I solved my mystery fatigue with AI(metalearn.substack.com)
metalearn.substack.com
I solved my mystery fatigue with AI
https://metalearn.substack.com/p/i-solved-my-mystery-fatigue-with-ai
26 comments
My gut as a physician says AI will revolutionize primary care the most and the premise of AI having more specialized knowledge than a PCP holds water - I think the future of primary care is AI equipped midlevel providers - so I was very excited by the intro only to be let down. A lot of buzz about nothing sadly.
The only takeaway here is logging helps detect patterns, we already knew that.
The only takeaway here is logging helps detect patterns, we already knew that.
For simple things, if an AI (combined with blood tests) can do what the doctor can do, then technically I don't need the doctor. I also don't need the friction that comes in working with a doctor, considering the AI is close to frictionless.
> ... "considering the AI is close to frictionless" ...
I feel like this bit is more of a problem than many folks realize. I know that people see "frictionless" as a desirable trait, but for many of the things folks are using AI for these days, you're gonna want "push-back" sometimes. Especially in cases of health care and computer programming, there are times when the user is straight-up wrong about what they're trying to do, say, or believe, and the last thing you wanna hear when your life or job or the lives or jobs of others are on the line and you're about to make a huge mistake is "You're absolutely right! Let me get right on doing that for you!"
I feel like this bit is more of a problem than many folks realize. I know that people see "frictionless" as a desirable trait, but for many of the things folks are using AI for these days, you're gonna want "push-back" sometimes. Especially in cases of health care and computer programming, there are times when the user is straight-up wrong about what they're trying to do, say, or believe, and the last thing you wanna hear when your life or job or the lives or jobs of others are on the line and you're about to make a huge mistake is "You're absolutely right! Let me get right on doing that for you!"
You're absolutely right! What I do is have the LLM rank and score candidates for me given my situation. This helps me focus on what's more likely versus less likely. Blood tests are not free; they're in fact fairly expensive in aggregate, so this filtering has been essential.
> technically I don't need the doctor
That’s the goal for doctors too. It would be great to get simple things off the system.
But I think the more realistic intermediate step is a trained person cheaper than a doctor - nurse, PA, etc - aided by AI. The current generation of agentic AI doesn’t seem to be there yet and is too agreeable from RL.
“you’re probably fine sleep it off combined with: drink more water, eat healthier, exercise more, sleep better, consume less alcohol and quit smoking/vaping” +/- “we’ll check some labs to make sure” is the correct answer for probably 95%+ of encounters so it’s not hard for an automated system to handle most simple things, even without AI.
That’s the goal for doctors too. It would be great to get simple things off the system.
But I think the more realistic intermediate step is a trained person cheaper than a doctor - nurse, PA, etc - aided by AI. The current generation of agentic AI doesn’t seem to be there yet and is too agreeable from RL.
“you’re probably fine sleep it off combined with: drink more water, eat healthier, exercise more, sleep better, consume less alcohol and quit smoking/vaping” +/- “we’ll check some labs to make sure” is the correct answer for probably 95%+ of encounters so it’s not hard for an automated system to handle most simple things, even without AI.
Is it really the goal for doctors? I don't believe it. They run an exclusive protectionist racket.
See https://www.msn.com/en-us/health/other/this-state-is-testing...
Title: This state is testing out AI doctors—and actual doctors aren’t happy about it (Wall Street Journal)
New York state residents get the worst of it with the state bending over backwards to take away the people's rights.
Also, let's not confuse independence with AI. Independence is where I can do some extra bloodwork and diagnostics to satisfy my well-being. I don't need an AI limiting what I investigate either.
See https://www.msn.com/en-us/health/other/this-state-is-testing...
Title: This state is testing out AI doctors—and actual doctors aren’t happy about it (Wall Street Journal)
New York state residents get the worst of it with the state bending over backwards to take away the people's rights.
Also, let's not confuse independence with AI. Independence is where I can do some extra bloodwork and diagnostics to satisfy my well-being. I don't need an AI limiting what I investigate either.
