unexplained fatigue

Unexplained New Onset Fatigue and Other Symptoms

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For almost a year, I have suffered from fatigue, morning sinus and congestion problems, and other health issues including type 2 diabetes, insomnia, and depression. For the last four months, I have been dealing with a skin rash on my legs, arms, stomach, and small outbreaks on my face. I have been misdiagnosed by my primary doctor and two different naturopaths. They told me that it was fungal and I was given anti-fungals. I don’t remember the name. After a second visit to a dermatologist, the doctor did a scraping and a biopsy and told me that it definitely wasn’t fungal. They are going to do some patch tests this week. I have had to keep my mental outlook positive because, for the last year, the doctors have had no answers.

My primary has told me that I am an anomaly. Great! But still no answers. She has done a plethora of blood tests, two or three CAT scans, and other imagery. The only blood test that was a little high was my white blood cell count. My iron is high because of my testosterone injections. I was initially told that I had Lyme’s disease but my blood tests found that to be negative. Then I was told that I have Epstein Barr, but my blood tests were negative for that also. I am used to an active lifestyle, lifting weights, hiking, backpacking, fishing, martial arts, etc., but, for the last year, I have been extremely low energy with significant fatigue. I will sleep 8 hours, get up for a while, and just feel like going back to bed. I would like my life back!

Early Thyroid Problems

I take levothyroxine because my thyroid was low about 20 years ago. They did a scan of my thyroid and told me that my thyroid was quite small, probably due to my Graves’ disease treatment when I was 16 years old. I was told that I was close to death at that time. I remember some of the unpleasant things I went through at that time. They gave me a drink called a “nuclear cocktail” and then, for the next 4+ years, they treated me with propylthiouracil. I fought my way through this disease and started lifting weights and working out when I felt better. I was about 16 years old at the time. I continued to work out and have been athletic all of my life.

Back Pain and Spine Curvature

After years of athletics that included snow skiing and martial arts, I began to develop significant back pain. After an MRI in 2004, the doctors asked if I had polio. The test showed curvature of the spine, a bulging disc, and some areas of bone on bone.  At that point, I was prescribed oxycodone and have been on it ever since. Despite the back issues, I have functioned fine until this last year when a variety of new symptoms manifested, including unremitting fatigue. I have had a big change in my energy levels, sex drive, and the pain issues have increased and so it is a struggle to lift weights. My hands, shoulders, spine, and feet have increased pain. I have always been very self-motivated, but this last year has been very tough. The doctors say that I have osteoarthritis and fibromyalgia. I don’t know anymore.

Maybe Thiamine for the Fatigue?

Recently, I listened to Elliot Overton’s interview with Dr. Marrs about thiamine and found many of my symptoms were possibly linked to thiamine deficiency. I have taken a myriad of nutritional supplements over the years. They are listed below. All to no avail. I have also started taking thiamine, but the jury is not out on that yet. It has been pretty expensive with all the doctor appointments and nutritional/medical expenses.

There is a lot more that I have probably missed, but I wanted to keep this to a short story, not a novel. What am I missing with my health issues? The fatigue is unending. The doctors have no advice and consider me an anomaly. Am I? Or are we simply missing something?

Current Medications

  • Levothyroxine-125mcg – for approximately 29 years.
  • Sertraline-50 mg – last two years
  • Lisinopril-10mg – last year and a half
  • Metformin-750mg – last two years
  • Hydroxyzine-50 mg – at bedtime for sleep issues for the last year and a half
  • Oxycodone-10 mg up to 4 times a day since 2004. I see my spine doc every 2 months. I have some spine damage and joint issues from the martial arts and various other sports.
  • Dicloflenac- 50 mg (Rarely use)
  • Lunesta-3 mg (1 at night) – this was given to wean me off of clonazepam.
  • Testosterone-.5 ml – injection every 2 weeks – for low testosterone
  • Aspirin-81 mg-one a day for thick blood due to the testosterone replacement therapy
  • Kenalog injection for rash. I have had only one injection and the dermatologist told me that it would be good for a month.
  • Triamcinolone cream to use on the various rash sites.

Current Supplements

  • Vitamin D3-10,000 IU a day (Kirkland brand)
  • B12-5000 mcg sublingual 1 a day
  • Saw Palmetto-450 mg, 1 a day (ZHOU brand)
  • Ceylon Cinnamon-1200 mg, 1 a day (Spring Valley brand)
  • Garlic-2 capsules, 1 a day (Kyolic brand)
  • Niacinamide-500 mg, 2 times a day (Nutricost)
  • Liposomal Vitamin C-1400 mg, twice a day
  • Benfotiamine-300 mg, twice a day

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This article was published originally on February 19, 2020.


