Sigh! I have had this issue my whole life. Endless trips to the endo never found anything.
I found some relief from eating an almost 100% protein diet. It takes forever to digest protein and it has to go to fat before it becomes energy.
Numerous small meals. Just snack all day.
I eat carbs at bed time so I can sleep. Might as well make the fatigue useful. Vitamins help.
I keep candy around so I don't just drop while at work.
It all sucks. Hope you find an answer. I gave up and just learned to cope 30 years ago.

Hey, I was very much like the two of you for many years. Doctors were mostly clueless. They just wanted to put me on medication for ADHD.

A close female friend suggested that I might have mild hypoglycemia. I seemed to have more of a reactive hypoglycemia whereas she seemed to have regular hypoglycemia.

I lived life on a physical and especially mental roller coaster. I was using sugar, caffeine, etc to energize my foggy sluggish brain. However I'd take too much and be hyperactive. Then an hour later I'd crash and be a brain-fogged space cadet!

My friend recommended the glucose tolerance test (GTT). She had passed out during her GTT test many years earlier. Apparently the test results were STILL not bad enough for her to get a hypoglycemia diagnosis by a mainstream doctor!

She did find the recommended dietary adjustments for hypoglycemics to be helpful:

Eat small, frequent meals

Be cognizant of the glycemic index of foods (you don't want fast-burning ones)

Eat healthy little snacks between meals and mid evening.

Eat more protein.

I'm in the US so my 2006 GTT results provided very different numbers than yours. However my chiropractor described it as a fairly flat-looking response after he graphed it.

My fasting blood Sugar was quite normal at around 90.

An hour after consuming the sugary drink it was almost 10 points LOWER wheras my chiropractor's graph expected the glucose level to be higher than the fasting level! It then remained roughly the same over the next two hours, in the normal range.

However strangely I did not "crash" with fatigue and fog as I expected. I was SO pissed because I had been searching for clues for so long and was desperate to get a solid lead.

I actually called the chiropractor from the lab and asked him to order another hour!

However maybe 20 minutes after the third blood draw I could feel myself "crash" I was wobbly, mentally fogged out. I dropped a cup of water.

However by the time of the 4th blood draw I had bounced back and was not so bad. So the test did not catch the "crash."

I don't know what the underlying cause or causes will be for you but I later found a heavy metal toxicity problem--mostly lead and cadmium.

Since I made many changes to my supplements at the time I was doing HM detox--Cutler protocol--I don't really know what combination of factors greatly improved my situation. However I'll share the following thoughts from my experience.

Clearly the hypoglycemia dietary recommendations above were helpful. They did not come close to resolving the problem just kept me from descending into the deeper states of brain fog. Life was not being lived on a mental energy roller coaster.

Today I still keep those recommendations in mind but I don't need to strictly follow the diet. I can and do cheat often but I never "crash" the way I used to nor do I become so hyperactive.

A multivitamin with generous amounts of minerals was helpful. I was not so tired after eating big meals and had better energy levels during the day.

A digestive enzyme was and is certainly helpful. It was especially helpful after eating meals containing beef and other proteins. I was not so tired after such meals and had less gas.

I ran out of the enzymes a week ago and so decided to test my need for them. The fatigue after meals is not as bad as it used to be but gas continues to be an issue when not taking the enzyme.

I did not take support for stomach acid at that time but I bet the minerals in the multi vitamin were helping to support production of acid.

I was not aware at that time of theories about *increasing* support for stomach acid when GERD is a problem. I had GERD for over a decade, but it too went away and has not been a problem for over ten years. I have links to more about that if requested.

Late in 2006 a new semi-natural doctor, a colleague of Dr Daniel Amen, started me on low, 5mg doses of Adderall 3-4 times per day for mostly inattentive ADD. This was after a Spect brain scan.

Adderall helped to energize my brain so I was less inclined to try to turn it on with caffeine, sugar, etc. Again, it was just a puzzle piece, not a fix-all.

