How is your stress level? Thyroid and cortisol? I know you are very well versed in this stuff but I always wondered if chronic fatigue syndrome was just a late stage of adrenal fatigue..?
I've mentioned it a few times on this site recently but adrenal fatigue caused me hell for a few years and it is still something I need to consistently attend too. I am very passionate about keeping the adrenals happy
Psychological stress is fine. The question Dr Mariano and I are trying to solve is if there's some sort of chronic inflammation going on that's increasing stress hormones. I have pretty clear symptoms of low thyroid, but when I try to increase my dose from 50 mcg T4 to more, or try NDT or T3, I get worse fatigue and brain fog -- the opposite of what you'd expect with hyperthyroid reactions. My hypothesis is that I'm having mitochondrial issues that are preventing thyroid from drawing on ATP, or possibly iodine deficiency (currently supplementing).
Cortisol was always slightly low in the morning and fine if not touching the upper edge of high at other times in the day (and normal at night). I tried up to 30 mg of hydrocortisone, thinking it would help thyroid get into cells, without any clear benefit in symptoms, and ended up dropping it because it caused my adrenal hormones other than cortisol (progesterone, pregnenolone, and DHEA primarily) to go too low, which cumulatively can have a worse effect than not being on HC.
What were your adrenal levels (ACTH and cortisol especially) with adrenal fatigue? My case has involved borderline high ACTH and previously over the range DHEA(S), which is the opposite picture of how adrenal fatigue goes. With my disproportionately low cortisol in relation to ACTH, I thought I had some slight version of congenital adrenal hyperplasia, where an enzyme deficiency causes low cortisol and (by feedback to the brain) high ACTH and therefore high DHEA.
In the last few weeks I've noticeably gotten better with mood, fatigue, brain fog, and needing less sleep -- not dramatically with the latter three, but still noticeable. I've attributed this to taking 200 mg of coq10 (was below the range last year when pulled), and/or iodine, sea salt, and one or two other supplements that are slipping my mind at the moment.