Chronic Fatigue Unknown Cause

I started getting fatigue in my early 20s. I would work 5 days a week in an office then spend the whole weekend in bed.
30s now and it’s getting worse, I’m working part time and I’m so exhausted. My ideal thing to do is just rest. I would pick sleeping over a free holiday!
The doctor has been no help, they have said it’s maybe caused by anxiety or depression but I don’t agree with the depressed part.
Few coffee a day keeps me going.

I’ve only felt normal (energy) when I happened to take antibiotics (Amoxicillin) for another reason and felt 100% normal during that time. I tested it again and again it worked. I can’t keep on taking antibiotics for ever.

What the hell could possible be causing this fatigue if this specific antibiotics is helping. No help at all from any doctors.

****Update - thanks everyone for the brain storming on what it could be and how to find out. Some more information about my situation.
Had a full blood test done. They found extremely low vitamin D but I took vitamin D and didn’t help.
I think I still have some hormonal imbalance I believe from like 15 years ago (acne appearing once a month even in my 30s). No thyroid or fertility issues though.

I’m worse in the morning and better towards the end of the day after 4pm.


  • +53 votes

    You might have a vitamin R deficiency. Add more malk to your diet.

  • See another doctor. Or ask for a referral to a specialist?

    • +3 votes

      The OP already asked for "no help at all from any doctors", so maybe we're only allowed to suggest alternative therapies.

    • I’ve seen a few doctors (GP) with no help.

      What specialist could I be directed to? I have no idea.

      • nutritionist

        • OP's success with antibiotics could indicate a microbiome issue.

          Perhaps a ketogenic diet could be helpful. They key is to eliminate components which may be harmful to a healthy gut microbiome such as alcohol, sugar and unnatural additives. You may want to try increasing fibre too.

          Another course of antibiotics may serve to reset the microbiome to assist the establishment of dietarily induced changes.

          A faecal transplant may be worth asking about too.

      • I suffered from this for years, 8 months ago, my GP checked my thyroid function because of another issue. Results of the blood tests showed my thyroid was not working properly so was prescribed Eutroxsig 100mg, taken once per day. Within two weeks, my thyroid was functioning properly and my chronic fatigue disappeared completely a couple of weeks later.

      • +8 votes

        I would try to see an immunologist. They have good knowledge in many disorders. Good place to start.

      • +2 votes


        • Ask for a full hormone analysis including:

          • Total and free testosterone
          • FSH and LH
          • SHBG
          • Estradiol, high sensitivity
          • Prolactin
          • DHEA

          EDIT: OP is female, but the above may help other readers.

          OP, do you take a contraceptive pill? Perhaps it is causing adverse effects and your antibiotic course diminished your absorption of it.

      • General physician.
        They have knowledge about most medical specialities.

  • I’ve just gone through a horror six months where my bodys immune system attacked itself, paralyzed half my body temporarily thank god , months in hospitals and rehab/expensive blood products. Lucky if i drive again in a year. Don’t mess with this stuff, to only see one doctor is ludicrous, if i didn’t check out of one hospital because they didn’t know what was going on after weeks of me being there I’d be either dead, in a wheel chair permanently . Go to as many doctors as you need to until you get an answer….. They believe mine started from a virus back in November so dont mess around mate.. Where fragile as humans so go find the answer, you’ll probably feel like a pin cushion at the end but it’ll be worth it… All the best…

    • Woow!! That’s crazy. I’m glad to hear your doing OK now.
      Did they know what virus it was?

      • Yeah mate it’s been herendous, wasn’t going to post it up but if it helps someone it’ll be worth it.. They have No idea,i reckon i had a gut virus beforehand, not properly cooked chicken can do it also… If you look up CIDP will give you more info, it’s quite rare also….
        Thanks for your reply mate appreciate it…..

        • Partial paralysis? Did they test for Botulism? Symptoms include cramps, vomiting, breathing problems, difficulty swallowing, double vision, and weakness or paralysis.