  1. Wow this is such an interesting case but frustrating at the same time. I can’t help but thinking that you have some major issues with diet based on the drugs you’re taking. If you eat highly processed foods then this is what ends up happening unfortunately. Gotta fix your nutrition first and foremost if that’s an issue. If you need a reasonable option for help then reach out to Revero.com so you can work with a doctor on this or Ifm.org can help you find a functional medicine doc in your area to help. Sounds like you don’t know what you’re doing, AT ALL, and I mean no offense. This isn’t uncommon but extremely dangerous. Conventional medicine is a joke and doctors are just drug dealers and procedure pushers at this point unless you break a bone, need stitches, or get a serious infection (and even this one is questionable now). There’s so much valuable info on this site. I’ve read just about every article which has helped me immensely and directed me down paths which have taught me invaluable information. Get your nutrition dialed in today and then follow Chandler’s advice and come off these drugs VERY SLOWLY! Also remember, this isn’t your fault if you didn’t know any better but now you do so get after it. We’ll be anxiously awaiting the article about how you resolved all of this.

  2. Sleep apnea is a very serious disease , tired , bad mood , no energy…best solution is have jaw surgery and lose weight be slim !..—> eat little and live long time .

  3. The clue is fatigue. This is due to failure of the body cells to make ATP. Thiamine stimulates energy metabolism. Read all the posts on HM on thiamine to avoid repeating the advice re treatment

  4. Recently the idea of virus blocking glucose entry to the cell came across my reading. Dr Proal has a video explaining this, https://www.youtube.com/watch?v=zVwH1bd5u5E, and these are the references she gives showing blocking the ability to absorb glucose. So, your tired and I’m willing to bet you have an unidentified gut virus disrupting your ability to use glucose and that’s causing the fatigue.

    Viral insulin-like peptides activate human insulin and IGF-1 receptor signaling: A paradigm shift for host–microbe interactions:


    The extracellular domain of Staphylococcus aureus LtaS binds insulin and induces insulin resistance during infection:


    So, you are showing bone issues and I believe the bones to be structural, but also mineral storage facilities that the body taps into when it needs extra minerals, so minerals for bone health should help. So chromium helps the glucose transporter, molybdenum and selenium needs increase when you have increased oxidative stress. I’m sure I saw something on boron helping gut health, so boron, and that needs magnesium with it. Of course there is zinc. And then you need copper for the mitochondria, but make sure it is plant copper. I believe you need extra minerals when the body is fighting something, and it looks like you’ve been fighting something to the point that your reserves are being stripped.

    And then when you are fighting something, and have gut issue, well, Metformin is a poor option for gut health issues, and, your amino acid balance can go out as well. I think the best way to address that is well balanced single amino acids. Leap2bfit is the best formulation that I know of, but there is also a very well designed one in Italy that I don’t remember the name.

    I think the boron is more important than we realize. It looks to me that it is important in maintaining muscle and testosterone. If you want to explore further, here’s some references for you:
    Pizzorno L. Nothing Boring About Boron. Integr Med (Encinitas). 2015;14(4):35-48.
    Chapin RE, Ku WW, Kenney MA, et al. The effects of dietary boron on bone strength in rats. Fundam Appl Toxicol. 1997;35(2):205-15.
    Nielsen FH. Studies on the relationship between boron and magnesium which possibly affects the formation and maintenance of bones. Magnes Trace Elem. 1990;9(2):61-9.
    Penland, J G. “Dietary boron, brain function, and cognitive performance.” Environmental health perspectives vol. 102 Suppl 7,Suppl 7 (1994): 65-72. doi:10.1289/ehp.94102s765
    Nielsen FH. Biochemical and physiologic consequences of boron deprivation in humans. Environmental Health Perspectives. 1994 Nov;102 Suppl 7:59-63. DOI: 10.1289/ehp.94102s759. PMID: 7889883; PMCID: PMC1566640.

  5. Oh- and have you tried tyrosint for your thyroid? I switched to it after discovering the others have wheat in them as a side ingredient.

  6. Going gluten free helped me. Eating a celiac diet.
    No wheat, barely or rye.

    Have you been checked for folate methylation? A b complex with folate as 5- methylteyrahydrofolic helped me absorb better since I have the celiac gene and the mthfr gene.

    Wishing you well!

  7. Thiamine and magnesium are cofactors to ALL the enzymes that collectively synthesize ATP, the energy currency, Cofactorship means that the respective enzymes do not function without them. Obviously these deficiencies, easily produced by the average American diet, together with genetic risk factors, are only mild to moderate because complete deficiency would result in death. I have studied thiamine and the effect of its deficiency for about 35 years with clinical research in both patients, animals and medical practice. I was educated and practiced as a family doctor in Britain as an orthodox, pharmaceutical wielding physician but my experience at Cleveland Clinic taught me that we were on the wrong track in medicine. Instead of confining our strategies to killing the attacking bacteria, the virus or the cancer cell, we need to follow the dictum that was announced by Louis Pasteur who said on his death bed “I was wrong. It is the terrain (natural defenses of the body) that matters” There is only one way of doing that, through a complete understanding of how food is used as fuel to create the energy that enables us to be alive and function.

