What Is Going On With Me? Fatigue, Burning Legs, Skin And Gut Problems

[RFTG]

Hi!

I am at a lost here, and would really need some help. Sorry about the length of this thread but I wanted to share all the things I have observed regarding my health. I really hope you have the time to read it through and please don't hesitate to come with any suggestions or thoughts you might have.

Background
27 year old, male. Skinny-fat - 6 feet 2,5 inches. 169 lbs with most fat accumulated around stomach, thighs, breast, face(?)). Whenever I start eating more I pretty quickly accumulate fat around stomach, breast and my fat looks more bloated. I also look young for my age, with very little body hair. I feel that the health problems I will share below is stopping me from having a great life at the moment and it also makes me avoid certain social occasions. Next year I am graduating from university and want to have great social skills in the job interviews so I am determined to fix this. It's not like I am depressed, it's more like I just want to be the best healthiest person I can be.

Symptoms

• Intense Tingling/Crawling/Burning (difficult to describe) sensation in both legs, from just above the knee and down, including feets. Any time I am in motion the sensation subsides completely, but my legs feel rather weak. This started occurring perhaps three years ago and I am really worried what it could be. My doctor noted several similarities with Restless legs syndrome, and suggested I could try Pramipexole (dopamine agonist) in a low dose (starting with 0,09 mg and if needed up to 0,54 mg per day). I think it's too early to tell but thinking it may have some effect at 0,18 mg. Not sure if placebo, but I think it may have a positive effect on my well-being as well. Only side effect I noticed was if I take it too close to bed-time I get insomnia, but if I take it a few hours earlier I instead get really tired in the evening.
• Lately been having frequent headaches; when I for example look at the computer screen or trying to read I can't really focus my eyes.
• Brain fog - Must have been many years ago since I last felt that I could think clearly. It's like I can't picture things clearly in my head.
  
• Feeling tired and sometimes a bit dizzy, weak legs, excessive yawning especially in the evenings.
• Sleep is not perfect, going to sleep early but I wake up at least 1-2 times a night.
• Feeling quite stressed sometimes, and anxiety can be high. I have had panic attacks, but this is rarely.
• My skin get dry and irritated (red) when I sit in front of laptops, computer screens, mobile screen for some time. I have experienced this for many years and I believe it started occuring at the time I was on tetracyclines. Phototoxicity? Recently started using a SPF 30 zinc oxide cream which helps a little bit.
• Acne problems for the last 10 years (been on several rounds of tetracyclines, two rounds of Accutane, all the topical prescriptions cream out there, with only temporarily effects. It used to be much worse, and could nowadays be described as relatively mild papulopustular acne, but it still has a rather profound negative effect on my well-being. Interesting fact here is that I pretty much always break out badly, accompanied with a red face, after I have been out in the sun, but it have gotten much better since I started using the SPF 30 zinc oxide cream.
• Facial bloating - I can feel that I look bloated in my face.
• IBS symptoms including:
  
• Acid reflux: If I eat and lie down I get acid reflux problems. This I can feel at night when laying down as well. Whenever I swallow I will get a gurgling upwards sensation in my throat
• Quite often presence of mucus in stools and usually a lot of sticky yellow on toilet paper.
• Loose stools . In the morning I need to go to the bathroom between 1-4 times before I can go out "without fear". Interestingly I rarely need to go the bathroom more times after this during the day.

Diet
I am still transitioning into some "RP guidelines", but diet consists of potatoes, white rice, zucchini, cheese, orange juice, grass fed ground beef, cod, coconut oil, butter, oranges, watermelon, honeydew, grapes, eggs (two a day) lamb liver (100g weekly), and salmon, tuna and chicken occasionally. Prior to this I used to eat a Fodmap diet, Paleo and no dairy whatsoever. I haven not intentionally eaten any PUFA oils or similar for years. See attached files for an example day. In the attached file I have listed the raw carrot salad, however, I have stopped it as I notice very small carrots pieces in stools and on toilet paper the next day after I have eaten it. I also notice this sometimes with tomatoes, and not sure what this could mean.

Supplements: Estroban one serving (8 drops) every morning. Apart from this I take, as mentioned, Pramipexole and also Desloratadin for grass allergy.