          • @zathras: Hi Guys
            Thanks for your interest and kind words, Luckily it didn’t shut my diaphragm down it was heading in that direction, Your in big trouble then.
            I’m lucky i left rehab on crutches, feet are still 40%numb from 100% including hands (although hands are 90%back to normal) .. Hav to learn to walk again. Look like a drunk without crutches but im improving and it’s not an option to stay like it… It all good it can always be worse….
            Yes was tested for everything mate, have had issues swallowing etc…
            Oh the miracle of IVIG and the fantastic doctors and nurses i can’t thank them enough. Where truly blessed in this Country…

            Take care out there..

    • Hey guys I found patient 0

      • +24 votes

        Here's someone saying they nearly lost their life to a rare disease and the best you can come up with is a shitty joke to entertain a bunch of randoms. You're a shit person.

    • It's an autoimmune disease. I knew some people that have that too. Hope you are staying well now!

  • Get an experienced G.P to do some thorough medical examination including blood tests to rule out any medical conditions that could be triggering it. If everything is clear they might refer you to a psychologist.

    • They have done some blood tests and some heart tests done and all good.
      Went to a psychologist and diagnosis was anxiety but surely it doesn’t cause such fatigue. I was going accept anxiety was the cause until the antibiotics made me feel normal.

      • anxiety but surely it doesn’t cause such fatigue

        Will power behaves like a finite quantity and anxiety drains it.

      • Anxiety uses a lot of energy. If you've been clinically diagnosed you should at least try what they are suggesting.

      • Check the actual tests done.

        My doctor gave me a comprehensive blood test once while I was feeling lethargic. All came back good. I looked at the results a week later and saw a test for vitD was missing. Went back and organised that test separately - was indeed very low, as I suspected. Got out in the sun and supped for a couple of months, monitored D, lethargy went away as D level went up.

      • +2 votes

        I was going accept anxiety was the cause until the antibiotics made me feel normal.

        Some antidepressants have psychostimulatory effects which can lead to increased vigor and appetite, weight gain, improved sleep and sociability in patients. In fact, the first ever antidepressant was an antibiotic called Isoniazid, which was accidentally found to have euphoric effects in patients with tuberculosis who were receiving this drug.

        I don't believe that amoxicillin has been studied for such effects but that doesn't mean it doesn't have mood-enhancing side effects. I wouldn't rule out anxiety if I was you.

        • I believe each course cleared their gut microbiome, thus the temporary lift in a feeling of general wellbeing.
          That's an area I'd be looking to improve upon.

      • Went to a psychologist and diagnosis was anxiety but surely it doesn’t cause such fatigue.

        It can. Mental exhaustion from anxiety, and a tendency for it to affect quality of sleep. I was a zombie for years because of it.

  • Have you had a discussion with your GP about a specialist referral to an Immunologist or an Infectious Disease team? Worth a discussion if you've already gone down the Psych and Pathology pathways. They might find something the other specialties might not have knowledge of ie. underlying virus normal bloods haven't found, unknown immune system deficiency, food allergies etc. Good luck.

  • Try eating red meat (by itself other than salt) and raw green vegetables with no other additives for seven days.

    What this does is provides full nutrition without eating any refined foods which presumably will eliminate this as a cause if nothing else.

    The antibiotic experience makes me think your gut biome is borked. Which is usually caused by the Western diet specifically refined grain and sugar.

    There is now a large body of evidence linking many psychological disorders to Western diet including anxiety and depression. The psychological symptoms, if diet is causing those, will improve greatly in a few days.

    Apart from anything else refined grain and sugar cause muscle inflammation across the whole body which exacerbates any other conditions such as anxiety.

    • Yes I’ve read about this. I tried Palio diet a few years ago and it actually made me have sore joints and a crazy migraine so I stopped it. I should try again and try pass the ‘die off’ effect.

      • I take Candex SB from Chemist Warehouse and that completely fixed my gut biome along with healthy eating.