  8. In my view, most of these comments are missing the point. The CAUSE of illness is energy deficiency and of course I agree with Dr. Marrs concerning medication withdrawal, because many of them actually precipitate thiamine deficiency. She would be the first to agree with me that thiamine is the least discussed supplement in this forum and is the most important—-simply because it stimulates energy production. It may just be true that thiamine and magnesium are indeed the “keys to disease”. I looked up thiamine deficiency on Pub Med today and found a multitude of published manuscripts on the medical use of megadose thiamine. It is no longer the “brain child” of a few physicians who have long been under the “microscope” of professional criticism. The American College of Advancement in Medicine ACAM@ACAM.org and the International College of Integrative Medicine (ICIM) are the two physician organizations that have survived years of marginalization and scorn. They can provide the name of a physician nearest to the patient’s address.

  9. I’d agree about the levothyroxine. There is a whole patient awareness movement trying to educate people about the ineffectiveness of levothyroxine compared with natural dessicated thyroid (dried extracts of animal thyroid gland). Poor thyroid function will affect everything in the body.
    I’m not a doctor, so this is just my personal opinion.

    Like others above, I’d be very concerned about the mega-dosing of vitamin D. Vit D has numerous nutrients which work alongside it, including magnesium, zinc, boron and vitamin K2. Taking vit D without those accompanying nutrients is a very bad idea.

    I know people have mentioned vits A and D, and referenced Chris Masterjohn, but this is a topic on which I’d be super-cautious. Without a liver biopsy, you don’t know how much vitamin A is stored in your liver, and I believe the RDA amounts of vitamin A recommended are intended to allow some of that to be stored in your liver. If you have poor liver function due to thyroid issues and all the medications, your liver’s ability to handle vitamin A is likely to be severely restricted. There is a slowly growing awareness of some people having developed acute and/or chronic vitamin A toxicity by following the advice given by the Weston A Price movement with which Chris Masterjohn is aligned, or even from supplementing vit A at much lower levels than he recommends. I myself developed acute toxicity within a month of supplementing at a rate which conventional medical wisdom says would take 7+ years to become problematic. In many cases people were also taking vitamin D alongside, or using cod liver oil, which provides both, yet that didn’t protect them from developing toxicity.

    I’d not take any individual B vitamins without the others for any length of time, as they all work together. For example, my own personal experience is that B1 without B2 just precipitates a worsened B2 deficiency, and it’s known that B12 and folate both need to be taken together. (I’ve personally also found that B vits without adequate choline are a very bad idea) It is also well-known that most B vitamins increase your need for magnesium, which is why Derrick Lonsdale always tells people to take magnesium along with thiamine. There are anecdotes in the comments on his articles here about people who failed to do that and got worse rather than better. I was once prescribed Diclofenac for a problem which turned out to be caused merely by magnesium deficiency.

    Whatever you decide to do, I’d make very slow changes, whether that’s increasing or decreasing supplements or pharmaceuticals. Any rapid changes are likely to throw you even further off balance.

    Hope you manage to make some progress.

  10. I’m not a doctor either but wanted to chime in because I had similar symptoms with the exception of the rash. Just recently I had an acute attack of appendicitis where the appendix was removed. My first, and hopefully last, abdominal surgery. Apparently it was huge and ready to blow. I had been feeling terrible for months with low, low energy. My immune system was in great distress as I was always fighting some bug or condition. I had been doing Keto too. This comment may not relate to your situation but I wanted to post because I wondered if a physical exam could have caught this earlier? My doctor never pushes and probes my organs as they did many years ago. I feel so much better now even though I’m barely healed.

    • It is interesting that appendicitis is a stress induced disease and fatigue is the hallmark of energy deficiency

    • Hi T, I signed up for Epocrates but it does not give safer alternatives for the drugs. I am trying to cut back on some of this medication. I think that you have to pay for the app that suggests drugs that do not interact with current medications.

  11. Hi William. I am not a doctor so cannot give advice as such, but I have found over the years that medication doesn’t actually cure anything and has often made things a lot worse.

    I am Type II diabetic since 1997 and on insulin since 2003. I have tried various things over the years to try and reverse the diabetes, but there are two things that have really helped. The first was dumping wheat/gluten. That made a big difference. Gluten can create havoc in the body, causing a huge array of different issues, including fatigue, rashes, depression, neurological issues, digestive issues, you name it.

