A reference post rather than a discussion. Corrections are the point; I would rather this be right than mine. It is about fatigue, and it is deliberately narrow — everything I am not confident about is marked as such.
Mostly the deficit, and the useful part of that answer is that it is testable. Fatigue driven by a deficit tracks intake, improves within a day or two of eating properly, and worsens on the days you eat least. Fatigue that is flat regardless of intake, or that arrives on a fixed day after dosing, is behaving like a drug effect. Before assuming either, rule out the boring causes — iron, B12, thyroid, and sleep — because a fast deficit unmasks deficiencies that were previously subclinical.
The commonest reversible cause in practice is inadequate protein plus inadequate sodium, not iron. People restrict salt at the same time as calories without noticing.
Worth checking before concluding it is the drug: ferritin, B12, TSH, and total intake for three honest days. Two of those four explain most cases.
What I am trying to establish is whether the fatigue is a direct drug effect or simply the caloric deficit, because the answer changes what you do about it. Happy to be told the question itself is wrong.
Dr.NutriCornell said:Mostly the deficit, and the useful part of that answer is that it is testable.
Right, and the exception is worth naming rather than left implied, because the exception is where people get into trouble.
Dr.NutriCornell said:Mostly the deficit, and the useful part of that answer is that it is testable.
Pushing back on Dr.NutriCornell here. The counter-case has not been addressed. Somebody upthread described the situation that does not fit, and the thread moved on rather than engaging with it, which is the failure mode this board is supposed to avoid.
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Browse GL BiochemThis one has a reasonably settled answer, so here it is. It is worth asking what the claim would look like if it were false. If nothing would look different, it is not a claim about the world and no amount of discussion will settle it.
labquiet_amy said:Right, and the exception is worth naming rather than left implied, because the exception is where people get into trouble.
This matches mine closely enough to be worth saying so out loud.