        The die off is horrid but only lasts a week or two.

      • A meat + green veg only diet is a ketogenic diet and what you're describing matches well with the "keto flu" as your body adapts to running primarily on ketones instead of glycogen. Supplementing salts usually fixes it and failing that riding it out for a few days will make it go away.

        • I wonder if a dramatic increase in typically consumed meat could throw off the balance of pro inflammatory omega 6 fats to anti-inflammatory omega 3s.

          I'd increase wild (not farmed) fish intake.

    • -1 vote

      I thought you'd be a left wing vegan.

    • horse meat is the best for fatigue but cant find any in aus (no roo isnt the same)

  • I was feeling the same during my 20's & 30's, then was diagnosed in my 40's with multiple sclerosis. See your GP, and consider if there are any other issues such as balance or muscle weakness. I'm not trying to worry you, as everyone is different. Good luck.

    • My sister was also told chronic fatigue for years until she moved to Queensland and the heat set off other symptoms (relating to her eyes) which lead to her MS diagnosis. It might be worth checking with your Dr if you have other symptoms. As scary as MS seems I think not knowing what is wrong would be worse.

    • I was about to suggest this!

      I'm in my late 20's (female) and in the middle of waiting for my scars to (profanity) me up badly so we can diagnose it. However, my neurologist has emphasised that my anxiety and depression could have been caused (and/or exacerbated by) my numerous brain scarring.

      I also did a full blood test and only vit D and cholesterol were a bit not normal. Everything else was fine.

      Exhaustion is also a big factor in my life and it, as well as a plane ride overseas, set off what we've found out now. Was lucky the GP I went to patiently listened to what my symptoms were and decided that with my random vertigo wasn't good and needed me to have an MRI.

  • Are you female? If so, has anyone looked into endometriosis? I have friends who have minimal pain, but the lethargy and fatigue is constant.

    • Yes I’m female. I’ll have a look into this.

      • Good luck

      • +2 votes

        Fellow woman here. I can vouch for this - I have had stage 4 endo since I was diagnosed at 17. I'm glad they found it early - extreme abdominal pain during menstruation, excessive bleeds, digestive issues and fatigue are just a few of the symptoms. Your mental health is also exacerbated by it. If this sounds like you please see a GP and ask for a referral to see a gynecologist.

      • The antibiotics relieve SIBO (small intestinal bacterial overgrowth), which gives your body a short break from a leaky gut (increased intestinal permeability) :/

        Increased gut permeability allows excess toxin into the body (like goitrogens and lectins) while impairing nutrient uptake (like Vitamin D, Iron, B12, Calcium - guessing some of these will be low too)

        Some of the time leaky gut results in Hashimoto's Thyroiditis (low thyroid function, best tested by measuring thyroid antibodies)

        To resolve it quickly, use the GAPS healing and elimination protocol (essentially ketogenic/zero carb short term diet)

        • I was convinced I had leaky gut 4 years ago as I also had a stage of IBS. Tried the paleo diet and it made me even more sick that I had to take pain killers everyday so I stopped. Excess probiotics give me joint and, muscle pain and migraines. I researched leaky gut back then and tried all these probiotic and natural remedy’s like black walnut etc.
          The IBS has been gone for more than 2 years now luckily but still left with this crappy fatigue.

          Had the thyroid test done and was in the normal range.

          • @Jumpup: Paleo doesn't help the gut, infact, it rips it apart even more especially if nuts and whole grains are included :/

            You also need to test thyroid ANTIBODIES, not T3 and T4 levels, they are different things!

            And the GAPS protocol is NOT paleo, it's completely different and medically validated (it is what is used on highly allergic kids)


  • i went through something very similar years ago. Many Dr's including specialists had no idea what was wrong. Antibiotics would help .
    I got a nasty infection a few years ago and got really run-down where I had no energy after it. A dr gave me a b12 injection and it helped immensely. The tablet form never did anything for me.