Blood tests

Recent tests from two weeks ago (fasting 8 am):
Hemoglobin (Hb) 140 g/L (134-170)
Cortisol 489 nmol/L
Testosterone 20,7 nmol/L (4,9-32) (577 ng/dl)
SHBG 33,4 nmol/L (13,1-57,4)
TSH 1,8 miU/L (0,4-4.0)
Glucose 5,4 nmol/L (4,0-7,5)

Tests from june 2016 (just to add in some other measures)
Ferritin 201 µg/L (30-400)
Homocysteine 9,6 µmol/L (<15)
Folate 5,4 nmol/L (>7,0) (July 25 after supplementation with Folate and B-complex: 30,9)
Vitamin B12 430 pmol/L (140-650)
Albumin 48 g/L (36-48)
Iron 15 µmol/L (9-34)
Transferrin 28,4 µmol/L (24-41)
Hemoglobin (Hb) 129 g/L (134-170) (July 25 131 g/L)

Thank you for taking the time to read.

 

[haidut]

Hi!

I am at a lost here, and would really need some help. Sorry about the length of this thread but I wanted to share all the things I have observed regarding my health. I really hope you have the time to read it through and please don't hesitate to come with any suggestions or thoughts you might have.

Background
27 year old, male. Skinny-fat - 6 feet 2,5 inches. 169 lbs with most fat accumulated around stomach, thighs, breast, face(?)). Whenever I start eating more I pretty quickly accumulate fat around stomach, breast and my fat looks more bloated. I also look young for my age, with very little body hair. I feel that the health problems I will share below is stopping me from having a great life at the moment and it also makes me avoid certain social occasions. Next year I am graduating from university and want to have great social skills in the job interviews so I am determined to fix this. It's not like I am depressed, it's more like I just want to be the best healthiest person I can be.

Symptoms

• Intense Tingling/Crawling/Burning (difficult to describe) sensation in both legs, from just above the knee and down, including feets. Any time I am in motion the sensation subsides completely, but my legs feel rather weak. This started occurring perhaps three years ago and I am really worried what it could be. My doctor noted several similarities with Restless legs syndrome, and suggested I could try Pramipexole (dopamine agonist) in a low dose (starting with 0,09 mg and if needed up to 0,54 mg per day). I think it's too early to tell but thinking it may have some effect at 0,18 mg. Not sure if placebo, but I think it may have a positive effect on my well-being as well. Only side effect I noticed was if I take it too close to bed-time I get insomnia, but if I take it a few hours earlier I instead get really tired in the evening.
• Lately been having frequent headaches; when I for example look at the computer screen or trying to read I can't really focus my eyes.
• Brain fog - Must have been many years ago since I last felt that I could think clearly. It's like I can't picture things clearly in my head.
  
• Feeling tired and sometimes a bit dizzy, weak legs, excessive yawning especially in the evenings.
• Sleep is not perfect, going to sleep early but I wake up at least 1-2 times a night.
• Feeling quite stressed sometimes, and anxiety can be high. I have had panic attacks, but this is rarely.
• My skin get dry and irritated (red) when I sit in front of laptops, computer screens, mobile screen for some time. I have experienced this for many years and I believe it started occuring at the time I was on tetracyclines. Phototoxicity? Recently started using a SPF 30 zinc oxide cream which helps a little bit.
• Acne problems for the last 10 years (been on several rounds of tetracyclines, two rounds of Accutane, all the topical prescriptions cream out there, with only temporarily effects. It used to be much worse, and could nowadays be described as relatively mild papulopustular acne, but it still has a rather profound negative effect on my well-being. Interesting fact here is that I pretty much always break out badly, accompanied with a red face, after I have been out in the sun, but it have gotten much better since I started using the SPF 30 zinc oxide cream.
• Facial bloating - I can feel that I look bloated in my face.
• IBS symptoms including:
  
• Acid reflux: If I eat and lie down I get acid reflux problems. This I can feel at night when laying down as well. Whenever I swallow I will get a gurgling upwards sensation in my throat
• Quite often presence of mucus in stools and usually a lot of sticky yellow on toilet paper.
• Loose stools . In the morning I need to go to the bathroom between 1-4 times before I can go out "without fear". Interestingly I rarely need to go the bathroom more times after this during the day.