    The other has been to change to a plant-based diet. I followed high fat Keto for several years (& coughed & spluttered all the time…?) but in the end my insulin resistance went into orbit & not even high amounts of insulin would get it down. When my digestion finally refused to process animal protein I switched to plant-based & to my amazement within 5 weeks my insulin sensitivity returned, my blood sugar dropped & I had to radically cut my insulin by more than half (50+ units down to 20-25). If I am very disciplined, & stick rigidly to only fresh raw vegetables & some fruit & no added fats or oils, I only need 12-15 units.

    For me, it is the fat that drives the insulin resistance & the cloggy sinus & constant throat clearing. The less fat I consume, the better my insulin sensitivity & the less cloggy I get. I have come to realise that my biggest issue is that my body is toxic – from metabolic wastes that it cannot remove properly, & from hard to detoxify drugs & other stuff I have thrown at it over the years.

    I am not deficient – and in that I mean that I am getting what my body needs – it’s just that it cannot extract & utilise what it needs from the food I eat because my cells are so congested with garbage they cannot eliminate. I recently read a fascinating book explaining this, written by a doctor almost 100 years ago (Toxemia Explained by Dr. J H Tilden MD – available on Amazon Kindle).

    What is helping me is following the Mastering Diabetes protocol. They have a website plus Instagram & FB pages & loads of free info. #masteringdiabetes I also like Dr. Brooke Goldner’s free Smoothie Solution protocol too. There are loads healing from their autoimmune & other conditions – #smoothieshred on Facebook plus a website. Both MD & Dr. G offer personal support although that is a paid service. These protocols help the body sweep out the trash & get everything working far better.

    • It has been published that 70% of diabetics are thiamine deficient and the “cloggy sinus” is due to dysfunction in the nasal cycle (look this up). Autonomic neuropathy is very much part of diabetes and is a direct result of thiamine deficiency

  12. Disclaimer – I am not a Doctor and my comment should not be used as medical advice.

    A few things pop out for me besides the polypharmacy – firstly the lisinopril. This interferes with Angiotensin I converting to Angiotensin II which causes rising bradykinins in the body. One side effect can be urticarial rash. Another can be cough, congestion, etc as it is an allergic reaction. When I had an adverse reaction they had me take an anti-histamine right away.

    The vitamin D without K and vitamin A is a problem unless the diet has a lot of vitamin A such as liver. D and A are mutual and either without the other is eventually toxic. Vitamin A/D ratio should be 10:1

    Finally the niacinamide and methylation and fatigue. Niacin and niacinamide are both great for soaking up excess methyl and too much shutdown of methylation can cause fatigue. The cinnamon is a great methyl donor but I doubt the two are in balance. Perhaps work with a functional doctor on testing methylation status.

    Again, talk to your Dr. for any medical changes and do not take this as qualified medical advice but if this was me and I had to dig out from this I would switch to an A/D/K supplement or liver from the D only unless lots of vitamin A in the diet. That may or may not include beta-carotenes as many people have genetics where very little beta-carotene is converted to A. I would start backing off the niacinamide/cinnamon together or get methylation tested and I would talk to the Dr on whether the rash was a lisinopril induced urticaria caused by angioedema in the skin and the possibility of switching to a different BP medication.

    • Hi T, thanks so much for the information. I am going to try and organize this and formulate a plan of attack. I have also posted to new symptoms for review. I sure appreciate your time….Bill

      • I recommend this article by Chris Masterjohn on A, D and K

        “Spiesman treated 54 individuals who suffered from frequent colds (five to seven colds per winter) with massive doses of either vitamin A alone, vitamin D alone, or vitamins A and D together. He treated them during the winter, for as many as three years, with a dosing schedule reaching a maximum of 40,000 IU for vitamin A and 300,000 IU for vitamin D.

        Spiesman found that vitamins A and D only reduced colds when fed together”

        “Likewise, he found that vitamins A and D were only safe when provided together:
        Vitamins A and D are toxic when provided alone, but safe when provided together.”

        “Nevertheless, the study quite clearly provides proof of principle in humans that vitamins A and D are most beneficial and safest when provided together, just like in the animal experiments.”


  13. The megadosing Vitamin D3 is causing metastatic calcinosis, driving the pain and nearly all of the other problems.

    There is very likely overt or hidden Vitamin A toxicity, also being driven by the multiple medications slowing its detox thru the liver, which then further worsens the calcification problem. This may be further compounded by high carotenoid and/or Vitamin A foods or supplements (now or in the past).

    You are taking at least one supplement that contains significant aldehydes (cinnamon), and several of your supplements shut down ALDH (which detoxes aldehydes, including the retinaldehyde form of Vitamin A, this leading further into the Vit A toxicity problem I mentioned).

    These are issues that I fix on a daily basis, but almost no other practitioners know how to look for these things.

    If you are interested in more info, my contact info is here.