I was and still take catecholamine (ADD)-related support supplements that were recommended by Dr Amen and Andy Cutler.

All of the above interventions were before I started HM detox in 2010. I had much more stable mental and physical energy by that time, but I very much needed the interventions every day.

Cutler's detox process can be rather involved, especially if you want to try to work around the many ways HMs affect our natural biochemistry. Since I am interested in that I did more tweaking and experimenting than most people.

Cutler highly recommends adrenal cortex support for those with a mercury problem. My symptom list better matched lead and cadmium but I previously had 5 silver=mercury Amalgam fillings. They were removed in the months and years prior to starting detox.

Clearly small 10-20mg doses of pregnenolone, much smaller doses of DHEA and some adrenal glandular were helpful in a number of ways. I certainly loved the more masculine feel and personality--so did my lady friend ; ) I got followup blood tests and worked with my functional med doctor.

The theory there is that the adrenal cortex hormone, cortisol is a glucocorticoid involved to some extent in regulating blood sugar. Many people in the detox support groups report mild hypoglycemia symptoms.

There is a theory that heavy metals damage the body's ability to make sulfate needed for the liver sufation detox pathway. My symptoms seemed consistent with this.

The body needs sulfate for the natural breakdown of adrenaline-like chemicals in the body. It also needs sulfate to break down phenols from foods--grapes, banana, chocolate, many citris and other fruits, etc. THAT WAS MY LIST!

For SO many years I had looked for something that explained my list of food sensitivities !!! I came across the list in an article by Dr R Warring on the lack of sulfate in autistic kids--God bless her!
https://en.wikipedia.org/wiki/Rosemary_Waring
http://newtreatments.org/ga.php?linkid=252

So cutting back on high phenol foods and drinks also helped to stabilize my mental and physical energy levels. Unknowingly for years I had been using high phenol foods and drinks to turn on my brain. They of course resulted in higher levels of catecholamine (ADD-related) neurotransmitters--adrenaline, etc. However I could not keep the effect stable so I lived on an energy roller coaster.

My primary intake of sulfate was from glucosamine sulfate. I was taking more of it after 2009 because I had symptoms of Arthritis in my knee where a surgeon inserted a rod after my broken leg. I had a bone density problem that has now normalized after years of detox.

It was so exciting to see puzzle pieces coming together.

My chiropractor mentioned that the brain will use the amino acid glutamine for fuel when it is low on glucose. Both my female friend and I tried it.

Bingo! Glutamine was a major factor for both of us, especially between meals. I highly recommend it!

A few people who are sensitive to Mono-Sodium-Glutamat (Natrium Glutamat) (glutamate) may need to take extra vitamin B6. Supposedly B6 is involved in converting glutamine towards the calming neurotransmitter GABA and away from the potential exitotoxin, glutamate.

Interestingly the body needs glutamine to make its uber important liver detox antioxidant, glutathione. Glutathione is often low in autistic kids and people with a HM toxicity problem.

Glutamine is needed for muscles and for the lining of the gut--two areas that are so often problematic for autistic kids and people in detox groups.

Cutler mentions chromium for reactive hypoglycemia. I started to take 100mcg or so twice per day. I did not notice a difference, but this is the last intervention I added. I had already gotten much improved by this time. I continue to take it based on the related theory. Supposedly chromium is needed to move glucose into cells. This provides cells with more energy and there is less glucose remaining in the blood that has to be handled with insulin, etc.

Again I would not expect your needs to be exactly the same as mine. My lady friend seemed to really need adrenal cortex support and glutamine. She did not seem to have much of a need for sulfation support or ADD medication.

I don't usually write this much but I clearly remember how it felt to be suffering with most of your symptoms plus a declining career, struggling relationships--and clueless doctors--for over a decade. I hope something here will be useful to you. Please let us know.

ATB

Joe