Writing this once so I can stop repeating it across threads. 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.
The question I want answered is whether the fatigue is a direct drug effect or simply the caloric deficit, because the answer changes what you do about it. Numbers rather than impressions, if you have them.
hank_denver said:Mostly the deficit, and the useful part of that answer is that it is testable.
Agreed on the substance. I would put less weight on the timescale, because two months of anything is not enough to distinguish a trend from a wobble.
hank_denver said:Mostly the deficit, and the useful part of that answer is that it is testable.
This is where I part company with the consensus forming above. Pushing back on the anecdote-stacking. Twenty people reporting the same thing is twenty samples from the same self-selected pool, not twenty independent confirmations.
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View ResultsShort answer first, then the reasoning. Take it one variable at a time. Almost every unanswerable question in these threads is unanswerable because three things changed in the same fortnight, and no amount of subsequent argument can untangle them after the fact.
Correct me if the detail matters more than I have assumed.
Dr.ObesityMed said:I would put less weight on the timescale, because two months of anything is not enough to distinguish a trend from a wobble.
This matches mine closely enough to be worth saying so out loud. I had assumed I was the exception until I read this.