    • Thank you Dr. There is so much information here. I am going to try and organize the information so that I have a plan of attack.

    • Also, I would love to have your contact info. I feel like I am in the infant stage of my recovery and am trying to organize all the information these wonderful people are providing me with. Thanks again.

      • Click on his name above, or search the internet for “Nutrition Restored Dr. Garrett Smith” and you will be able to contact him.

        His work has been very helpful to me.

  14. Last comment… In terms of thyroid meds, I am happy on Naturethroid as an alternative to Levothyroxine. But I have Hashimoto’s, and my thyroid gland is nearly gone, so I can’t possibly go without, and I take a pretty high dose. I have felt pretty awful in the past when my dose was too low. It can help to get your test results and see for yourself what your thyroid numbers are like.

    Maybe also think about acetylcholine and whether any of those meds are classified as anticholinergic? I personally feel weak and fatigued without plenty of acetylcholine, so it’s another thing you could look into.

  15. I would not be taking all that vitamin D without K2. What is your alkaline phosphatase level on a comprehensive metabolic panel?

    • I don’t know if they did an alkaline phosphatase check. No one told me that I had to take K2 in conjunction with the D3.

      • I was told I had to take K2 when taking the D3 to prevent problems with calcium not making into the bones and causing trouble elsewhere.

        I personally eventually got muscle pain on Metformin, but I can’t tell if muscle pain (myalgia) is the kind of pain you’re living with.

  16. For the B12 piece, you may need to try injections. Sublinguals didn’t work for me, and I’m not the only one! I ended up with nerve damage despite sublinguals, but the injections work (and my nerves seem to have healed on weekly injections).

  17. Hello William,
    You might find helpful my husband, Bill’s recent experience with medications. He started out being prescribed Carbidopa/Levodopa for a tremor that developed suddenly, without the benefit of a neurological exam. The medication never really helped his intentional tremor, but he continued to take it. Later he developed anxiety, insomnia, psychosis which caused his Drs to add more medications like Klonopin and Quetiapine to help him sleep. They only had a worsening effect on him. An ED psychiatrist took him off Klonopin, but the psychosis continued. Depakote was added as a mood stabilizer, and Aricept for dementia. Things seemed to improve for a while, but slowly descended back to anxiety and depression. Then Orthostatic Hypotension landed him in the hospital after a syncopatic episode (he fainted). Celexa replaced Depakote, thinking it would help his depressed state. Falls at home, weakness, more cardiac issues, and severe weight loss had his cardiologist offering to place him in Hospice. All this happened in the span of four years; a once athletic, competitive sailor now unable to walk, much less enjoy the life he once knew.

    The good news is while in the hospital, an inpatient neurologist visited Bill and told us he would like to take him off C/L and observe him. The medication was titrated down slowly, with no adverse effects. The neurologist then looked at the other meds and did the same. He cited Polypharmacy as a complicating factor in Bill’s recovery. We have more work to do, but symptoms like night terrors, paranoia, hallucinations, abdominal pain, anxiety, gut dysbiosis, are a thing of the past. Finding Drs Lonsdale and Marrs’ work on Thiamine as a treatment for Dysautonomias (in my husband’s case, Orthostatic Hypotension) has been life-saving. By oral supplementation of Thiamine, Bill has reversed OH. It took eight weeks of slow titration up to see positive results. It’s been 7 months, and his blood pressure continues to be normal.

    I’d like to encourage you to find a professional (a pharmacist, physician, or specialist in polypharmacy) to review your med list and look for counterindicated or duplicated drugs. What you listed is a lot, and side effects, even the rash you are experiencing can be caused by any one of them.

    I have some ideas concerning the supplements you are taking, but I think you would do well to address the pharmaceuticals first. I wish you all the best!


    • Thank you so much for all the information. My plan now is to organize this info and formulate a plan of attack. I feel kinda overwhelmed, but I am committed to finding root causes.

  18. I am not a dr either, just one in the functional health space. So big grain of salt.

    Levothyroixine is inactive T4. Many of my clients tell me that it doesn’t do anything for them when I ask them, but they keep taking it cuz the dr told em so. Better to have a functional practitioner reassess thyroid entirely. You just might do better on an iodine protocol. And I would do a hair tissue mineral analysis to see what is going on with your minerals, the “spark plugs of life.” Good chance with your pharma history, you have depleted vitamins and minerals considerably, which will up your stress on your adrenals and deplete thyroid activity (of T3 helping to ignite glucose in cell) Speaking of adrenals, they need a ton of Vit C especially when drained as you seem to be right now. Adrenals also need Mg and B1 and Niacin to boost ATP to produce stress hormones. And yo need vitamins and minerals to address back pain and curvature.

    When someone has a long history of pharma use and a slew of symptoms, nutrient deficiency of vitamins and minerals is the primary suspect, not pharma deficiency.

