I NEED HELP ASAP – I'm hitting a wall!

Hey everyone on the forums. I've been dealing with this mess for a while now.

I've got Hashimoto and subclinical hypothyroidism.
My hormone levels hover right on the edge of normal—ft3 is at the top end, ft4 is fine, though it used to dip toward the bottom occasionally. My TSH fluctuates between 2 and 4, and I’m not on any meds. My anti-TPO dropped from 160 down to 80. My ferritin has always been slammed, so I take supplements and monitor it. B12 too. Cortisol looks okay. Haven't done saliva testing yet.

The real kicker is this insane fatigue that hits around 6 PM and drags on until about 9 PM. It doesn't matter if I slept for 16 hours or just sat on the couch all day—it happens every single time.
Blood work, CRP, liver panels, lupus antibodies, ANA profiles, rheumatoid factors—everything comes back clean. CRP is totally normal.

Back in 2015, my OBGYN said I had microcystic ovaries but told me not to worry. My hormones were fine then. Periods are heavy and painful. CA125 and other tumor markers are all normal.

About a month ago, I went back to the doctor because of uterine pain and constant bloating in my lower abdomen, like I'm pregnant or something. No matter how much I work out or watch what I eat, nothing changes. I’m pretty disciplined about taking care of myself, but I still feel terrible. The doctor said the ultrasound showed absolutely nothing—no fibroids, no cysts. I honestly expected her to find something because I get this dull ache mid-cycle that feels like period cramps, even when I'm not on my period. I mentioned that hair growth has sped up lately and I was worried about PCOS, but she insisted the ultrasound looked clear. My Pap smear came back normal, too. I'm hoping she actually saw everything correctly; I'd hate to think she missed something obvious.

One HUGE thing: whenever I eat carbs—especially rice or sweets—I get hit with this crushing exhaustion. I feel like I need to sleep immediately. I get this weird sensation in my head, almost like a mild tremor or like I'm coming down with the flu. It's hard to describe.

My fasting glucose was between 5.8 and 6.0.
Personally, I’m betting it’s insulin resistance.
I'm running out of places to look. I've always been thin, but I'm gaining weight specifically in my lower belly and hips. What tests should I run to confirm this? Should I just do a standard OGTT or check my insulin levels?
I've been active for years—non-smoker, no drinking, I run and do weight training (recreational level)—but I still feel like a sponge, sluggish, and stuck with this belly fat.
Looking at my symptoms, that's my best guess. Any advice on how to prove it for sure?

My doctor says my labs are fine and basically thinks I'm making it all up... but I'm telling you, I am exhausted. I can barely get out of bed for work in the morning, I can't shake the brain fog, and it's ruining every part of my life.

Thanks in advance for any help or advice. I'm honestly miserable.

Michelle Chavez16 said:Hey everyone on the forums! So, I’ve been dealing with this issue for a really long time now...

I’ve been diagnosed with Hashimoto, specifically subclinical hypothyroidism.
My hormone levels are pretty much hovering right at the edge of the normal range—ft3 is at the top end, ft4 is totally fine, though over the years it used to dip toward the lower limit, but never actually went low. My TSH fluctuates between 2 and 4. I’m not even on any medication for it. My anti-TPO was 160, but it dropped down to 80. My ferritin has always been insanely low, so I take supplements and keep an eye on it. Same thing with B12. Blood cortisol looks normal. I haven't done a saliva test yet.

The thing that’s absolutely killing me is this insane fatigue that hits around 6 PM and just lingers until about 9 PM. It doesn't matter if I slept for 16 hours straight or if I spent the whole day sitting on the couch doing nothing—it happens every single time.
My CBC, CRP, liver panels, lupus antibodies, ANA profiles, rheumatoid factors—everything comes back normal. CRP is totally fine.

Back in 2015, a private OBGYN told me I had microcystic ovaries, but said it wasn't a big deal. My hormone levels were okay back then. Periods have always been heavy and painful. CA125 is normal. All my tumor markers are fine too.

