Fatigue and Burnout
Convergence Model
Colour Key
🟠Pathological | 🔵 Neuro | 🔴 Outcome
flowchart TD
A[NTBI / ROS - Oxidative Stress] --> F[Fatigue]
B[Autistic Burnout - Masking Cost] --> F
C[Sleep Disruption - Circadian Misalignment] --> F
D[Low Testosterone - Pituitary Iron] --> F
E[Low Cu / Zn - Impaired Enzymes] --> F
G[Dopamine Dysfunction - Depleted DA/NE] --> F
F --> H[Reduced Capacity]
H --> I[Increased Masking Load]
I --> B
classDef pathological fill:#f1948a,stroke:#c0392b,color:#1a0505
classDef neuro fill:#85c1e9,stroke:#2471a3,color:#0a1929
classDef outcome fill:#f7dc6f,stroke:#b7950b,color:#1a1400
class A,D,E pathological
class B,C,G neuro
class F,H,I outcomeSymptom Context
- Extreme fatigue
- Burnout pattern
- ADHD + autism baseline neurocognitive load
- Concurrent iron dysregulation (TSAT 60%, previous ferritin ~700)
Plausible Overlapping Drivers
- Iron-overload toxicity pathway
- NTBI/LPI -> oxidative stress -> mitochondrial strain
- Neurodivergent allostatic load
- chronic sensory/executive demand -> burnout vulnerability
- Sleep and circadian disruption
- common in ADHD/autism and can amplify fatigue severity
- Micronutrient imbalance
- low-normal zinc/copper may worsen energy and cognitive resilience
- Endocrine disruption from iron overload
- pituitary iron deposition → hypogonadotropic hypogonadism, subclinical hypothyroidism
- see Endocrine Effects of HFE Iron Overload
Research Notes
- Duca L et al. Int J Mol Sci 2025;26(13):6433 - NTBI/LPI toxicity model
- Thorsen M. Prog Mol Biol Transl Sci 2020;173:331-354 - oxidative/mitochondrial findings in ASD literature
- Mahony C, O'Ryan C. Front Psychiatry 2022;13:985713 - mitochondrial allostatic load perspective in autism (conceptual framework)
- Hauck S. Front Psychiatry 2025;16:1701625 - perspective linking stress, neurodivergence, and functional iron blockade
Clinical Framing
This is likely multifactorial rather than one cause. Your biochemical profile gives a concrete treatable axis (iron regulation), while neurodivergent burnout provides an interacting non-lab axis.