Dealing with a laundry list of symptoms: chronic fatigue, brain fog, tingling, nausea, tinnitus, and

Hi everyone,

The title might seem a bit dramatic—but it isn't far from the truth. I need some help in the form of advice on what to do next.

For months now, I’ve felt my body shutting down. It’s progressively getting worse. Total lack of energy—I feel like I’m losing my cognitive edge—I simply cannot concentrate.

I sleep ten hours, wake up exhausted, manage one tiny task for work, and then have to lie back down; I spend my entire day like this. Fortunately, I’m working from home due to the pandemic—otherwise, I probably would have been fired by now. This isn't just "man, I had a long day at the office" fatigue—this is a complete physical shutdown. Even blinking feels like an effort.

I used to train normally back when I was actually healthy; now, I force myself through ten minutes of a workout and the rest of the time I am a dead weight. My aerobic capacity is terrible (I haven't fully recovered from COVID 😁).

I’m starting to get paresthesia—tingling sensations—in my legs. My B12 and folate (7) levels were right on the borderline when I tested a few months ago. There might be a connection there. I haven't been supplementing because my primary care physician says they aren't technically "below" the limit. 🕺
Also, my Vitamin D was well below the lower limit, so I supplemented that until bloodwork showed it was back in the normal range.

A few months ago, I had an MRI of the brain, a CT scan, an abdominal ultrasound, and a full thyroid panel—nothing unusual turned up.
Ferritin is elevated, TIBC is low, MCH and MCHC are low, and MPV is high.
An endocrinologist diagnosed mild insulin resistance—again, nothing drastic.
I had an H. pylori infection right around the time these symptoms started appearing—I had a gastroscopy, and while later tests showed the infection is gone, my stomach issues persist daily—constant nausea. Gluten antibodies came back negative.

I’ve also developed brutal tinnitus—it's 24/7—something I’ve never dealt with before.

My doctor insists it's depression and wants to start me on antidepressants. He doesn't want to run any more tests. Look, the brain is an organ and maybe it is that—I have no issue with that—but I want to investigate my body more thoroughly before making that decision. Honestly, I am experiencing elements of depression and anxiety now, but I tell myself it's a consequence of my body "dying" and seeing my inability to function every single day.

Does anyone have any ideas on what else I can do? Any Dr. House-style advice? I’m willing to go private—I don't care about the cost anymore because I can't function like this, and I’d give anything to feel normal again.
I'm 29 years old, but I feel 92.

I would appreciate any advice. Right now, I'm thinking about looking into the MTHFR mutation based on those old lab results, and re-testing my B vitamins to see if anything has changed over the last few months. Nothing else comes to mind.
Immunologist?

Perhaps this might be of some assistance to you
testosterone replacement therapy

So, did you get your hormones checked out yet?
Man, I went through the exact same thing you're dealing with right now.
Just zero energy, trash sleep, brain fog everywhere, and basically no libido at all.
They tried to push antidepressants on me too, just like they probably will you. Honestly, those things just turn your brain to mush, so I hopped off them after the trial period was over.
I finally got my labs done and saw that my levels were pretty low (even though they were technically still within the "normal" reference range).
My endocrinologist basically told me everything looked fine and just sent me on my way.
I wasn't buying it for a second, so I decided to take matters into my own hands and started my own treatment plan 😁.

Now, I actually feel like I'm back in my early 20s again.
If I had actually listened to that doctor, I’d probably be drugged up on antidepressants and all sorts of psychiatric meds that don't do squat for actual hormonal issues.

So, my advice? Get a full hormone panel done first.
Testosterone isn't just about physical stuff; it has a massive impact on your mental state.
It's tied directly to dopamine—which handles your motivation and energy—so you really need to check that.
If those numbers come back totally normal (like, if you've got at least 600 ng/dL testosterone and decent free levels), then it probably isn't a hormone issue.
Here's what you should look for in a hormone panel:
-testosterone
-free testosterone
-prolactin
-SHBG
-FSH/LH

If it turns out those aren't the problem, I honestly can't think of anything else off the top of my head.

mistynomad12 said:Have you checked your hormone levels yet?
I went through the exact same thing.
Zero energy—poor sleep quality, zero focus, non-existent libido.
Just like you, they tried to push antidepressants on me. They just cloud your mind—I hopped off them once the trial period ended.
I got my labs done and saw my levels were pretty low (even if they were technically still within the "normal" reference range).
My endocrinologist told me everything was fine and sent me on my way.
I didn't buy that—so I started managing things my own way. 😁.

Now, I feel like I'm back in my early 20s.
If I had listened to him, I’d probably be stuck on a cocktail of antidepressants and other psychiatric meds right now—none of which actually fix underlying hormonal issues.

So, first step: get a full hormonal panel.
Testosterone isn't just about physiology; it has a massive mental component.
It's tied directly to dopamine—your motivation and energy—so you need to check it.
If those numbers come back totally normal (meaning you have at least 577 ng/dL testosterone and decent free T), then the issue likely isn't your hormones.
Hormonal panel:
-Total Testosterone
-Free Testosterone
-Prolactin
-SHBG
-FSH/LH

If it's not that, nothing else comes to mind immediately.