Diet
I am still transitioning into some "RP guidelines", but diet consists of potatoes, white rice, zucchini, cheese, orange juice, grass fed ground beef, cod, coconut oil, butter, oranges, watermelon, honeydew, grapes, eggs (two a day) lamb liver (100g weekly), and salmon, tuna and chicken occasionally. Prior to this I used to eat a Fodmap diet, Paleo and no dairy whatsoever. I haven not intentionally eaten any PUFA oils or similar for years. See attached files for an example day. In the attached file I have listed the raw carrot salad, however, I have stopped it as I notice very small carrots pieces in stools and on toilet paper the next day after I have eaten it. I also notice this sometimes with tomatoes, and not sure what this could mean.

Supplements: Estroban one serving (8 drops) every morning. Apart from this I take, as mentioned, Pramipexole and also Desloratadin for grass allergy.

Blood tests

Recent tests from two weeks ago (fasting 8 am):
Hemoglobin (Hb) 140 g/L (134-170)
Cortisol 489 nmol/L
Testosterone 20,7 nmol/L (4,9-32) (577 ng/dl)
SHBG 33,4 nmol/L (13,1-57,4)
TSH 1,8 miU/L (0,4-4.0)
Glucose 5,4 nmol/L (4,0-7,5)

Tests from june 2016 (just to add in some other measures)
Ferritin 201 µg/L (30-400)
Homocysteine 9,6 µmol/L (<15)
Folate 5,4 nmol/L (>7,0) (July 25 after supplementation with Folate and B-complex: 30,9)
Vitamin B12 430 pmol/L (140-650)
Albumin 48 g/L (36-48)
Iron 15 µmol/L (9-34)
Transferrin 28,4 µmol/L (24-41)
Hemoglobin (Hb) 129 g/L (134-170) (July 25 131 g/L)

Thank you for taking the time to read.

What is the range for cortisol on your blood test? The accumulation of fat in those areas while staying skinny in rest of your body can be a sign of high cortisol. Sleep issues, IBS, headaches, brain fog and especially weak legs are also classic signs of elevated cortisol. Have you measured DHEA-S, prolactin and creatine kinase (CK)?

 

[RFTG]

What is the range for cortisol on your blood test? The accumulation of fat in those areas while staying skinny in rest of your body can be a sign of high cortisol. Sleep issues, IBS, headaches, brain fog and especially weak legs are also classic signs of elevated cortisol. Have you measured DHEA-S, prolactin and creatine kinase (CK)?

Thanks, that is very interesting. It does not say but it could be 135-540 nmol/L (between 06 am to 10 am) Unfortunately I haven't been able to get the specific tests you mention.

 

[haidut]

Thanks, that is very interesting. It does not say but it could be 135-540 nmol/L (between 06 am to 10 am) Unfortunately I haven't been able to get the specific tests you mention.

I would then do two cortisol tests - AM and PM. It means 2 blood draws in one day but it will show if there is a proper daily rhythm of cortisol release. If it is flat or PM is higher than AM then cortisol is certainly an issue to discuss with a doctor.

 

[Forsythia]

Intense Tingling/Crawling/Burning (difficult to describe) sensation in both legs, from just above the knee and down, including feets. Any time I am in motion the sensation subsides completely, but my legs feel rather weak.

What you are describing can be due to a B12 deficiency. Suggest you supplement with sublingual Methylcobalamin and see if the symptoms improve.

 

[Richiebogie]

Rice and citrus can be problematic. Try going without these for a few weeks.

You could get your manganese, vitamin k and good carbs up by eating more figs, dates, bananas, mango, prunes...

Too much fat could give you headaches. Maybe reduce your cheese to 50g per day.

A little table sugar is ok in cheesecake, tonic water or your coffee.