    I would be thinking of 100-150 mg of B1 in divided doses, per Dr Lonsdale and Marrs for therapeutic intervention, a minimum of 3000 B3 as Niacin, not Niacinamide, You need the flush. At least 3000 mg of Vit C – reach for bowel tolerance and back off a smidge.

    Diet can also drain vitamins and minerals. So, that has to be assessed. Gut health has to be assessed. Are you absorbing anything? Is your gut leaking, creating inflammatory and autoimmune cascades?

    Low T do you really have to take that? Does replacement therapy really work? No. How did T go low? No conventional dr goes after root cause, just replacement therapy, like levothyroxine. See, they never ask why? If it’s low, just give em replacement therapy for the rest of their goddamn lives. That is astoundingly lazy. If I tried to do that, I wouldn’t have any clients at all. I can’t get away with that shit. Not that I want to.

    And then you get to take aspirin every day of your life to thin the blood viscosity resulting from T shots? NSAIDs every day are not a healthy way to go about your day. In fact, that will cause new complications down the road. Most nutrients act in a way to thin or regulate blood viscosity. Just need the right amount. But if you stop T shots, then blood viscosity should improve on its own anyways.

    And Kenalog, a corticosteroid to suppress a rash? But wait, you already suffer from chronic and adrenal fatigue. So, let’s just drain the adrenals further. And suppressing a symptom that is trying to get out of your body is only going to drive the symptom deeper and manifest at an even worse symptom than a rash at a later date. Better to consider a skilled homeopath to deal with the “psora” miasm causing your rash. Someone like Doug Brown ( I am not yet a homeopath).

    • My low T was caused by the Graves Disease that I had when I was 16 years old. They treated it with, what they called, a nuclear cocktail. I was then on propyltriuracil for about 4 years. Those treatments caused my thyroid to shrink. The doctors don’t seem to know how to check for adrenal fatigue, so I am not quite sure how to address that possible problem. Thank you!

  19. With respect to the message I posted earlier about selenium, it is interesting that low selenium status is associated with increased risk of Graves’ disease. I don’t know what might have predisposed you to selenium deficiency, but that could have been the first domino to fall, and then it was treated with radiation instead of finding the cause.

  20. That medication list is a little frightening for me – until you are clear of those it is likely not possible to know what are your underlying symptoms issues. On the face of them and taking away any side effects and EFFECTS of those drugs and their interactions, you sound like a classic chronic infection person – ie lyme and coinfections.

  21. Hello William, I don’t know anything about meds but as for the fatigue and rash, have you been checked for coxsackievirus? It can be a cause of chronic fatigue. It is often found in relation to selenium deficiency, and some people get relief from the fatigue by taking selenium supplements.

  22. Sorry to hear you’re going through all this! I can relate to much of it because of ongoing health issues myself. I’ll jot some thoughts/questions here in point form.

    ~The rashes.. Have you been tested for strep antibodies? Some variants of streptococcus bacteria can settle in various organs or muscles, and can present with rashes.

    ~I find when taking B1 & B12 that my need for potassium increases. When it’s low I get insomnia, fatigue, racing heart etc..

    ~Am wondering if you’ve had your copper/ceruloplasmin/zinc ratios evaluated?
    High copper (especially if ceruloplasmin is low) can result in fatigue/impaired adrenals, and a host of other issues, including hormonal imbalances (ei low testosterone!).

    ~The sinus issues could be caused by MCAS or Histamine intolerance or mold exposure or CSF leaks (see next point).

    ~The spine issues.. I would look into ‘Cerebrospinal fluid leaks’, which can cause a host of spinal problems, and even can gush from the sinuses (!!)

    Hugs and best of luck to you!

    • Hi Ester, I believe my primary has tested me for a lot of things. The only things in my blood tests that were slightly abnormal were low ferritin and slightly elevated white blood cell count. I have not had my copper levels evaluated.

  23. I first want to point out that I am a researcher and not a medical doctor and so my comment cannot be construed as medical advice. Having said that, your situation and symptoms are not uncommon. Each them can be traced to one or more of the medications that you are taking, alone and in combination. I encourage you to look up the side effects of these drugs to see how much of your recent decline in health is related to polypharmacy.
    Specifically, the long term oxycodone use causes the low testosterone, higher blood sugar, among other issues. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2852206/
    • Increase GH, TSH and prolactin
    • Decrease LH, testosterone, estradiol, and oxytocin
    • Hypogonadism
    • An effect on the secretion of other pituitary hormones
    • A decrease or increase of food intake
    • Hyperglycemia
    • Impaired insulin secretion

