Anyone know or have any suggestions what I can do that will improve my fatigue symptoms? Know anything that works?

[Regalbirdy]

I have noticed that I have been running out of energy after lunch recently (lunch is gluten-free food from home). Unfortunately this is then affecting my ability to concentrate at work. Has anyone any experience as to whether this is a side effect of depression? I know that I get fatigued when I have been glutened but I think it could be more than this.

[Mia1057]

It also just might be that you are not eating enough calories at lunch. I realised that this was happening to me after the dietician pointed out that I was basically eating 100 calories for breakfast and 250 for lunch which for me was salad and chicken or salad and tuna or salad and?? But you get my point. She told me to add some fruit and some sort of carb rice, potatoes, or GF pasta and try and ensure lunch was at least 600 calories. I did that and felt so much better.

[Regalbirdy]

Thanks for the interesting suggestion Mia. I I'm not sure it is so true in my case but I will bear it in mind. Normally I like to eat well at lunchtime. This can be a variety of things - Heinz beans, DS crackers, fruit, a soya yoghurt, cake, jacket potato, a fruit and nut bar etc.

The last time I had a really bad attack, I had eaten two rice cakes for lunch with a banana plus some Heinz beans. I would have blamed the rice cakes except they were the last two in the packet and I had not had any symptoms eating the rest of the packet. I am slightly puzzled!

[Regalbirdy]

Thanks for the interesting suggestion Mia. I I'm not sure it is so true in my case but I will bear it in mind. Normally I like to eat well at lunchtime. This can be a variety of things - Heinz beans, DS crackers, fruit, a soya yoghurt, cake, jacket potato, a fruit and nut bar etc.

The last time I had a really bad attack, I had eaten two rice cakes for lunch with a banana plus some Heinz beans. I would have blamed the rice cakes except they were the last two in the packet and I had not had any symptoms eating the rest of the packet. I am slightly puzzled!

[Jacks in reply to Regalbirdy]

When I read your 'eat well' list I noticed there wasn't any protein. I'd definitely have a crash if I'd eaten the same lunch.

[Penel]

It can be difficult to know for sure, but another possibility is that you are eating too many low GI/GL carbohydrates and experiencing a 'carb' crash'. This is when your insulin has been raised very quickly to deal with the carbs, your body then clears it away and leaves you with low blood sugar and a feeling of fatigue, irritability etc. Rice cakes have a high GI.

[Penel in reply to Penel]

Should have said " too many high GI carbohydrates". Sorry. Makes no sense otherwise.

[mitchellbarbara]

before I figured out I had a gluten issue, I was experiencing a profound fatigue...what I discovered by accident, was that when I doubled up on my multi vitamin I felt better, so I added bunches of suppliments...another thing that helped was to eat nutrient dense...salads did nothing for me...not enough nutrients..home made soups were great.....I had my biopsies a week ago, and the withdrawal symptoms I have been going thru, were helped by adding sub-lingual B-12...

[Apricot]

Would suggest smaller amounts of food at regular intervals. Too long a gap between breakfast and lunch...thus blood sugars get too low...then rapidly high when you eat lunch..

I am also interested in the idea of sublingual vitamins...where do you buy them??

With best wishes

Apricot (snowed in, 9.30, Yorkshire)

[Regalbirdy]

Mitchellbarbara, profound fatigue is a good way of describing the symptoms I have had. Sometimes I feel like a toy from the Duracell advert - the one with all the pink bunnies banging on drums from the 1980s (check out YouTube if you're not sure what I am talking about...) I see everyone else running on Duracell batteries and I'm on the rubbish ones that wind down and then stop!

This usually hits in the afternoons and it's so frustrating (I often snack through the day and have put on a little bit too much weight as a result - though thanks very much for your suggestions apricot). I can pretty much rule out B12 as a cause due to my doctor being pretty good at ensuring my 12 levels are right - I have had enough B12 injections to keep an elephant happy! I had to ask four times to get them, however persistence paid off with that issue.

Mitchellbarbara, you also raise an interesting point about increasing the dose of multivitamins you take. That may be worth me considering, as well as eating more homemade soups etc.

Right now I am still trying to unpick all the different issues that my CD has caused and overall I am starting to feel better than I did pre-diagnosis. I do have to keep reminding myself that I have still a fair way to go as I am only four months being gluten-free.

Another problems being coeliac has caused, is that for the last 3 to 4 years I have had Seasonal Affective Disorder, which is a form of mild depression. Has anyone else had experience with managing this and/or fatigue?

[Penel]

Have a look at food that contains serotonin, which can help combat SAD. This is one article on it

marksdailyapple.com/seroton...

If you need snacks to get through the day try a handful of nuts. Make sure you are getting enough fat in your diet, it won't make you put on weight but will stop you feeling hungry. Perhaps try some carbohydrates like sweet potato.

[Hidden]

My suggestion is to ask for a blood test to check out levels of vitamins and minerals.

In my situation a CD diagnosis was the final piece in the jigsaw. Many individual secondary problems had been identified and treated by my GP but it took a specialist (in my case a haematologist) to join the dots and get to the root cause.

Before I was diagnosed with CD I had fatigue, brain fog, inertia as well as intestinal symptoms. A routine blood test showed I was low in iron (and so was anaemic), low in folic acid, low in vitamin D. I also had abnormal red blood cells (macrocytosis). I suggest also getting checked for levels of vitamin B12 and calcium.