 

[Mito]

Symptoms

• Intense Tingling/Crawling/Burning (difficult to describe) sensation in both legs, from just above the knee and down, including feets. Any time I am in motion the sensation subsides completely, but my legs feel rather weak. This started occurring perhaps three years ago and I am really worried what it could be. My doctor noted several similarities with Restless legs syndrome, and suggested I could try Pramipexole (dopamine agonist) in a low dose (starting with 0,09 mg and if needed up to 0,54 mg per day). I think it's too early to tell but thinking it may have some effect at 0,18 mg. Not sure if placebo, but I think it may have a positive effect on my well-being as well. Only side effect I noticed was if I take it too close to bed-time I get insomnia, but if I take it a few hours earlier I instead get really tired in the evening.

Do your leg symptoms get worse during the night? Is that why you take Pramipexole in the evening?

 

[RFTG]

I would then do two cortisol tests - AM and PM. It means 2 blood draws in one day but it will show if there is a proper daily rhythm of cortisol release. If it is flat or PM is higher than AM then cortisol is certainly an issue to discuss with a doctor.

Thanks, I will keep that in mind for the next time I am doing tests.

What you are describing can be due to a B12 deficiency. Suggest you supplement with sublingual Methylcobalamin and see if the symptoms improve.

I have thought about this, and have used Thorne Basic B-complex with Methylcobalamin. I can't remember if it did anything for my legs problems, but I have actually wanted to try it again. Thank you!

Rice and citrus can be problematic. Try going without these for a few weeks.

You could get your manganese, vitamin k and good carbs up by eating more figs, dates, bananas, mango, prunes...

Too much fat could give you headaches. Maybe reduce your cheese to 50g per day.

A little table sugar is ok in cheesecake, tonic water or your coffee.

I will experiment with this, and thanks for pointing out suggestions for manganese.

Do your leg symptoms get worse during the night? Is that why you take Pramipexole in the evening?

Yes, that is correct! Now I take it at about four hours before bed and I seem to have no trouble getting to sleep. However my sleep quality is not good, but that it has never been I am afraid. Waking up a few times per night, and with an urge to pee about two times per night.

 

[RFTG]

Next I will try to incorporate more carbs, while lowering fat intake a bit. I have also thought about, beside Estroban, supplementing with low dose Aspirin (125 mg), B-Complex, Coffee and Vitamin K2 15 mg. The latter inspired by the liver health protocol which has been discussed in some threads.

I am a bit uncertain though if I should, instead of a B-complex, try a few of the B-vitamins in isolation first. I just realized I have an unopened bottle of Niacinamide from Jarrow at home. The capsules are 250 mg, which might be too much though?

 

[Matt1951]

500 mg of niacinamide would be a good start. 250 mg is not too much. I agree with trying the coffee. I also agree with your approach to increasing metabolism. Lack of body hair doesn't mean anything, some men have a lot, some very little, there is no relationship to male health, it is just genetic.

 

[Constatine]

Thiamine would certainly help with your brain fog. Red light exposure is a safe bet to reduce acne, edema, fatigue, muscle weakness, stress, and maybe even IBS (though I don't know if there are any studies of red light on IBS). Considering how often your skin gets red I would try to do things to limit the FFA oxidation. Aspirin and (like Matt mentioned) niacinamide can help with this.

 

[RFTG]

500 mg of niacinamide would be a good start. 250 mg is not too much. I agree with trying the coffee. I also agree with your approach to increasing metabolism. Lack of body hair doesn't mean anything, some men have a lot, some very little, there is no relationship to male health, it is just genetic.

Thank you very much. I seem to do fine on coffee so far, and will titrate up the amount sl0wly.

Thiamine would certainly help with your brain fog. Red light exposure is a safe bet to reduce acne, edema, fatigue, muscle weakness, stress, and maybe even IBS (though I don't know if there are any studies of red light on IBS). Considering how often your skin gets red I would try to do things to limit the FFA oxidation. Aspirin and (like Matt mentioned) niacinamide can help with this.

Thank you so much. I will try Energin, which includes both Thiamine and Niacinamide. Red light is also on the list for things I would like to try.

 

[Mito]

Red light is also on the list for things I would like to try.

There are a couple studies that used red or near-infrared light for restless legs syndrome. Here is one of them:
http://moscow.sci-hub.ac/3b131f6bae96653ec3b66ee33209b5f6/mitchell2010.pdf

 

[RFTG]

There are a couple studies that used red or near-infrared light for restless legs syndrome. Here is one of them:
http://moscow.sci-hub.ac/3b131f6bae96653ec3b66ee33209b5f6/mitchell2010.pdf

Thanks that sounds interesting, I couldn't access the link though! Red light is definitely on my things to try list.

