Extreme Fatigue With a Few Clues in Blood Work. What am I Missing?

[Nelson Vergel]

Trintellix 10mg/day, Vyvanse 30mg/day, HCG 350iu/wk, Arimidex 0.5mg/wk, Tirzepatide 5mg/wk.

I bet you are not sleeping well. Trintellix plus Vyvance can be stimulating. Stop the arimidex also.

Tirzepatide can cause fatigue in some people if your blood sugar goes into the hypoglycemic range.

Your thyroid seems OK.

If your bilirubin is high (how high?), I suspect that you are taking something else orally or that you should be checked for hepatitis.

What is your blood pressure? What's your T dose?

By the way, if someone can work out with heavy weights three times per week, I would not consider that person fatigued.

 

[obesechess]

I bet you are not sleeping well. Trintellix plus Vyvance can be stimulating. Stop the arimidex also.

Tirzepatide can cause fatigue in some people if your blood sugar goes into the hypoglycemic range.

Your thyroid seems OK.

If your bilirubin is high (how high?), I suspect that you are taking something else orally or that you should be checked for hepatitis.

What is your blood pressure? What's your T dose?

By the way, if someone can work out with heavy weights three times per week, I would not consider that person fatigued.

Howdy,

1. It is possible that these are interfering with my sleep, but short of getting a sleep study done I don't have a way to verify that. I generally feel alright when I wake up, but the side effects of me not taking these medications are worse than "fatigue" so I intend to stay on them. Might get a sleep study though. I have had a few folks recommend that I stop the arimidex, even a such a small dose, and I am curious as to the thinking. Certainly open to peoples' thoughts. My recollection is that I was completely off it for a while and my estrogen slowly crept back up into the high forties, though I'm at a lower body fat percentage now. But yes, I'm open to your thinking on arimidex.

2. Noted on thyroid.

3. High bilirubin was a typo. It is normal (0.6mg/dL, ref range 0.2 - 1.2mg/dL).

4. Blood pressure at last test was 116/67. I am not on T, I am on HCG Monotherapy.

I appreciate everyone's insight here. I am honestly at this point leaning towards "chronic low-grade stress impacting my physical health" rather than any underlying health condition. I have check-ins with my urologist and with a holistic/functional medicine doc in the next two weeks, but I am leaning towards this being psychosomatic and lifestyle related, especially given the way the symptoms come and go. I am generally feeling better than I did when I made this post - except for the last few days, which have been incredibly stressful - so I don't know. Again, everyone's input is appreciated and I'll keep reading and poking around the thread as folks chime in.