Testosterone, Free T, and SHBG are all normal.
Total Testosterone is 577 ng/dL.
Free T is 0.4 nmol/L.
My Prolactin used to run high on tests a few years ago—above the limit—but if there were a serious prolactinoma, it would have shown up on a brain MRI.

Joseph Green12 said:Testosterone, free T, and SHBG are all normal.
Testosterone is 20 nmol/L (which is about 577 in your units)
Free T is 0.4 nmol/L
My prolactin used to be high on tests a few years back, like above the limit, but if I actually had a prolactinoma, an MRI of my head would have caught it

Well, I guess it's not the hormones then.
I'm no doctor or anything, so I honestly don't know what else could be causing those symptoms.

In the vast majority of cases, symptoms like these are actually driven by depression. Honestly, if I were in your shoes, I’d think the best first step would be to sit down and have a real conversation with a psychiatrist—maybe even look into some standard depression therapy—just to see if that provides any relief. If that doesn't do the trick, then we can easily pivot and start digging for other underlying causes.

Before I finally got my Fibromyalgia diagnosis, I was dealing with everything from constant fatigue and stomach issues to tinnitus and being unable to touch wheat, yeast, or dairy without feeling like crap.
It took me ten whole years to actually get an answer, and honestly, things just kept getting worse every single year.
I'd say you should definitely go read up on Fibromyalgia first—see if any of it sounds like what you're going through—before you start diving into more tests and stuff.

Everything you're describing sounds like what happens when your iron or ferritin levels take a dip, particularly with that constant fatigue and the tingling sensations.

driftingcanyon2 said:Every single one of those symptoms points toward low iron or ferritin levels—especially that constant fatigue and the tingling sensations.

My ferritin actually came back high on my blood work.

"My endocrinologist says I have mild insulin resistance—so, once again, nothing major."

Look, any kind of insulin resistance shouldn't be ignored, especially at your age. You’re probably dealing with glucose fluctuations or even reactive hypoglycemia, which can make you feel just as low as clinical depression. When your insulin sensitivity tanks, your cells aren't just failing to grab glucose; they're struggling to absorb everything else too—amino acids, vitamins, minerals, the whole works.

Thyroid issues?

placidfalcon said:"The endocrinologist diagnosed mild insulin resistance—nothing major again."

No level of insulin resistance should be considered "mild"—especially at your age. You likely have glucose fluctuations or even reactive hypoglycemia—and those symptoms can feel exactly like depression. When insulin sensitivity drops, your cells struggle to absorb more than just glucose; they miss out on amino acids, vitamins, and minerals too..

I picked up a glucose meter, but I'm not seeing any massive spikes. I should be able to catch that hypoglycemia with this, right? Or is the reaction just too fast?

I’m about 99% in the same boat—the only real difference is I’ve probably run a few more tests than you have. I ended up leaning heavily into neurology and immunology, specifically hunting down Lyme disease.
The main outlier for me is that I’ve been on antidepressants for about six months now, since everything else came back clear. My only official diagnosis so far is benign fasciculation syndrome from a neurological standpoint. I managed to bump my Vitamin D levels from 16 up to 120 (though honestly, it didn't change a thing), tested positive for H. pylori via bloodwork, and my morning cortisol levels are running high.

At this point, I’m pretty convinced I’m dealing with fibromyalgia and chronic anxiety. For me, the fibromyalgia shows up more as paresthesia—that weird tingling sensation—rather than actual muscle weakness.

Have you gone ahead and checked with a neurologist or maybe run a Lyme disease test?

Jacob Lopez51 said:It’s about 99% the same as my experience—though I think I’ve run a few more tests. I leaned heavily into neurology and immunology—specifically testing for Lyme disease.
The only real difference is that I’ve been on antidepressants for six months now, since everything else came back clear. My only official diagnosis is benign fasciculation syndrome from a neurologist. I bumped my Vitamin D from 16 up to 120—zero change there—and tested positive for H. pylori in my blood, plus my morning cortisol is elevated.

I suspect it’s actually fibromyalgia and chronic anxiety. For me, the fibromyalgia manifests more as paresthesia than actual muscle weakness.

Did the antidepressants help? Did your condition change at all?
I looked into fibromyalgia after someone mentioned it earlier, but honestly, it feels like a "catch-all" diagnosis to me—just some vague, unmeasurable label they hand out when they can't figure out what's actually wrong.

restlessdriver said:Have you actually gone through immunological testing—specifically for Lyme disease?

No—what specifically should I be looking for?
And if I head over to a local burrito stand to ask them to run a full immunological panel, how much sense does that even make?

Yeah, Burek. I dropped about 5k... they send the Borrelia samples from Quest Diagnostics over to $233 Germany for some immunoblot test, and I came back totally negative for multiple strains—and honestly, I don't even remember ever getting a tick bite...