 

[RFTG]

I've just noticed that my calluses on my hands (typical gym calluses) are bright orange. Is this a sign I need to cut back my Vitamin A intake? For the last month I have eaten 100 g Lamb Liver each week. This is something I have never done before. I have also taken one serving of Estroban per day (6000 iu). As for beta carotene I very very rarely eat carrots, and I haven't eaten sweet potatoes for many months.

 

[Mito]

Thanks that sounds interesting, I couldn't access the link though! Red light is definitely on my things to try list.

Here are the studies.

 

[tara]

As an experiment, have you tried to see if your sleep improves if you eat more through the day, or if you leave a small carby and maybe salty snack beside the bed that you can eat without disturbing yourself too much when you wake up? Not sure that this will make a difference, but it might if you are relying ion stress hormones to sustain blood sugar through the night. You are very tall and that may not be enough food.

 

[EIRE24]

I've just noticed that my calluses on my hands (typical gym calluses) are bright orange. Is this a sign I need to cut back my Vitamin A intake? For the last month I have eaten 100 g Lamb Liver each week. This is something I have never done before. I have also taken one serving of Estroban per day (6000 iu). As for beta carotene I very very rarely eat carrots, and I haven't eaten sweet potatoes for many months.

Did you notice any difference in skin from saturating yourself with this amount of vitamin A?

 

[RFTG]

Here are the studies.

Excellent, I will read it later! Many thanks.

As an experiment, have you tried to see if your sleep improves if you eat more through the day, or if you leave a small carby and maybe salty snack beside the bed that you can eat without disturbing yourself too much when you wake up? Not sure that this will make a difference, but it might if you are relying ion stress hormones to sustain blood sugar through the night. You are very tall and that may not be enough food.

Thanks for the suggestion, I am currently trying to up my calories. I believe like you say that I might benefit from more foods, and I know I have been under-eating sometimes during the last couple of years. I have tried things like OJ, cheese, ice-cream before bed, but my gut seems to hate it when I do that, and it therefore exacerbate my sleeping issues.

Did you notice any difference in skin from saturating yourself with this amount of vitamin A?

No I haven't noticed anything really, but I have noticed some other positive things that I think can be contributed to the fat solubles synergetic effects. In my experience Vitamin A is not a cure for acne but it can certainly help temporarily. It might be the magic bullet for acne if you have a true deficiency, but I am certain that's not the case for me. I have been on Accutane twice in the past, and as you know this is a synthetic form of Vitamin A, which would compare to a daily dose many many times greater than what I have been taking lately. Accutane cleared me up both times, but it was a slow working progress where results were seen after 5-6 months. Results lasted for a month afterwards each course. So while Vitamin A certainly can manage the problems, at least in my case it does not correct the underlying issues. Same goes for topical Vitamin A like retinoids. At times I use certain prescription creams and they can temporarily manage the inflammation, but just like Vitamin A orally it will not fix the underlying issue.

Tetracyclines worked much better than Accutane, first time I used it. It cleared me up within weeks. The only problem was it came back worse just days after stopping the antibiotics. Ten years later I still suffer from some side effects of using tetracyclines over a longer time. I would like to try a low dose antibiotics again while being on an optimal diet though. Perhaps another type, as I suspect I am resistant to tetracyclines now. Feel free to PM me if you are stuck and have any questions (my skin has improved a lot the last few years).

 

[tara]

Thanks for the suggestion, I am currently trying to up my calories. I believe like you say that I might benefit from more foods, and I know I have been under-eating sometimes during the last couple of years. I have tried things like OJ, cheese, ice-cream before bed, but my gut seems to hate it when I do that, and it therefore exacerbate my sleeping issues.

Undereating is one of the most reliable ways for me to mess with my sleep. I've found filling glycogen stores through the day and a small supper before bed often works better for me than trying to catch up in the evening. If I eat enough through the day I seldom need the night time snacks theses days, but they can help if I run short and wake up too early.