I really appreciate it!

@LittleGreyCat no I'm not taking statins. Psychiatric meds have made me zombie-like in the past but the ones I currently take I've been on for years so I don't think that's causing the fatigue.

@Energize I've had a lot of bloods done in the last 8 months to be honest which is how the diabetes got picked up (I went to the GP because of fatigue so they tested standard things, I'm not sure of the details). My Levothyroxine was increased for the first time in years but apparently the current dose is correct and the Metformin/diet changes have worked in lowering my HbA1C.

I had no idea about folate so thank you for that and I will ask about those things at my GP appointment.

Do you mind explaining what you mean about hypothyroidism often being under-treated?

@donnellysdogs when the B12 injections began several years ago I could notice when I was due it and I could feel a difference after having it. My diabetic nurse asked me about that in my last visit actually - I do not notice the injections making any difference to energy levels anymore.

@DCUKMod thank you for the link, I will have a look at it before my GP appointment.
 
CrazyCatLady2693 said:

Do you mind explaining what you mean about hypothyroidism often being under-treated?
Click to expand...
Hi @CrazyCatLady2693
It seems many GP's tend to keep TSH higher than what would be optimum. My suspect this may be because of potential risk of heart problems if heart is working too hard due to increased metabolism. Certainly my GP is frequently wanting to reduce Levo but I have to keep reminding them that I function best with TSH running very low.

Also, GP's won't (or are not allowed to) check on T4 vs T3 levels to see if the patient is converting T4 to T3 efficiently. Added to that, there has been all the controversy about T3 and stricter controls re prescribing it partly, if not totally, due to the high price attached to buying the medication. Personally, having had blood tests, it would seem I don't convert T4 to T3 well so, although I feel better on higher dose Levo, my T4 runs slightly too high (for GP's comfort) hence a reduction and consequent increase in fatigue!

I don't have any references to under-treatment of Hypothyroidism, though, but did read about it somewhere.

Hope you will feel better before too long
 

CrazyCatLady - If you visit the link I gave you, you are likely to encounter members over there whose GPs appear to "play very safe" when treating hypothyroidism. By that I mean once an individual is diagnosed as hypothyroid (usually simply by their TSH being out of range), they are content or even keen to resist further upward titration of corrective medication once the TSH gets back within the "normal range", rather than seek an ideal situation. At my lab, the "normal range" is 0.3-5, whereas a euthyroid person would usually be under 2, and often ideal levels skirt around 1.

I'm no expert in thyroid matters, although I have done some reading, due to a few issues myself. Fatigue wasn't one of my issues, but it so very often is.
 
I suspect this may be due to your hypothyroidism. At my last visit with my endocrinologist he wanted new thyroid blood test taken. Unfortunately due to staff shortages the hospital asked me to get my GP to do these. This she did and a receptionist called two days later to say my thyroid was fine. I have been told this for so many years by many GPs. Most give minimum medication to keep patients in range. However some patients need more. I have now requested a print out of my results to see for myself. I may then go back and discuss with her. I once had a GP who put me further up the scale for two years. It was amazing the difference. I wonder If you might like to try the same.? Good luck
 
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