About a month ago, I went back to the gynecologist because I’ve been having uterine pains and constant bloating in my lower abdomen, like I'm pregnant or something. No matter how much I work out or how strictly I watch what I eat, nothing changes. I’m the kind of person who is super disciplined and tries everything to fix myself, but I still feel terrible. The doctor said she couldn't see anything at all on the ultrasound—no fibroids, no cysts... I was really hoping she’d find *something*, because mid-cycle I get this dull ache that feels exactly like period cramps, even though it isn't my period. I mentioned to her that my hair is growing way faster than it used to and that I was worried about PCOS. She just insists the ultrasound looks clear. My Pap smear came back normal. I mean, hopefully she actually looked properly, because I can't believe she missed something...

One more HUGE thing: whenever I eat carbs—especially rice, sweets, or stuff like that—I get hit with such intense exhaustion that I immediately need to sleep. I get this weird sensation in my head, like a light shakiness, almost like I have the flu. I don't even know how to describe it...

My fasting glucose was around 5.8 to 6.0.
Personally, I’m really suspicious about insulin resistance.
I honestly don't know where else to turn. I've been thin my whole life, but now I'm just gaining weight in my lower belly and hips. What tests should I ask for to figure this out? Should I do a standard OGTT or check my insulin levels?
I've been active for years, I don't smoke, I don't drink, I run, I do weight training (just recreationally), and yet I still feel like I'm made of water... just sluggish, and there's this constant fat buildup on my stomach.
Looking at myself, that's just what it feels like. Please, if anyone has advice on how to confirm this for sure, let me know...

My doctor keeps saying my results are fine and she doesn't know what to do with me, basically implying I'm making it up... but guys, I am constantly exhausted. I can't even get out of bed for work in the morning, I can't shake the fog, it's affecting every single part of my life.

Thank you all so much for the help and advice, because I'm seriously struggling here.

You aren't alone.

Michelle Chavez16 said:Hello to all the forum members! To be honest, I have been struggling with this issue for quite some time now.

I have been diagnosed with Hashimoto, specifically subclinical hypothyroidism.
My hormone levels generally hover around the normal range; my FT3 is at the upper limit of the reference interval, while my FT4 stays within normal bounds—though over the years, it has occasionally dipped toward the lower end, though never actually falling below the threshold. My TSH fluctuates between 2 and 4. I am not currently on any medication. My anti-TPO was 160, but it has since dropped to 80. My ferritin has always been drastically low, so I take supplements and monitor it closely. My B12 is also something I keep an eye on. My cortisol levels in the blood are normal. I haven't done salivary testing yet.

What truly plagues me is this abnormal exhaustion that hits right around 6:00 PM, lasting until about 9:00 PM. It doesn't matter if I've slept for sixteen hours or if I've spent the entire day sitting at home without moving an inch—it happens every single time.
My complete blood count, CRP, liver enzymes, lupus antibodies, ANA profiles, and rheumatoid factors—everything comes back normal. My CRP is fine.

Back in 2015, a private gynecologist told me I had microcystic ovaries, though she mentioned it wasn't a major concern. My hormone levels were fine back then. My periods are heavy and painful. My CA125 and other tumor markers have all come back normal.

About a month ago, I went back to the gynecologist because I’ve been experiencing uterine pain and constant bloating in my lower abdomen, almost as if I were pregnant. No matter how much I exercise or how strictly I stick to my diet, nothing changes. I am someone who possesses the discipline and persistence to help myself, but I still feel terrible. The doctor said that on the ultrasound, she couldn't see anything at all—no fibroids, no cysts. I was actually expecting her to find something, because even in the middle of my cycle, I experience this dull, aching pain similar to menstrual cramps, even when I'm not on my period. I told her that my hair is growing much faster than it used to and that I suspected PCOS. She insisted the ultrasound showed nothing. My Pap smear came back normal. I assume she checked everything thoroughly; I can't imagine she would have missed something.

There is one more CRITICAL thing: whenever I eat carbohydrates—especially rice, sweets, or things like that—I am hit with such intense fatigue that I immediately feel like I need to sleep. A strange sensation takes over my head, like a mild shivering or a feeling similar to having the flu. I don't quite know how to describe it.

My fasting blood glucose was between 5.8 and 6.0.
Personally, I suspect insulin resistance.
I am at a loss as to where else to look. I have been thin since I was a child, yet I only seem to gain weight in my lower abdomen and hips. What kind of tests would be best to confirm this? Should I go for a standard OGTT or check my insulin levels?
I have been active for years; I don't smoke, I don't drink, I run, and I practice weight training (recreationally), yet I still feel "waterlogged," sluggish, and constantly carry fat on my stomach.
Looking at my symptoms, it feels most likely to be that. Please, could you direct me toward which tests would most certainly confirm this?

