Case Study: Fatigue And Nutrient Deficiencies
William is a 65 year old retired architect who came to see me for help with fatigue and depression. His energy level had been gradually deteriorating for the previous four years. His doctor had ordered some basic blood tests and couldn’t find anything wrong, therefore concluded his low energy must be a symptom of getting older and being retired.
William wasn’t happy with that explanation. He had a lovely wife and a small group of close friends, who he enjoyed going out with. His friends were the same age and they seemed to be far more energetic and were thoroughly enjoying their retirement.
Depression is a condition that slowly crept up on William in the previous two years. He told me that he was losing enthusiasm for activities that previously excited him. William’s quality of sleep was quite poor. He found it easy to fall asleep; however, would wake 3 or 4 hours later and the rest of the night would be marked by a light, restless, unrefreshing sleep.
I decided to order some of my own blood tests for William. I ordered the following blood tests for William:
- Vitamin D
- Vitamin B12 and homocysteine
- Thyroid gland function – including TSH, free T4 and free T3
- Liver function test
I also ordered a stool test for William to check for intestinal parasites. The test is called a PCR test and it checks for genetic material from a wide range of different harmful intestinal bugs. I ordered this test because William told me he regularly suffered with irritable bowel syndrome symptoms – he was usually bloated and his bowel motions alternated between diarrhea and constipation. These are common symptoms of a gut infection. The fatigue and disturbed sleep are also sometimes clues.
I found several problems with William’s test results:
- Low blood vitamin D levels. This is common in many of my patients and frequently leads to fatigue. We can make vitamin D in our skin from exposure to the sun’s UVB rays, but our skin become less efficient at that as we get older. I asked William to take one vitamin D capsule each day with breakfast or lunch. The digestive problems William experienced indicated he didn’t digest fats well. Vitamin D is a fat soluble vitamin. Poor fat digestion can lead to hormone deficiencies and fatigue, as many of our hormones are made from fat. I gave him an ox bile supplement to take with meals, to improve absorption of beneficial fats.
- William was low in vitamin B12. I ordered the homocysteine test as well because it is sometimes more reliable for checking B12 status than just looking at B12 levels in the blood. As we get older it becomes more difficult to absorb vitamin B12 from food, mostly due to lowered stomach acid and digestive enzyme levels. So I gave William a B12 supplement.
- William’s thyroid blood test indicated he has a mildly underactive thyroid gland. His TSH was 4.8. Some doctors may consider that to be okay but I know it’s not in the optimum range, and you will experience fatigue and other symptoms of an underactive thyroid gland with a result like that. I wrote a prescription for a low dose of porcine thyroid extract (Armour).
- William’s liver function test result showed a mildly fatty liver. His stool test indicated the presence of a gut parasite called Blastocystis hominis. This particular bug can create a great deal of inflammation to the intestinal lining. That’s bad because it inhibits proper nutrient absorption, but also because it creates a leaky gut and subsequent immune system problems and fatigue. I gave William a prescription for the antibiotic metronidazole and also gave him Intestinal Para Cleanse capsules. I gave him a glutamine powder to help soothe and repair an inflamed intestinal lining.
- Regarding his diet, I asked William to follow the eating guidelines in my book Fatty Liver You Can Reverse It. The diet in this book would also help improve his gut health. To enhance the improvements in his liver health, I gave William Livatone capsules.
William was very happy to discover there are genuine reasons why he hasn’t been feeling well lately. He was very happy to follow the plan I gave him. I expect to see William again in 4 weeks.
The above statements have not been evaluated by the FDA and are not intended to diagnose, treat or cure any disease.