    Sertraline- magnifies some of these responses and interacts with oxycodone. Alone, sertraline can cause high blood pressure, and does cause loss of libido, insomnia, anxiety, depression, increased suicidality. Setraline with oxycodone risks something called serotonin syndrome (we have an article about that on this site). In its acute stages, the symptoms of serotonin syndrome include: mental status changes, neuromuscular hyperactivity, and autonomic hyperactivity. An article here. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3865832/
    It is considered rare and with an acute onset, often in combination with other drugs, but in reality, the effects would accrue over time and more likely only recognized once the syndrome is fully underway.
    Both drugs affect testosterone and libido. The addition of testosterone to this mix then raises BP even further, along with the risk of clotting.
    Lisinopril- is an ACE inhibitor working on aldosterone system to reduce blood pressure. It was given to reduce the elevation in BP that was, if not directly caused, at least exacerbated by the sertraline/oxycodone combo, and then magnified by testosterone, which was given to offset the effects of oxycodone and sertraline on hormones and libido. Lisinopril lowers androgen levels further. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2883618/

    See the pattern emerging.

    Metformin- reduces blood sugar, in your case, likely caused by the combination of drugs above and diet. It also blocks thiamine, folate and B12, which in turn cause a laundry list of other symptoms. Of note, metformin also reduces the ability of skeletal muscles to produce ATP by almost 50%, as well as the insulin sensitivity usually created by exercise. Your inability to exercise is in no small part likely due to the metformin. I have multiple articles on metformin effects on this site. Please review them.

    Hydroxyzine is an antihistamine, used for allergies, anxiety and sleep, all likely caused by the sertraline and the combination of other drugs that are causing mast cell dysregulation.

    Lunesta- to wean off of clonazepam. Both drugs risk interactions with oxycodone and neither should be used together. In this case, the risk respiratory depression, low heart rate and BP are possibilities. Perhaps the combination of oxy and clonazepam were keeping your BP under control for a while but now the lunesta is exacerbating. The sleep issue is likely caused by the sertraline.

    Aspirin- blood thinner, required in this case because of the testosterone, which was required because of the oxycodone and sertraline. It also an NSAID, and with NSAIDs, there is a risk of atrial fibrillation, which in turn leads to a risk of blood clots.

    And the early damage of the thyroid gland, probably, in no small part, contributed to some your health issues early on via mitochondrial damage, which over time, would become more prominent and worsened with additional medication.

    There is no mention of your diet. A poor diet would contribute to these issues, as would alcohol and tobacco use and any environmental exposures to additional toxicants. Even if your diet was pristine, however, the polypharmacy would be sufficient to send your health into rapid decline.

    Unfortunately, the only way to unwind this is to slowly, and I mean slowly, withdraw from these medications, one at a time over an extended period, months to a year. The assistance of a physician is greatly encouraged. If you were to stop taking any of these medications too quickly, you would have severe withdrawal effects, which given their interactions with heart function, could be deadly. It is doable though over and extended period of time. Simultaneously, diet has to be corrected and nutrient supplementation has to be titrated up gradually. Your chemistry is very disrupted and nothing should be done rapidly. I am not a fan of herbal supplements, particularly in light of all of the other chemistry issues and instead would prefer one approach healing the mitochondria nutritionally. Others may disagree.
    If you choose not to reduce the medications, I am afraid your health will continue to decline. The human body is not made to handle this many medications indefinitely, arguably, if ever.

    • Hi Chandler, I have read your review and now need some guidance in regard to what direction to take. I would like to get off most of these meds and was wondering which would be the first that you would recommend to wean off of. I believe that I will still have to take some sort of thyroid medication throughout my life. And, if you have some suggestions of which medication to start with, do you have any suggestions on a healthy replacement? I am going to have a lot of questions as we progress. Thanks.

      • Perhaps the antidepressant, but titrate slowly. Create a plan of a gradual reduction over an extended period of time and stick to it. Don’t try to rush it. Give your body a chance to adapt its systems to the absence of the drug. Metformin is also something that can be withdrawn, perhaps simultaneously, perhaps not. You’ll have to start with one and then if things are going well, begin reducing the other gradually. Simultaneously, you need to optimize your nutrition, whole foods, protein, fat, fruits/vegetables, avoid processed foods, alcohol, sugars. And yes, I would suggest thiamine. You are already taking benfotiamine and that is working for you, keep at it. If not, there are variety of formulations that work a bit differently. Finally, there was a lot of advice given, realize that each of us has our biases, myself included. You’ll need to do the research and determine your course of action based not just on the advice given here, but a researched and reasoned conclusion that you make for yourself. If something doesn’t sound or feel right, investigate and then make a decision.

        • Dr. Marrs, could you do me a favor. It seems as though my worst symptom is this intense inflammation. I was wondering if you could present this issue to the group and see if they have any suggestions. I was thinking that it might be good to address the most pressing issue first. Thanks!