1. Having concerns over unvetted AI is not the same thing as running an exclusive protectionist racket.
2. Doctors who depend on revenue from forced visits to renew prescriptions are grifters and not close to a majority. The profession obviously isn’t perfect but the vast majority of physicians I know would be happy to lighten their rosters.
With that said it can’t be a system that creates problems and dumps them back on physicians to fix, hence #1
2. Doctors who depend on revenue from forced visits to renew prescriptions are grifters and not close to a majority. The profession obviously isn’t perfect but the vast majority of physicians I know would be happy to lighten their rosters.
With that said it can’t be a system that creates problems and dumps them back on physicians to fix, hence #1
Point #1 is nonsense because the ratio of problems eliminated to those created will be easily be 99:1. I estimate this ratio is closer to 50:50 for human doctors.
Ultimately, it should be about personal freedom. This is not a contagious disease we're dealing with here.
Ultimately, it should be about personal freedom. This is not a contagious disease we're dealing with here.
It’s called evidence based medicine for a reason. Medicine has long since moved away from making decisions based on whether a person thinks it will be better.
> Ultimately, it should be about personal freedom. This is not a contagious disease we're dealing with here.
The state regulates health and medical devices for a reason. Look at what’s happening with all of these prescription mill apps these days which are still theoretically overseen by a licensed healthcare professional - plenty of medical errors and harm in the name of increasing access (a good thing, when done well). We’ll see criminal investigations within a year.
> Ultimately, it should be about personal freedom. This is not a contagious disease we're dealing with here.
The state regulates health and medical devices for a reason. Look at what’s happening with all of these prescription mill apps these days which are still theoretically overseen by a licensed healthcare professional - plenty of medical errors and harm in the name of increasing access (a good thing, when done well). We’ll see criminal investigations within a year.
I get it, and it draws parallels with debugging and incident response in software dev. Your best tool is good data, if you have more data, you’re able to make good judgement in short time. If AI helps you collect good data about your condition, then presenting that to a clinician is certainly better than “it hurts, idk” because there’s only so much they can do at the time
But where does that happen in the article?
Even for the part where she discovers she was in a caloric deficit and that carbs helped, the AI didn't seem to have a role:
> Figuring out what to track is an iterative process. At first, I logged only daily calories. But when I noticed that a small amount of carbs sometimes helped me recover faster mid-episode, I tracked carbs on the same spreadsheet.
The carb realization happened before tracking carbs. And why did it take a specialist to notice she was in a 300 calorie deficit? That seems like something that any AI process would trivially notice.
I don't know. This article is puzzling. I think using AI to analyze health records is interesting, but this article didn't really have anything supporting that other than to mention that she put everything into Claude on the side.
Even for the part where she discovers she was in a caloric deficit and that carbs helped, the AI didn't seem to have a role:
> Figuring out what to track is an iterative process. At first, I logged only daily calories. But when I noticed that a small amount of carbs sometimes helped me recover faster mid-episode, I tracked carbs on the same spreadsheet.
The carb realization happened before tracking carbs. And why did it take a specialist to notice she was in a 300 calorie deficit? That seems like something that any AI process would trivially notice.
I don't know. This article is puzzling. I think using AI to analyze health records is interesting, but this article didn't really have anything supporting that other than to mention that she put everything into Claude on the side.
Maybe I am missing it, but I don’t see where AI solved anything in this anecdote. Rather, a team of medical professionals and a patient willing to advocate for herself did.
If AI enabled her to advocate for herself to the right professionals, and do so with data in hand, that’s huge.
AI guiding a process is valuable even if it doesn’t replace all the parts of the process.
AI guiding a process is valuable even if it doesn’t replace all the parts of the process.
But the article doesn't even make that claim. The doctors who adjusted her medication were already her care team for the brain tumor.
She said she started logging calories but recognized the carb connection before she logged carbs.
I kept waiting for the payoff where the AI led to something, but it never came.
She said she started logging calories but recognized the carb connection before she logged carbs.
I kept waiting for the payoff where the AI led to something, but it never came.