I’ve tried a few different antidepressants, but none of the SSRIs really did anything for me—SNRI works slightly better, I guess. Right now, I’m just on 100mg of Sulpiride. Honestly, nothing hits quite like an anxiolytic—something like a benzo—but that's obviously just a short-term fix.

Give us an update... I'm curious to see what Burek says, though knowing them, they'll probably just predict the worst-case scenario so you end up spending more money.

If I were you, I'd get a full panel done... ANA, RF, anti-CCP, EBV, CMV, thyroid antibodies, and then start with that Borrelia testing. That whole Borrelia thing feels like total quackery to me.

Joseph Green12 said:I picked up a glucose monitor, but I’m not seeing any crazy spikes. I should be catching those hypoglycemic crashes with this thing, right? Or am I just reacting too fast?

Look, reactive hypoglycemia usually hits you as total exhaustion or feeling wiped out right after you eat—that classic spike followed by a massive crash. You'll also feel it if you go a few hours without food and that fatigue kicks in..

Just so we're clear, you can't track insulin resistance with a standard glucose meter. You could have perfect blood sugar readings for years while being pre-diabetic, and you wouldn't see high numbers until full-blown diabetes sets in. The only way to really spot resistance early is through fasting insulin tests or specific clinical screenings..

placidfalcon said:Generally speaking, reactive hypoglycemia usually shows up as fatigue or feeling wiped out after eating—that's when you get a sharp glucose spike followed by a massive crash—or if you go a few hours without food and feel that same exhaustion...

You can't measure insulin resistance with a standard glucose monitor. You could have perfect blood sugar readings for years while being pre-diabetic; those elevated glucose numbers often don't show up until diabetes actually develops. The only way to catch it is through fasting insulin tests or specific glucose tolerance tests...

I actually tested for that—used the HOMA-IR index to check my insulin resistance.
Regarding hypoglycemia, though—should I be trying to catch that with my glucose meter?

Joseph Green12 said:Hey everyone,

This might sound a bit dramatic, but honestly, it’s pretty close to my reality right now. I’m looking for some advice on what my next move should be.

For months now, it feels like my body is just shutting down. It’s been getting progressively worse. I have zero energy, I feel like I'm losing my cognitive edge—it's like I can't focus on anything at all.

I sleep for ten hours, wake up feeling exhausted, manage to do one tiny thing for work, and then I’m back in bed. I spend most of my day like that. Luckily, since the pandemic, I’ve been working from home; if I were commuting to an office, I probably would’ve been fired by now. This isn't just that "man, I had a long day at the office" kind of fatigue—this is a total systemic shutdown. Even blinking feels like a chore.

Back when I was actually functioning normally, I used to hit the gym regularly. Now, I force myself through ten minutes of a workout and the rest of the time I’m just a dead weight. My cardio is also pretty terrible (I never really recovered from COVID 😁).

I’ve started getting paresthesia—pins and needles in my legs. When I tested a few months ago, my B12 and folate (7) levels were sitting right on the bottom edge of the normal range. There might be a connection there. I haven't been supplementing them yet because my primary care physician insists they aren't technically "below" the threshold. 🕺
Also, my Vitamin D was nowhere near the minimum requirement, so I’ve been supplementing until my blood work finally showed it was back in the normal zone.

A few months back, I went through the whole works: brain MRI, CT scan, abdominal ultrasound, and a full thyroid panel—nothing particularly unusual turned up.
Ferritin is high, TIBC is low, MCH and MCHC are low, and MPV is elevated.
An endocrinologist diagnosed mild insulin resistance—again, nothing major.
I was dealing with an H. pylori infection right around the time these symptoms started surfacing. I had a gastroscopy done, and while later tests showed the infection was gone, my stomach issues persist daily—constant mucnina. Gluten antibodies came back negative.

On top of everything, I’ve developed this brutal tinnitus—it's 24/7. I've never dealt with anything like this before.

My doctor is convinced this is just depression and wants to put me on antidepressants. He doesn't want to run any more tests. Look, I get it—the brain is an organ too, and maybe he's right, but I’d really like to dig deeper into my physical health before committing to that path. To be fair, I definitely have elements of depression and anxiety, but I tell myself that those are secondary symptoms resulting from the fact that my body is effectively "dying" and I see every single day how much I'm failing to function.

Does anyone have any ideas on what else I could check? Any Dr. House-style suggestions? I'm willing to go fully private for this; I honestly don't care about the cost anymore because I can't live like this. I'd give anything to just feel normal again.
I'm 29 years old, but I feel like I'm 92.

I'd appreciate any insight. I was thinking about looking into the MTHFR mutation and re-testing my B vitamins to see if anything has shifted over the last few months. Beyond that, I'm stumped.
Maybe an immunologist?

What kind of symptoms are we talking about?
If you ask me, instead of throwing money at endless testing, you should invest in psychotherapy (CBT).

I don't know, personally, I wouldn't jump straight to antidepressants. Try pushing yourself to stay active—take walks, get some exercise. And make sure you're replacing those vitamin deficiencies.
Pay attention to your diet, too; eat things that actually give you fuel.