Why am I so tired all the time?

Quantified Self Project Logs
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Introduction

I am a 40-something male with unusual fatigue. I fell asleep during a Metallica concert in college. My 76-year old father sleeps 20 hours per day, and my 11-year old son is also exhibiting unusual fatigue. Doctors have been unable to help. Blood tests have revealed nothing unusual. I drank so much caffeine, I started having heart arrhythmias 40+ times per day.

Out of desperation, I’ve begun to track every conceivable factor in energy production and fatigue that I can find and experiment with them. I am new to QS and eagerly looking forward to learning from the community.

Questioning

Since energy and fatigue is such a huge subject, I’m taking a systems-based approach to the body. From my research, it seems like the body’s energy is derived and/or affected by eight main subsystems:

  1. Breath
  2. Sleep
  3. Hydration
  4. Diet
  5. Movement
  6. Mood
  7. Biochemicals
  8. Environment

Each subsystem seems to have stressors (like alcohol) and requirements (like sleep or food).

I’m approaching this project by reading the top books in each area, seeing which sources they reference and reading those, documenting stressors and requirements, trying to eliminate the stressors, trying to build up the requirements, and documenting the results.

Observing

I have been tracking over 30 different factors in the above 8 areas over the past 6 months.

  • energy (morning, noon, and night) on a scale of 1-5 (5 being the highest)
  • mood (morning, noon, and night) on a scale of 1-5 (5 being the highest)
  • sleep (total, deep, REM, and Garmin sleep score)
  • calories (breakfast, lunch, dinner, snack, total)
  • caffeine (morning, lunch) (after a couple months, I eliminated caffeine in the afternoon)
  • movement (steps, aerobic calories, minutes of anaerobic exercise)
  • water (Morning, noon, and night in ounces)
    …and more

For the full list, I’m keeping the data in a Google spreadsheet here:

Consolidating

Since neither the doctors nor I know what is affecting my family’s energy, I am casting a wide net. Here are the experiments I am currently tracking:

Breathing Experiments

  1. Slow breaths
  2. Nasal breaths while taking the stairs
  3. Nasal breaths while running
  4. Sleep tape
  5. Breathe right strips
  6. Saline rinse for allergies

Sleep Experiments

  1. Sleep tape
  2. Breathe right strips
  3. Cooler bedroom temperatures
  4. Blackout curtains
  5. Air filter
  6. Humidifier with essential oils
  7. No caffeine 8 hours before bedtime
  8. No liquids after 5 PM
  9. No screens 1 hour before bedtime
  10. Low blue light LED light bulbs
  11. Blue light blocking glasses

Hydration Experiments

  1. Humidifier
  2. Lower caffeine
  3. Sleep tape
  4. Smoothies
  5. More fruits and vegetables
  6. MCT oil
  7. Massage gun
  8. Stretching daily
  9. Drinking 32 oz of water with electrolytes before coffee

Reasoning

With my crude 1-5 scale, I have begun to refer to my perfect days - the days when I have a 5 energy morning, noon, and night, and I have a 5 mood morning, noon, and night - as my 5-star days.

When I started this experiment in December, I had no 5-star days. Last month, I had six. My efforts seem to be working, but I know I have a lot of room for improvement.
EnergyProgress

I am tracking this experiment on my blog at TheEnergyBook.com.

Next Steps and Questions for the QS Community

Next I will be reading the energy/fatigue research on:
4. Diet - paleo, intermittent fasting, calorie restriction, affect of carbs on energy/insulin
5. Movement - HIIT, cardio, anaerobic, moving every 15 minutes, why the body needs movement
6. Mood - mood has the highest correlation with my energy currently. FASCINATED by this.
7. Biochemicals - caffeine, hormones (testosterone, adrenaline), supplements (B, D, COQ10)
8. Environment - seasonal affective disorder, red light therapy, polar plunges

Questions:

  • Any recommended resources I should read on energy and fatigue?
  • Any recommendations on how I’m structuring this experiment? (I know I’m taking on a lot)
  • Any recommended machines for measuring energy? (I use a Garmin Fenix 6)
  • Thank you for reading through all this!
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Fascinating write-up, thanks for sharing!

Are you just using GSheets for tracking? I’ve recently been using the Metriport app, which has proven useful.

I also use the Garmin sense watch for sleep tracking, which I can wear for a week straight with recharging which has been great.

I’m also tracking screen time with “My screen time” app, which I can use to export data to a CSV file.

With so many interventions, I would be concerned that I wouldn’t be able to pinpoint the benefiting factors. Have you thought about how you might do this?

1 Like
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Hi Chris,
I have been underwhelmed by most sleep trackers.
When I was experimenting my favorite was ZEO.
Have you done a sleep study?

Are you tracking circadian rhythms such as body temperature?
Do the results line up with expected norms.

