Revolver writes:
For the past three years I’ve been struggling with severe fatigue and gradual weight gain. I’ve done sleep studies, blood tests, diet, exercise, and nothing seemed to help. In the last year I’ve gained 40 pounds, partially because I’m too damn tired to exercise regularly.
I went to see my primary care provider, who dismissed my concerns right away as being my depression’s fault. I’ve been on anti-depressants for 5 years, and the only reason I feel sad now is because I’m too tired to do anything! But she would not even consider alternative causes and prescribed a new anti-depressant (that has some ugly side effects) and told me to diet and exercise. She said that weight gain is normal for a woman in her mid-twenties.
When I said I was too tired to exercise, she said, and I quote, “Sometimes when I don’t exercise for a day or two, I just feel like sitting on the couch. But then I force myself to exercise and I feel so much better.”
Thank you, o wise one, for such a gem of information. It’s not like I haven’t been told to exercise and diet before, or that I haven’t tried it. Nope, I’m just fat and lazy.
I was so incredibly upset by this outright dismissal.
Then I turned to a different clinic, called Women-to-Women, where nurse practitioners have hour-long sessions with each patient. Before, I would have probably written this clinic off as being too homeopathic, too granola-crunching. However, my nurse practitioner believed me right off the bat that it wasn’t a matter of diet and exercise. She ordered a battery of tests, both blood and stool (ew!). We found out that I have insulin-resistance and severe vitamin D deficiency.
I will never respect my primary care provider in the way that I respect that nurse practitioner. To the doctor, I was just deliquent on my diet and exercise. To my nurse practitioner, I was the expert on what my body was telling me and she did everything she could to help me remedy my problems. Totally different experiences!
First, Do No Harm 
G
/ August 28, 2012Unfortunately, it is a classical case of bigotry from the MD. Shame of her !
La
/ August 28, 2012I saw a report on the news last night about a female doctor who absolutely refuses to treat anyone who weighs over 200 pounds. Why? Because it’s a safety risk to her staff. Is she kidding me? What does she think is going to happen? Unbelievable!
Lindsay
/ September 2, 2012A safety risk to her staff? How’s that work?
(I weigh about 200 pounds myself, so I wonder what I am doing that is so dangerous.)
The Well-Rounded Mama
/ September 1, 2012Glad you found better care for yourself! Did they rule out that your anti-depressant might be part of your weight gain? That can happen too.
Joint issues and fatigue can certainly be related to low Vit D. Glad you will be treating that, which is very important. But look into other things goo. Ask them to check your ferritin levels. (Usually they check hemoglobin and hematocrit, but you can be low normal in those and still have low ferritin. That could absolutely be involved in fatigue etc. too.)
And as always, I recommend that people get copies of their exact lab results and double check their results against the norms. Especially on those thyroid results. Often they are “normal” by the lab ranges some docs use and “low” by other diagnostic criteria. Research TSH results and compare yours to them, and be aware that the best diagnostic criteria for thyroid issues is controversial.
Hope you feel better soon!
chaoticidealism
/ September 2, 2012Yeah, exercise is good for you in general, but any decent trainer would tell you that you shouldn’t be forcing yourself past your energy reserves. We’re talking recreational exercise here–not professional athletics. Getting out and moving. Feeling the sun on your face. Stretching your legs. And if you’re so tired that you can’t exercise, and you get more tired whenever you do, there’s a problem.
I have a heart arrhythmia that had been getting worse over a few years, and eventually I started getting faint whenever I exercised, got dehydrated, got tired, or just generally got stressed out. I had to talk my doctor into getting a heart monitor for a couple of days, because the arrhythmia never showed itself too strongly when I was in the office. With the recording, they finally identified it–premature ventricular contractions, something that’s quite common but that I experience unusually often. Beta blockers fixed the problem, and now I can exercise whenever I like–which is usually daily walks or bike rides, because I am the sort of person who can’t sit still for long, but not athletic enough to appreciate really intense things like running.
I can’t imagine what it would have been like if the doctor had insisted that my problem came from not exercising enough. Ironically, the end result would have been an inability to exercise, as the arrhythmia continued and I randomly found myself having to lie on the ground near the sidewalk, trying to figure out why I felt dizzy. Instead, because I made enough of a stink about it and insisted on looking into it further, I’m as active as anyone and I never have dizzy spells anymore.
Some doctors don’t seem to understand that fat people can and do enjoy exercise, and are just as annoyed and frustrated as skinny people are when we can’t get out and move. They assume that fat equals not liking exercise, when in reality they can be completely unrelated. I’m glad my doctor listened to me, but I wish I hadn’t had to insist so strongly.
Leia
/ November 1, 2012So like some of the other commenters I agree vitamin D deficiency can cause fatigue, and so can other hormonal concerns. Have you been assessed for PCOS, 40lbs in yr is a lot, but PCOS would explain the insulin resistance, the fatigue, the weight gain and the depression. Unfortunately the treatmentis loosing weight….le sigh. the insulin resistance could also be separate issue as a result of your weight increase, but do some research and see if PCOS fits (hint: I’ve also noticed that once you are so many lbs over weight…you are at risk to have all the symptoms without the disease anyway…hence calling it a “syndrome”). Either way if you have insulin resistance, ask about Metformin to help with insulin sensitivity and weightloss. You want to prevent Diabetes at all costs. I wish you luck on this journey.
P.S. the only time I lost weight and didnt try was when I was unemployed, walked/metro’d everywhere and didn’t have a care in the world. Moral of the story? Stress is a bitch…and yeah exercise increases you insulin sensitivity.
Sincerely,
Medschool stole my body
Anna
/ January 16, 2013You are aware that basically everyone is deficient in vitamin D? They’ve done studies of city workers and found that none of them had sufficient levels of vitamin D. All of those people are probably more fatigued than they should be, but most people just get on with it. I work underground now. I was vitamin D deficient before this when I used to see sunlight sometimes. I must have ridiculously low levels now that it’s winter and I never get to go outside apart from for five minutes to get a sandwich at lunch. I’m tired but so is everyone I know. It’s very telling that you’re so satisfied by this explanation because you feel like it’s validating what you thought. In reality it could still be the case that the original doctor was correct.
Jennifer Hansen
/ January 31, 2013Telling of what? That she’s receiving treatment that makes her less tired?
Fat does not equal tired. Go crap on somebody else.
3-I
/ February 4, 2013“To my nurse practitioner, I was the expert on what my body was telling me and she did everything she could to help me remedy my problems.”
Nobody but the person experiencing the symptoms is an expert on the symptoms being experienced. Of course we’re happier with treatment and diagnosis that validates what we feel; why on earth would you think a doctor has any right to say “You’re not feeling what you think you’re feeling”?