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22 yr old male often fatigued in spite of healthy diet, lean body, and exercise

My son is 22 years old, very lean and active. On good days he mountain bikes, runs, and strength trains a few days a week. He has listened to many naturopath nutrition podcasts, and is diligent about not eating sugar, keeps his carbs low, eats tons of vegetables, Athletic Greens drink, and has healthy fats. His A1C is 5.6 (one point from being pre-diabetic). He has had bloodwork done, showing nothing wrong. His heart has been tested and is healthy. What else should be addressed? Could this be hormonal? Auto-immune? Any suggestions would be appreciated - please!  
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1756321 tn?1547095325
My blood sugar rose after high levels of toxic mould triggered CIRS (Chronic Inflammatory Response Syndrome). :(  

“Inflammation has a key role in the pathophysiology of type 2 diabetes and its associated metabolic abnormalities.”

Foods that help with blood sugar include raw honey (especially from a single floral source), fresh fruit, foods that contain beta glucan especially oats and barley.  Supplements include beta glucan, vitamin D, magnesium, zinc and chromium.  Optimal vitamin D levels are 100 - 150 nmol/L (40 - 60 ng/mL).  


“Researchers at the University of Toronto have found that honey improves key measures of cardiometabolic health, including blood sugar and cholesterol levels — especially if the honey is raw and from a single floral source.

The researchers conducted a systematic review and meta-analysis of clinical trials on honey, and found that it lowered fasting blood glucose, total and LDL or ‘bad’ cholesterol, triglycerides, and a marker of fatty liver disease; it also increased HDL or ‘good’ cholesterol, and some markers of inflammation.

These results are surprising, because honey is about 80 per cent sugar,” said Tauseef Khan, a senior researcher on the study and a research associate in nutritional sciences at U of T’s Temerty Faculty of Medicine. “But honey is also a complex composition of common and rare sugars, proteins, organic acids and other bioactive compounds that very likely have health benefits.”*

*Temerty Faculty of Medicine University of Toronto article - Honey Reduces Cardiometabolic Risks, U of T Study Shows. Nov 16, 2022


“In this large epidemiological study in Chinese adults, higher fresh fruit consumption was associated with significantly lower risk of diabetes and, among diabetic individuals, lower risks of death and development of major vascular complications.11”*

*Fresh fruit consumption in relation to incident diabetes and diabetic vascular complications: A 7-y prospective study of 0.5 million Chinese adults. Huaidong Du et al. PLoS Med. 2017.


“Beta glucan is a specific form of soluble dietary fiber. It’s found in the cell walls of certain types of plants and some yeasts, bacteria, fungi, and algae. You can also find it in supplement form.

It has been linked to a long list of potential health benefits and studied extensively for its ability to lower cholesterol levels, decrease inflammation, improve blood sugar management, and more (2Trusted Source).

Beta glucan is found naturally in a variety of food sources.

Grains like barley and oats contain the highest concentration of beta glucan, though it’s also found in other foods.

Good sources include (2Trusted Source):

durum wheat

Additionally, the fiber is found in certain types of bacteria and fungi, including Saccharomyces cerevisiae, which is used to make nutritional yeast, wine, beer, and some baked goods. However, this doesn’t mean that alcoholic drinks are a good source of beta glucan (3Trusted Source).”*

*Healthline - What Is Beta Glucan? The Heart-Healthy Fiber Explained - Medically reviewed by Kathy W. Warwick, RDN, CDCES, Nutrition — By Rena Goldman and Rachael Ajmera, MS, RD — Updated on July 13, 2023


“The Journal of Endocrine, Metabolic & Immune Disorders, explains: “Vitamin D is considered a risk factor for the development of diabetes as well as its complications, particularly cardiovascular ones.

"In fact, low vitamin D levels have consistently been found to be associated with insulin resistance, and a high risk of developing type 2 diabetes.

“Specific receptors in the pancreas may only switch on when sufficient vitamin D is available. The thinking is that vitamin D may support the function of the pancreas.”

In 2019, a study published in the European journal of endocrinology discovered that just six months of vitamin D supplementation improved insulin sensitivity and production in 96 participants at high risk of or newly diagnosed with type 2 diabetes.”

The National Centre for Complementary and Integrative Health adds that magnesium may also play a critical role.

Other deficiencies potentially involved in diabetes are zinc and chromium, which have multiple roles in insulin and glucose control.”*

*Express UK - Diabetes: Four vitamin deficiencies considered 'a risk' for diabetes and its complications. Oct 17, 2022


“The pancreas needs magnesium in order to produce insulin, and to release that insulin into the blood stream in response to high blood glucose levels. Sufficient magnesium is also necessary for cells to respond to insulin effectively, so it helps glucose get into our cells from the blood stream.”*

*Biopractica - Magnesium is critical for balancing blood sugar levels Jul 15, 2020  
Helpful - 1
From Red_Star:

"My blood sugar rose after high levels of toxic mould triggered CIRS (Chronic Inflammatory Response Syndrome)."

I wondered this, and I also wondered if he'd had covid.

"Q: What do we know about new-onset diabetes after having COVID-19?

A: We have seen about a 60% increase in risk for new-onset diabetes in people who had COVID-19, usually type 2, compared with people who never had COVID-19. A study of over 181,000 U.S. veterans NIH external link showed that those who had COVID-19 had a 40% higher risk of new diabetes, compared with controls, after 1 year. And one meta-analysis NIH external link showed a 66% higher risk of new-onset diabetes in people who had COVID-19, compared with those who didn’t."


Long covid and fatigue is a very real struggle. There's a pro hockey player (Jonathan Toews) who was diagnosed with CIRS after covid, so there may be some overlap, if he's had covid.

Also, get a full thyroid panel done. His TSH may be fine - and "fine" doesn't always mean fine for him. Even low normal might be too low, but there are other tests that need to be done.

He needs a TSH, Free T3, Free T4, and thyroid antibody tests.

Thank you SO much for these replies! I appreciate this help greatly. I am definitely taking this information into account, and had forgotten about Beta Glucan and am ordering some now. My son did test positive for COVID-19 in 2021, but was only feeling slightly bad for a few days. Nonetheless, it is possible about long covid, so I will look into this further. We'll look into toxic mold being an issue as well.
Happy to help. :) Yes good info on COVID. The virus triggers the immune system to produce pro inflammatory proteins known as cytokines.

“Researchers looked at blood samples from the 40 who experienced long COVID symptoms, compared them to controls who were not infected with COVID-19, and found that those who had long COVID had evidence of inflammation (increased complement activity), blood cell dysregulation (hemolysis and platelet activation) and tissue injury in their blood.”*

*ABC news - New long COVID study uncovers high inflammation in patients as Senate calls for more research on 'crisis'. January 24, 2024
Avatar universal
If it's related to a food intolerance/sensitivity, I'd recommend trying zymptom.ai. You basically log your foods each day and the intensity of your symptoms. The AI breaks down the foods into ingredients and categorises them into common food intolerances (gluten, dairy, caffeine, high FODMAP, high glycemic index, etc.) and finds any patterns between your food and your symptoms (if there are any)
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