What causes extreme fatigue? antidepresants haven't helped and my tsh was normal. i also take 40 mg adderall (dextroamphetamine and racemic amphetamine) but still no energy and i must nap everyday.

Proper Sleep Hygiene: Chronic fatigue can have a myriad of etiologies. I would first examine your sleeping habits. Eliminate naps, do not use your bedroom for anything but sleep, no caffeine or sugar products before bed, etc... Furthermore, please discuss having a sleep study with your primary care provider before adjusting or adding additional psychotropics.

Many Causes: Other causes of fatigue: low or high blood sugar, hormonal imbalances, low blood pressure, mineral deficiencies, excessive oxidative stress (lack of antioxidant protection), lack of oxidative processes (low oxygen), immune system overload (lyme's, epstein-barr virus, mold toxins...), autonomic imbalance, medication effects.

Fatigue?: I agree wit dr. Rothmans recommendation, in addition i advise u to start exercise program, it can increase u central nervous system endorphin level , increase u energy , concentration, prove u mood and if u do it before 4 pm it can help u sleep well.