    B12 levels are hard to diagnose correctly, from the readings I have viewed. So even though it may not appear in a blood test, it does not mean you do not have a deficiency. The main symptom that came with it for me were tiredness and a numbness.

    • The infection caused malabsorption of b12?

      • could be vegan

        • Actually more nonvegans have B12 deficiencies than vegans, because vegans are (or should be) acutely aware of possible difficulties in obtaining it from a plant based diet, and so are usually all over it with monitoring and ensuring an adequate supply. Some estimates say as many as 40% of the American population have a B12 deficiency, mostly due to poor absorption.

          • @afoveht: Seems interesting, do you have a source?

              • +1 vote

                @afoveht: Without proper context, 40% is outright misleading.

                40% includes people in the lower range of normal - there's a range in pathology, well because people vary greatly.

                Although not properly referenced on the website, the original journal article reported:

                39% below <258 pmol/L
                17% below <185 pmol/L
                9% below <148 pmol/L

                They even state; " A commonly used clinical cutoff for low vitamin B-12 status is 148 pmol/L"

                • @bs0: Of course.

                  Some estimatates…

                  That's your warning to do your own research and make an informed decision rather than just believe a flat number.

                  • +1 vote

                    @afoveht: Well it's not an estimate, it's an outright misinterpretation of the information provided.

                    • @bs0: The lower range of normal is a marginal status, not necessarily a healthy status. Your take is fair enough, as is IMO that article's. The only one positively connecting the word "deficiency" and the number 40% here is me. In hindsight I should have been more rigorous in qualifying any number, and I won't do that again. Apologies.

                      It is not my intent to mislead or falsely represent anything. I sincerely say the intent of what I originally wrote remains unchanged - B12 deficiency is common amongst the general population; vegans will, I am certain, be more aware of B12 issues than the general population, because being hammered about B12 is practically a vegan rite of passage.

                      • +2 votes

                        @afoveht: For anyone else reading who would like a bit of evidence based reading, there's a systematic review here that examines 40 journal articles looking at B12 levels amongst vegetarians including 13 articles examining the vegan populations.

                        In a very brief summary, B12 deficiency can range between 0-81% in vegetarians, or between 0-86% vegans. 0%, reported in study examining a fortified diet, up to 86% percent amongst general vegan diet with or without supplementation
                        - comparing to the the 9% or 40% is self explanatory.

                        • @bs0:

                          0%, reported in study examining a fortified diet, up to 86% percent amongst general vegan diet with or without supplementation

                          Every vegan diet should be a fortified diet. This is the position of every credible dietetic org, and advocating for any vegan diet without B12 fortification, or calling it "general," is irresponsible. It is no suprise that up to 100% of vegans who don't receive B12 may end up with B12 deficiencies. It is also no suprise that down to 0% of vegans who do supplement have healthy B12 levels.

                          The first author (I could not find info on the other two) is a member of the PCRM, who strongly advocate for a fully plant based diet. This study is seemingly not intended to scaremonger against vegan diets or compare vegans to nonvegans, but to reinforce the necessity for B12 fortification, essentially highlighting failures in their own camp. "Vegetarians, especially vegans, should give strong consideration to the use of vitamin B12 supplements to ensure adequate vitamin B12 intake."

                          I repeat, vegans will generally be more aware of B12 issues than the general population, because being hammered about B12 is practically a vegan rite of passage. Cynicalmike did it (B12 low? First check if vegan), you just did it yourself, as did the writers of the document you presented.

                          • @afoveht: Pretty sure you've misread "general vegan diet with or without supplementation".

                            I am only demonstrating that proper scientific data shows vegans are at risk of b1è deficiency, to a higher extent than the rest of the population, using the article that you originally referred too and also misinterpreted.

                            Ironically, broad statements of "vegans will generally be more aware …" is just another anecdotal statement without evidence provided.

