@toomanyoars I looked at your profile and I see you are a mom with older kids. I thought I'd add that the symptoms with the hot flashes and not being able to sleep are also menopause symptoms. You can take bio-identical hormone replacement of estrogen balanced against progesterone and get that from a compounding pharmacy to control hot flashes if that is the reason. If you find yourself still looking for a cause as you follow the path to figuring this out, you might see a functional medicine doctor and ask. Symptoms do vary a lot individually and some people do have a lot of fatigue. You can call a compounding pharmacy if you need to get names of doctors who use their services.