Hello @jej, I would like to add my welcome to Connect along with @pwiley. It sounds like you have been dealing with a lot of symptoms for a long time with not much relief. I'm not a doctor and have no medical background but the spitting up of blood seems like it might be a major clue to what is going on. It sounds similar to hemoptysis. Here is some information I found that might be helpful. It also mentions fatigue as a symptom in table 3 Diagnostic Clues in Hemoptysis: Physical History under the Patient History section.

"Hemoptysis is the spitting of blood that originated in the lungs or bronchial tubes. The patient’s history should help determine the amount of blood and differentiate between hemoptysis, pseudohemoptysis, and hematemesis."
-- Hemoptysis: Diagnosis and Management:
https://www.aafp.org/pubs/afp/issues/2005/1001/p1253.html
Have you considered seeking help at a teaching hospital or major health facility like Mayo Clinic?