                            • @bs0:

                              I am only demonstrating that proper scientific data shows vegans are at risk of b1è deficiency, to a higher extent than the rest of the population,

                              Of course we are. And that's why we're on top of it, which is all I've been saying. Ask a typical nonvegan about B12 and you get a blank stare, ask a vegan and you get "OMG I haven't got a refill for my sups yet." It's about awareness, and the primary awareness nonvegans seem to have is that B12 is a "vegan problem" rather than the fact that B12 deficiency is common to most groups within western societies.

                              Have a good day.

    • This sounds very interesting. I’ll try ask for a b12 shot next time I visit a GP.
      Do you mind sharing what type of infection it was to see if I can link it to anything I’ve had.

    • Correct the B12 injection really does work for improving energy levels whether deficient or not and is very noticeable unlike most vitamins. The tablets are a complete waste of time.

    • Yeah I had tiredness and I dont know if i'd call it numbness - more pins and needles randomly, mainly in hands and legs. Also had low iron, this was specifically tested.
      Also note that blood tests dont automatically test for everything - they only test for what the GP requests, so if you've got a newby GP they might not request B12 levels for example (I have no idea what a 'full blood count' test includes and i'm newb myself)

      For me my B12/iron levels kept dropping off, found I can't absorb B12 after multiple blood tests so getting injections ongoing - currently on a waiting list to get a camera shoved up somewhere where I presume sunlight levels are limited. apparently this can shed more light in it.

  • I have a family member (female) who suffers from chronic fatigue, having huge dips in energy levels many times a day & a strong lack of energy overall, and they discovered it was an iron deficiency.
    Maybe look into your diet if you are getting enough iron (red meat etc), and otherwise you may need to take a supplement.

    As always the diagnosis above could be wrong, and it could just be a placebo affect, so consult your doctor about it first.
    I also agree with another comment see more than just 1 doctor.

    • Unfortunately I don’t think it’s iron as I take the supplements since I don’t each much red meant.

      • Iron in red meat is easily absorbed as opposed to supplements and spinach.
        People taking iron supplements or spinach (vegans) should take iron with vitamin C.
        Example - crush the iron tablet and let it soak in a glass of orange juice or apple cider vinegar (dilute with water) then drink, chuck in a few Vitamin D capsules as well.
        After the orange juice/ACV have a glass of water swishing the water around your mouth as orange juice/ACV can be harsh on your teeth/gums.

      • Maybe you need to eat more red meat?

        If you have any kind of weirdness in your diet I would address that first.

      • Food is much much better than supplements. Some supplements are barely absorbable.

  • Have you seen a specialist for sleep apnea?

    • I’ve just look it up and some of the signs don’t apply to me (sore/dry throat) but yes the insomnia part does apply. I wonder how common sleep apnea is.

      • Symptoms for sleep apnea aren't sore & dry throat. It is fatigue & waking up tired, this results in being moody & restless throughout the day, plus more.

        Get a referral to see a sleep specialist. Sleep apnea is very common.

      • Was going to say the same thing. Sounds just like sleep apnea. Do you snore ?

        • Yes I snore and my husband complains it’s extreme haha

          • @Jumpup: Then that's what it is. I got a sleep apnea machine and it changed my life.

          • @Jumpup: You may have other issues, but this won't be helping you (or your husband) and could actually be hindering your body healing itself.

            Snoring could be a sign your airways are struggling (happens to a lot of us as we get older, lose muscle tone around airways etc), and could be a symptom of moderate or even severe sleep apnea. Get a referral to a sleep specialist and do a test to see how you are breathing at night. They usually treat mild cases with a splint/mouthguard.

      • Very common. Work at airport and see a lot of passengers with sleepap machine. My partner has mild sleep apnea too. Same symptoms as you described. Low energy at mornings. Headaches etc. Better at night. Insomnia till past midnight. Got checked at a sleep clinic after staying overnight. Sleep apnea.

      • Sleep apnea isn't just insomnia. Its about the right kind of sleep or quality sleep.

        Some folks can doze off no problem, but if they're not getting the right kind of sleep over time, they'll start to experience the usual symptoms.