Are low values of UIBC and DHEA the reason for chronic fatigue?

Q. Can chronic fatigue be due to low UIBC and DHEA levels in blood?

Answered by
Dr. Divakara. P
and medically reviewed by Dr.Nithila A
This is a premium question & answer published on Feb 24, 2023

Hello doctor,

I am a 47-year-old male. I have chronic fatigue being on healthy diet. I am not on any medication. There is also low libido. In the blood test report, the levels of UIBC, DHEA, estradiol, vitamin D, progesterone, phosphorus, and platelets were low from the normal level and high B12 level. In the past, my blood test has shown low RBC. Can you tell me what is going on?



Welcome to

Your chronic fatigue can be explained by low levels of vitamin D, low phosphorus, and low DHEA (dehydroepiandrosterone). I will explain why do you have these low levels. There are many causes of vitamin D deficiency, but most common is inadequate exposure to sunlight which I think is the cause in you. Other causes of vitamin D deficiency are malabsorption of vitamin D, kidney disease (not in your case). Vitamin D is essential in the absorption of phosphorus in the intestines. So, a low vitamin D will eventually lead to low phosphorus. And both low vitamin D and low phosphorus can cause chronic fatigue.

Remedies are, increase your exposure to sunlight. There is no need for vitamin supplementation at present. Your LDL cholesterol and total cholesterol is on the higher side. I advise you to take tablet Rosuvastatin 5 mg at night after dinner for one year and repeat lipid profile after one year. Also, go on a low-fat diet.

Now coming to your low DHEA and low estradiol levels, DHEA levels usually decreases with increasing age so that it could be an age-related issue in your case. It can also be reduced in conditions like adrenal insufficiency, diabetes, kidney disease, but there is nothing in your reports to suggest these diseases. Low DHEA can explain for low libido and chronic fatigue, but low libido can also be due to depression and even abnormalities in prolactin levels (which has been not tested in you). Also, get one serum prolactin level tested.

My advice is to increase your physical activity and decrease your calorie intake, this will help in increasing DHEA levels. There is no need for taking DHEA supplements. Low estradiol is also due to low DHEA, but that is not significant. Increased vitamin B12 levels are usually seen in liver diseases or myeloproliferative disease (diseases of the bone marrow ), but one more common cause is if you were on multivitamin tablets it might have caused increased levels.

But if you were not on multivitamins, then I advise you get one bone marrow biopsy done for the evaluation or detection of myeloproliferative diseases because even low platelets are seen in these diseases. Kindly revert for any further queries or clarification.

Thank you doctor,

Vitamin D and phosphorus make sense. It has been a long, cold, and cloudy winter. The vitamin B12 and low platelets concern me. I do not take a multivitamin, but I have taken B12 supplements. But I stopped taking them one week before the blood test. What about the low UIBC? Is this something to be concerned about? In the past, almost all my blood test came back with high RBC and high MCV.

White cells were always fine, so I never worried about it. But I have struggled with chronic fatigue for three years now. I am 47, my weight is 175 and eat a healthy diet. But I cannot shake the fatigue. MIT comes and goes. If it gets bad long enough, more than two weeks, I will take Adderall for a week to function. Do you have any ideas?



Welcome back to

First regarding your high vitamin B12. Yes even if you were on B12 supplements one month before testing also can increase your blood B12 levels. So I advise you to repeat serum B12 levels after two months again. Low platelet could be because of many reasons like uncomplicated viral infections, some medications, bacterial infections, etc. Also, the number which you had is almost near normal. So it could be a lab artifact which sometimes means when they take blood sample the platelets will get clumped together and the lab machine gives less count than the actual value.

Why I was concerned was your vitamin B12 levels, and low platelet as this combination could indicate myeloproliferative disease. But now since we have a reason for your high vitamin B12 levels, I do not think your low platelet count is an issue. Get a repeat platelet after two weeks, and I am sure it would be in the normal limits. I also advise you to take more of the pomegranate fruit. I strongly do not recommend you take Adderall instead you can start taking calcium and vitamin D supplement.

Coming to low UIBC (unsaturated iron-binding capacity), an isolated low UIBC is of no significance. If it were associated with low TIBC (total iron-binding capacity) or transferrin, then it would have suggested iron overload, but TIBC and transferrin are normal in you. So low UIBC is of no significance.

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