I was treated for my deficiencies by my GP and began to feel a lot better.

I am still on prescribed supplements and will continue, until it is proven I can adequately absorb sufficient micro-nutrients from a normal diet.

Note also - I had previously been diagnosed with osteopenia and was on calcium/vitamin D supplement, but that was not enough to maintain an adequate level of vitamin D. Nor was it sufficient to improve my bone density; despite also taking alendronic acid, my bone density did not improve over 3 years between tests. If there is any question of low levels of vitamin D, or calcium - ask for a dexa (bone) scan, then you will know you are at a higher risk of fractures and can avoid doing high impact exercise.

Good luck!

[Regalbirdy]

Thanks for the link Penel, I found it a really interesting read. It talks about both traditional medicine and complementary therapies. I noted with a slight smile that it recommends doing Tai Chi, meditation and massage as possible alternative remedies - things I have already found my way into doing and agree that mentally these are especially beneficial. The site did confirm my thinking that physical fatigue can also a symptom of depression and I think I will need to decide in the coming weeks whether to consider going down the medication route - not an idea that I am particularly keen on.

Judy, I also agree with what you said about being diagnosed as CD as the final piece of the jigsaw. In my case, I am still working out how some of the pieces fit together which is why I posted the question. This might sound a little strange but I no longer sure what "normal" feels like. Due to having undiagnosed CD for so long (probably since a young child - I am now 40), I have lost all my previous frames of reference, as normal for me was to live with a string of individual issues that now I recognise were caused by having CD. I also get the brain fog if glutened, have had issues with also with anaemia (now clear), intestinal symptoms etc. Luckily for me, I am already awaiting the results of a recent Dexa Scan. Judy, it does sound like you have had a real problem trying to get your calcium levels sorted out, I hope things improve for you.

[Penel in reply to Regalbirdy]

Low levels of vit D can be associated with depression, hopefully your dexa scan should pick this up.

I have found Pilates to be a really effective exercise without being high impact.

Hope you can get sorted without too much medication.

[Penel in reply to Penel]

Whoops. Vitamin D levels would have to be picked up in a blood test not a dexa scan.

[Hidden]

To clarify the purpose of a Dexa Scan : nhs.uk/conditions/DEXA-scan... "A DEXA scan is a special type of X-ray that measures bone density. DEXA stands for dual energy X-ray absorptiometry.

DEXA scans, also known as DXA scans, bone density scans or bone densitometry scans are most commonly used to diagnose osteoporosis (where the bones become weak and fragile and more likely to break). They can also be used to assess the risk of osteoporosis developing.A DEXA bone scan can also help detect other bone-related conditions, such as osteopenia (very low bone mineral density) and osteomalacia (softening of the bones caused by a vitamin D deficiency). In children, osteomalacia is known as rickets.".

This article goes into a lot of detail about the role of Vitamin D but it doesn't associate low levels with depression. ajcn.nutrition.org/content/.... To summarise:

Vitamin D was discovered with many other vitamins and is classed as a vitamin even now. However, findings from the second half of the 20th century showed that vitamin D is truly a prohormone and not a vitamin. In addition to causing mineralization of the skeleton and increasing serum calcium and phosphorus concentrations, vitamin D is known to regulate parathyroid growth and parathyroid hormone production; it plays a role in the pancreas, has a significant effect on the immune system, and can help in suppression of certain autoimmune diseases and certain cancers.

Depression may be caused by low levels of folic acid. "An individual with folic acid deficiency may be asymptomatic most of the time. Clinical features may occur when a significant level of haemoglobin drops during a short period of time. The symptoms are non-specific and include ulcers at the corner of the mouth, soreness of tongue, diarrhoea or premature grey hair. Sometimes, such individuals also complain of difficulty in breathing during strenuous physical activity. Other features like depression, mood changes, memory problems, irritability, light-headedness and headache may also occur occasionally or in longstanding deficiency. surgerydoor.co.uk/advice/di...

[Penel in reply to Hidden]

The subject is certainly complicated. This is one scientific summary which suggests that lack of vit D is associated with depression sciencedaily.com/releases/2...

[Regalbirdy]

Wow, thanks both of you for the extra info. It has really helped and given me a lot of food for thought. I so don't want to go down the antidepressant route unless I must, and if Vit D supplements work then obviously that would be a lot better.

[Hidden]

Thanks Penel - that's interesting and Yes, its complicated!

The article referred to is an investigation of the effect that Vitamin D may have for Type 2 (i.e. acquired) diabetics. "Loyola faculty members plan to take vitamin D research a step further by evaluating whether weekly vitamin D supplements improve blood sugar control and (hence) mood in women with diabetes. Depression is associated with increased insulin resistance, so people with diabetes have a greater risk for the disease than those without depression. "There is evidence to suggest that vitamin D supplementation may decrease insulin resistance," said Dr. Penckofer. "If we can stabilize insulin levels, we may be able to simply and cost effectively improve blood sugar control and reduce symptoms of depression for these women.". As my note highlights, Vitamin D as a hormone "plays a role in the pancreas", which is the site of production of insulin. So, I suggest that the mechanism is Vitamin D to pancreas to insulin stability to blood sugar levels to mood/depression.

My advice is to get your blood checked and get supplements for whatever nutrients you require - Vitamin D is one, folic acid is another, Vitamin B12 is one I didn't mention earlier and low levels of B6 have also been linked to depression. If your blood is normal, ask for an investigation into other possible reasons for all your symptoms.