    • Hi Doctor Chandler, this is a lot of information. Like I said to another comment, I am going to try and organize this information and formulate a plan of attack. Also, I forgot to mention some new symptoms that I have been experiencing on a daily basis. The bottom of my left heel is so painful that I walk with a limp. Also, the top of my right thigh will feel very painful. It runs from the top of my kneecap, upward about 12″. Every morning I wake up congested with a lot of mucus. It feels like my lymph nodes are swollen but all the CAT scans have shown that everything is normal. I have to force myself to get motivated in the morning. Most times just feel like staying in bed. I work swing shift, and the symptoms seem to decrease in the evening. Will the other commentators see my new posts? I really appreciate their input.

      • Just a semi-educated guess: is your body starting to form stones (oxalates and calcium stones) in kidneys? What happens if you drink large volume of water in a day? Does fatigue and brain fog lessen? Try drinking a lot of water after you wake up. You will feel too weak to drink the water but force yourself to drink. High vitamin D can lead to excess deposit of calcium in kidney/gall bladder. Oxalate crystals can create back pain, pain on bottom of feet from sharp oxalate crystals, mucus buildup, flare on knee, dropped or dragging foot. Been there done all of this.

        • Wayne, do you think that I should discontinue vitamin D? No one told me that you had to take K2 with the D. I bought some D-K2 and was wondering if I should discontinue the D altogether.

    • I am trying to taper off Metformin, Lisinopril, and Sertraline. I am still feeling terrible. I have been getting headaches. I never had much of a problem with headaches before. My energy is still low, congestion and sinus drainage in the morning, and excessive pain in my thumb joints. This poison oak type rash has gotten better, but it is still somewhat present. Most days I feel discouraged and have tried to adapt my mental to just accept this condition. Pretty depressing.

      • I would not taper off everything all at once. Pick one of those and taper slowly, across weeks/months, staying at the fraction of the dose for at least a week, maybe two until your body adjusts, before lowering again. Tapering Lisinopril incorrectly could resulted in higher BP. Tapering sertraline too quickly will result in a nasty withdrawal syndrome. While tapering make sure your nutrients are on point. Thiamine, magnesium in particular. Additionally, know that this will take an extended period of time and that you will feel quite horrible until everything is out of your system and your chemistry has re-adapted. This is drug withdrawal. Just like the drug withdrawal seen on on TV in street drugs, perhaps not as intense but certainly miserable.
        And you should be working with a physician to taper and monitor.

  24. Hi William, it could be worth looking into getting evaluated for structural spinal issues (Craniocervical Instability, Chiari Malformation, Tethered Cord Syndrome). I wonder if the congestion you experience in the morning could be cerebral spinal fluid, indicating a leak. It might be the best place to start investigating these issues.

      • I’m just learning about all of these issues myself, I’m not a professional of any sort. But I’m trying to navigate similar symptoms.

        Yes, I would mention the possibility of a CSF leak to your spine doctor. To my knowledge, the treatment is something called a blood patch. It can be very effective from what I understand. Some people require multiple patches. It could also be a less effective treatment if other structural issues are present.

    • Hi Ryan, I will ask my spine doc about this the next time I see her. I have had RFI (Radial Frequency Neurotomy) at least 3 times now. It’s a very uncomfortable procedure.

  25. Looking at changes in the past 2 years:

    Sertraline-50 mg – last two years
    Lisinopril-10mg – last year and a half
    Metformin-750mg – last two years
    Hydroxyzine-50 mg – at bedtime for sleep issues for the last year and a half
    Lunesta-3 mg (1 at night) – this was given to wean me off of clonazepam.

    – benzo (clonazepam) withdrawal?
    – adverse effects of sertraline (Zoloft)?
    SSRIs have been documented as a cause of Drug-induced Lupus Erythematosis (DILE, skin and systemic)
    —-> lupus workup, FANA antibodies and pattern ?

    NOTE: IF it is suspected, PLEASE do not discontinue abruptly! Consider a very slow taper (~5%/month decrement even if it doesn’t seem to be doing anything positive)


  26. Look up potassium deficiency I know they say it’s dangerous but watch Dr Berg’s video’s about potassium and you’re start to see that everybody is probably deficient in it and he explains how the body gets rid of it and how it’s not toxic if done properly you’d just need to balance it out with other electrolytes.

  27. Hi William – I would start with a whole foods, low carb diet – no seed/vegetable oils. This should help/fix the Type 2 diabetes, insomnia and depression. Take a look at Diet Doctor’s page on Facebook for guidance. Best wishes for your return to health!

    • Thanks Ann,I will check it out. Are there any oils that you would recommend instead of seed or vegetable oils? I would like to wean off of the metformin and sertraline. Any suggestions would be valuable. I have to formulate a plan of what to do first. Thanks.

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