Beside ferritin, hemoglobin shouldn't be overlooked as the determinant of iron status. Hemoglobin is a part of the CBC (Complete Blood Count) test.
Iron supplements are notorious for irritating the stomach, worsening gastritis and acid reflux. Even iron bisglycinate, while fully effective, is a significant stomach irritant. Ferric pyrophosphate might be safer, and I'm trying it now, but I have to take it twice a day because once wasn't sufficient.
With regard to addressing anemia, active B12 (hydroxo/methyl/adenosyl), methylfolate e.g. Quatrefolic, copper, and vitamin A also matter.
One can also simultaneously be low or suboptimal in many other vitamins and minerals unrelated to anemia, e.g. vitamin D. Fixing only one of them is no guarantee of a sustained solution.
With regard to blood tests, it can take many iterations of doing them to find anything useful. Doctors are ridiculous to work with in this regard, so I bypass them and get the tests myself. Doctors work for the insurance firm, not for you.
Iron supplements are notorious for irritating the stomach, worsening gastritis and acid reflux. Even iron bisglycinate, while fully effective, is a significant stomach irritant. Ferric pyrophosphate might be safer, and I'm trying it now, but I have to take it twice a day because once wasn't sufficient.
With regard to addressing anemia, active B12 (hydroxo/methyl/adenosyl), methylfolate e.g. Quatrefolic, copper, and vitamin A also matter.
One can also simultaneously be low or suboptimal in many other vitamins and minerals unrelated to anemia, e.g. vitamin D. Fixing only one of them is no guarantee of a sustained solution.
With regard to blood tests, it can take many iterations of doing them to find anything useful. Doctors are ridiculous to work with in this regard, so I bypass them and get the tests myself. Doctors work for the insurance firm, not for you.
> As long as it is in the normal range for your sex and age, you're fine even if your ferritin remains at 0.
This is simply wrong when one considers that iron has many bodily functions outside of hemoglobin, such as acting as a cofactor in tyrosine hydroxylase for dopamine synthesis.
This is simply wrong when one considers that iron has many bodily functions outside of hemoglobin, such as acting as a cofactor in tyrosine hydroxylase for dopamine synthesis.
Apologies. Fixed. I will atone for it.
Have you tried supplementing iron every other day instead?
https://pmc.ncbi.nlm.nih.gov/articles/PMC12372323/
https://pmc.ncbi.nlm.nih.gov/articles/PMC12372323/
Alternate day dosing is a great tip for better stomach tolerability! If ferric pyrophasphate twice daily doesn't fix it for me, or if it becomes intolerable, then I will surely consider alternate-day iron bisglycinate. Thanks.
If you're not vegetarian, I recommend looking into heme iron. It's a lot more bioavailable, even more than iron bisglycinate, and in my experience it's much easier on the GI tract.
I solved a similar issue with the help of AI. I doubt I would have ever solved it with the help of a PCP, because of really subtle nuances. It’s been almost a year and my symptoms have basically disappeared.
AI helped me figure out my symptoms were related to histamine issues. This was really hard to track down. I started to tune into chicken and eggs causing me issues, but (1) I wasn’t actually allergic (2) chicken and rice is a standard safe diet (3) chicken is low histamine itself, but can trigger histamine release . It was further complicated because a bunch of foods didn’t consistently trigger reactions.
It was only after I tracked a bunch of foods and tried a bunch of different remedies that Claude was able to track down the pattern. From there, I was able to understand what foods would trigger my issues.
AI helped me figure out my symptoms were related to histamine issues. This was really hard to track down. I started to tune into chicken and eggs causing me issues, but (1) I wasn’t actually allergic (2) chicken and rice is a standard safe diet (3) chicken is low histamine itself, but can trigger histamine release . It was further complicated because a bunch of foods didn’t consistently trigger reactions.
It was only after I tracked a bunch of foods and tried a bunch of different remedies that Claude was able to track down the pattern. From there, I was able to understand what foods would trigger my issues.
Do you mind me asking what kind of symptoms you were experiencing?
