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  • Q&A with Australian Health Practitioners

    What is causing my severe exhaustion?

    I have been ill for the past 18 months - my doctor has done all the test we can both think of and they are all in the normal range, but he is still hesitant to diagnose. I am 54 years of age, in the middle of menopause, suffering from consistent migraines diagnosed by specialist as they do not go away, just subside and then blow up again. I have fructose and lactose intolerance, i want to sleep all day everyday, i have motivation and desire to do things but i dont have the energy to do so.
  • Find a professional to answer your question

  • 1




    At figureate, accredited practising dietitians Zoe Nicholson and Marlene Gojanovic will help you get off the dieting merry-go-round and show you how to change your … View Profile

    You’ve done the right thing by having any medical causes ruled out. Given you have had positive tests to fructose and lactose malabsorption, there is a chance you may have another food intolerance triggering the migraines and extreme tiredness. It is not uncommon for this food intolerance to become more pronounced during menopause as hormonal changes can lower your tolerance level.
    I am referring to a natural food chemical intolerance where a build up of natural salicylates, amine and/or glutamates in your system can exceed your threshold and start to irritate nerve endings triggering headaches/migraines and fatigue along with other symptoms including gut and bowel issues, skin conditions, sinus/nasal congestion and anxiety/mood disturbances. Some people experience just one or two symptoms, while others experience the full range.
    Unfortunately there are no tests to identify this type of food intolerance and dietary elimination and food challenge is the only method. I would advise you seek help from a dietitian experienced in this area if you feel this may be the way to go. I work extensively in this area and would be happy to help if you are in Melbourne.

  • 2


    My research interests include immunology and the mechanisms of amyloid formation. The latter has implications for people who are dealing with Alzheimer's Disease, Parkinson's Disease … View Profile

    You and your doctor may have considered this but, if not, I think that it would be worth getting your thyroid gland function checked out.

    The thyroid gland makes a hormone called thyroxine - low levels of thyroxine can lead to experiences of chronic fatigue.

    Also, production of thyroxine is controlled by a hormone called Thyroid Stimulating Hormone (TSH) - it is made by the pituitary gland. Measurements of blood thyroxine and TSH levels are easy to do.

    If either or both of them are abnormally low that could assist your doctor (ideally in collaboration with a specialist endocrinologist) to work out ways of helping you.

    All the best.

  • 1


    Dr Kevin Lee

    Endocrinologist, Nuclear Medicine Physician

    Consultant Physician in Endocrinology, Diabetes & Nuclear Medicine. I am on Twitter @dr_kevinlee. I am on Facebook I help patients with obesity, diabetes, thyroid, … View Profile

    Blood results in “normal” range may not necessarily normal. There are many examples of hormone or blood tests being “inappropriately” in the normal range.

    There are many endocrine tests designed to bring out the true functional response of the body hormones, often need to be done at specialised pathology centres or even hospitals, rather than just a one off blood test.

    Therefore it is always important to consider patient symptoms and not ignore them just because blood tests appear normal. 

    It is generally advisable to continuing seeing your GP if your symptoms persist. There may be a role for specialist involvement if deemed appropriate by your GP.


    Dr Kevin Lee
    BSc(Med), MBBS, MHS(Clin Epi), FRACP
    Consultant Physician Endocrinologist

  • Karen Coleman

    Counsellor, Naturopath

    I agree with Dr Lee in that testing is a science that is still developing and there are many more options that would look more specifically at your food, migraine and energy issues. Naturopathy would tend to work on improving your overall functioning rather than wait for a diagnosis. Functional testing might provide more specific answers for you. 

    No one can deny your reality and there will be options to help you through what must be limiting your life considerably.  Keep asking questions 

  • I am a Melbourne Relationship Counsellor and Family Lawyer who is skilful in helping people get out of the pain of relationship distress and create … View Profile

    I'm sorry to hear that things are so difficult. I'm wondering if you can reflect back and see if there were any other changes in your life 18 months ago. What was going on for you then? If you have ruled out medical conditions it may be worth considering some psychotherapy. There is a huge link between body and mind and science is now recognising that our physical well-being and emotional are inter-related. Also, you may wish to try some mindfulness practices which may increase your ability to manage what you are going through as well as help you to be able to respond from a more relaxed place. All the best.

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