My doctor tells me my results are fine and that she doesn't know what to do with me, suggesting maybe I am just imagining it... but people, I am constantly exhausted. In the morning, I can't even get up for work because of the fatigue; I just can't wake myself up. Every aspect of my life is suffering.

Thank you all so much for your help and advice, because I am truly at my wit's end.

Hang in there, dear Michelle Chavez16.

I suffer from a level of fatigue that I never anticipated; it doesn't matter what time of day or night it is, it becomes unbearable. I get so tired that I find myself asking, "Why on earth am I like this?" Regardless of whether I've been cleaning, playing with my little one, or just lying on the couch, I am abnormally exhausted, regardless of how much sleep or rest I get. I maintain a healthy lifestyle, in a certain sense of that word. I have been diagnosed with MS for two and a half years now, and my condition rarely worsens. Fatigue was listed as a major symptom for me initially; if this is simply what life looks like with this condition, then it's somewhat manageable (you learn to nap during the day and eventually adapt). I didn't feel it too intensely until a few months ago, so it hasn't been a sudden shift. Clearly, it is a very slow decline, and if it continues this way, I will eventually have to deal with finding a solution. Don't go trying to diagnose yourself; take it slow and try not to stress, as that only makes the fatigue worse.Best of luck

Don't go coming for me; some treatments aren't found in a pill bottle.

According to the Red Cross, diet is the foundation of therapy. In medical circles, they usually push a diabetic diet—at least that’s what my doctor at the Mayo Clinic told me. I was diagnosed when I was 37; before that, nothing was obvious, though I was dealing with a massive pile of symptoms.
Nowadays, you’ve got options like Paleo, LCHF, or Chronometer. Just do your own research on those.
When it comes to insulin resistance, I'm betting on Chronometer, based on what I've read from people who actually practice it. I can't speak for the others.

There are tests for insulin resistance. There are also certain medications people take that make them drop weight.
You don't have to be overweight to deal with PCOS; I know skinny people who have it, though they tend to lean toward gaining weight if they aren't careful or keeping things under control.

You really shouldn't let the weight pile up with PCOS. When you're messing with the hormone loop—testosterone, progesterone, estrogen, cortisol, etc.—once one thing gets out of whack, it drags everything else down with it.

PCOS is essentially a metabolic disorder, and everything else is just a symptom. It's tied directly to diabetes, high cholesterol, and whatever else follows that path.
Managing stress, getting out in the sun, hiking, and finding some spiritual balance will help get your hormones back in check. You have to find yourself, and honestly, I think a love for nature is what resets us.

If you're listing digestive issues, it's pretty clear you've got food intolerances. Given what we actually eat these days, it’s no wonder our digestion is a wreck.
Gluten is linked to both PCOS and Hashimoto, basically acting as a trigger for both.

Fatigue could be an iron deficiency. Low iron messes with your bloodwork. Back when my iron was low, my nose would bleed and my vision started failing... plus the forgetfulness.
Fatigue can stem from other deficiencies too. Vitamin D can cause total chaos in your system and lead to heavy, chronic exhaustion. And right now is peak season for deficiencies.
Unfortunately, the road to a diagnosis is a jagged one, and most of the time, doctors just tell you that you're making it all up.

My sister spent years feeling completely wiped out, bouncing from one specialist to another while everyone offered their own little theories about what was wrong. She spent ages drifting from doctor to doctor without any real answers, until people started suggesting she was just imagining things
which is always such a frustrating thing to hear. Eventually, she decided to see a private neurologist on her own initiative, and they ran a test for myasthenia gravis right away—it came back positive, and she’s been on treatment for four years now.
Even with all the regular check-ups, she hasn't really seen much improvement, which just goes to show how incredibly difficult it can be to pin down the actual root cause. I’m certainly not saying you have an autoimmune condition, of course,
but it might be worth looking into some additional antibody testing just to rule everything else out. Best of luck with it all! 🙂

It sounds like you're just dealing with low iron levels. I've settled on taking 200 mg every other day myself.