Not at all! I ended up identifying that a lost of my symptoms lined up with what /r/HistamineIntolerance and MCAS people describe as symptoms.
Chronically:
* I my energy levels were dropping. * I had terrible brain fog. * My moods were less stable and I was often very irritable. I felt way less resilient to stress. * My joints were constantly hurting * GI symptoms comparable to IBS
Acutely, I would get flare ups between 2 to 48 hours after eating food that were essentially a mix of flu and allergic reaction symptoms (despite not having allergies to these foods). I felt feverish, dizzy, light-headed, joint pain, head aches, diarrhea, nausea. There were a few times that it knocked me out for 24+ hours.
Three's also this "bucket" theory that I resonate with. Symptoms can fluctuate according to how "full" your bucket is. If you have an empty bucket, you might be able to tolerate whatever triggers with limited reaction. If you have filled bucket and overflow it, your symptoms cascade horrendously.
This part actually made self-diagnosis extremely hard because the same food wouldn't consistently trigger issues. This is on top of triggers already feeling a bit random. Pizza, for example, is wildly hit-or-miss by brand. Despite it all being essentially the same ingredients, some of it, I tolerate incredibly well. Some of it, I flare up terribly. Even more confusing, the cheap/low quality places (like Little Ceasars) sit perfectly fine with me, but many "fresh" or "high quality" ones completely crash me.
Chronically:
* I my energy levels were dropping. * I had terrible brain fog. * My moods were less stable and I was often very irritable. I felt way less resilient to stress. * My joints were constantly hurting * GI symptoms comparable to IBS
Acutely, I would get flare ups between 2 to 48 hours after eating food that were essentially a mix of flu and allergic reaction symptoms (despite not having allergies to these foods). I felt feverish, dizzy, light-headed, joint pain, head aches, diarrhea, nausea. There were a few times that it knocked me out for 24+ hours.
Three's also this "bucket" theory that I resonate with. Symptoms can fluctuate according to how "full" your bucket is. If you have an empty bucket, you might be able to tolerate whatever triggers with limited reaction. If you have filled bucket and overflow it, your symptoms cascade horrendously.
This part actually made self-diagnosis extremely hard because the same food wouldn't consistently trigger issues. This is on top of triggers already feeling a bit random. Pizza, for example, is wildly hit-or-miss by brand. Despite it all being essentially the same ingredients, some of it, I tolerate incredibly well. Some of it, I flare up terribly. Even more confusing, the cheap/low quality places (like Little Ceasars) sit perfectly fine with me, but many "fresh" or "high quality" ones completely crash me.
Mystery fatigue is tricky because there are generally no tests for what's going on and it tends to get better after a while on its own so it's hard to tell if anything worked.
I got an odd fatigue myself and went to the doctor for blood tests but nothing obvious came up. I'm guessing it's a post viral thing but there aren't really tests and it seems to be gradually getting better over a few years. Science could do with better understanding of that stuff.
I got an odd fatigue myself and went to the doctor for blood tests but nothing obvious came up. I'm guessing it's a post viral thing but there aren't really tests and it seems to be gradually getting better over a few years. Science could do with better understanding of that stuff.
It may sounds weird, but a traditonal Chinese herbal method can greatly decrease the side effects of any brain related cancer/tumor, or even cured it, happened on many patients.
If the article author saw this, you can reach at me, I will tell u the whole method and details, for free, for sure.
Because I think you were from China, too.
If the article author saw this, you can reach at me, I will tell u the whole method and details, for free, for sure.
Because I think you were from China, too.
For all of the writing about collecting data and using AI, she never explains what the AI did for her. Maybe it suggested trying iron supplements because her ferritin was slightly low on a blood test? I hope it explained that these blood tests can have transient highs and lows and that excess iron from supplements can have major negative health effects if not monitored.
For all of the lead up about using AI, there was never really a delivery where the AI was used to solve the mystery fatigue.
I’m glad this person is feeling better, but this post reminds me of those LinkedIn posts where someone is trying really hard to show their AI skills but used an example where the AI didn’t contribute to or accelerate the outcome.