I didn’t see a mention of SAD.
In addition to blue light blocking at night have you tried bright light first thing in the morning?

I know the HRV DFA alpha 1 is a new measure of how strenuous you exercise.
I wonder how well it would track your fatigue levels?

Good luck!

1 Like
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@Edward_Miller

I appreciate the feedback! Just downloaded Metriport and it looks custom fit for what I’m doing. Thanks for the tip!

Tracking screen time and exporting the data is a good idea. I hadn’t really thought about how draining time on my phone can be, but I ought to factor that in.

You make a good point about how I’m testing a lot of interventions at once. This is my top concern about my current methodology, but I’m loathe to go slower. With the vast amount of ground I have to cover, I’m already expecting to spend two years on this. I hate to stretch things out further.

But you’re right. If I’m going to try and accurately distinguish what is working and what isn’t, I need to slow down and separate out the experiments a bit more. I was just talking to a neurologist friend who was reminding me of homeostasis and pharmacokinetics. I need to be more methodical about tracking these experiments separately.

So, three thoughts:

  1. I was batching the experiments to see what subsystem my issue resided in (breath, sleep, hydration, etc.). I took a shotgun approach and tested every tip and trick I could find in each subsystem. My thought was that if I saw improvement in my energy, I must have had a problem there. However, I’m realizing as we discuss this that I made several assumptions there - that I had only one issue, that many changes might make incremental improvements to my energy, that I had the time to make all these changes, that I could retroactively isolate the changes that worked and scale back to just those. Those might have been foolish assumptions.
  2. I also took a number of diagnostic tests that I had hoped would isolate as many issues as possible without have to try additional experiments (like an elimination diet). I took the Viome mitochondrial and gut health tests. I took the SelfDecode DNA test. And I just ordered the Everlywell food sensitivity test. I realize now this doesn’t replace the need for me to be more methodical, but it did reduce my approach style down from a ‘grenade’ to a ‘shotgun’.
  3. So, estimating that my first three subsystems of energy required about 30 experiments in six months and I have five subsystems to go, I can roughly estimate that I will have 50 more experiments. I was haphazard in my deployment of experiments before, but I could have spaced them out in those first six months and taken approximately a week to test each experiment. If I planned out my experiments and tested each one for a week before moving on to the next one, do you think that would be sufficient? Obviously there are degrees of rigor. I’m not trying to recreate a lab experiment and I have a lot to cover, but I do want to give myself a better chance of knowing whether or not an experiment is working. Do you have any recommendations for time spent on each one?

Again, thank you for your time and consideration with this!

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@OP_Engr

Thanks for the feedback! I really appreciate your help.

I looked up the ZEO sleep manager. It looks like they stopped making it. I can only find it on eBay now.

But you make a good point about a sleep study. My doctor said the same thing. And my SelfDecode DNA test said that I’m genetically inclined to have insomnia. And my new Garmin has noticed I’m not getting enough deep sleep. So I’m leaning more and more toward sleep as being a key issue. So my doctor has ordered an at-home sleep study with a heart monitor and pulse oximeter. If he sees any problems there, he will order the full sleep lab study.

I have not tracked circadian rhythms with body temperature! I do lower the AC at night but that is as far as I have gone with temperature. I just googled this and will look into options. Do you have any recommendations?

I did mention SAD under next steps. I’m fairly certain my father has it and my wife has it, so my son might. As for bright light in the morning, I am always on a run outside when the sun comes up. However, do you recommend a bright, artificial light as soon as I wake up (at 5AM)?

I had not heard of HRV DFA alpha 1. I see that there is a Garmin app for tracking this. I will add this to my data and see if there is a correlation with my fatigue levels.

Thanks!

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It would be interesting to see what you look like on a continuous glucose monitor. Your symptoms sound like the classic “crash” effect from uneven blood sugar levels throughout the day. https://diycgm.com/

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Following up on this, on the last section if you wanted to access your Libreview data via API you could also use Vital, that way you don’t have to manually download your data e.g. Freestyle | Vital

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Really interesting research, thank you for posting about it. Have you thought about giving a bit more structure your process of prioritizing your ideas for testing? As you’ve said, you can’t try everything at once, and you are trying to intervene on a complex system that could be sensitive to many different interventions and combinations of interventions. Therefore, you need to develop a reasoned way to prioritize your tests. The way I formulate this problem is: How do I pick out especially promising ideas against a background of many plausible ideas?

For this, I like using natural experiments. That is, once you have a way of measuring your fatigue that you trust and a bunch of plausibly connected observations that you think may somehow be connected, you can carefully look at any days of especially high or low fatigue and ask: what was different on those days or the days just prior? Note that this is not (yet) any kind of formal intervention or trial. And it will of course miss complex and intermittent causal influences. But it’s good for giving some structure to a search for really big effects that may be repeatable.