Her thyroid hormone level should be checked, low thyroid often causes lethargy.
I'm pretty lazy about exercise myself. A 30 minute daily walk could be helpful and isn't a huge commitment.
PS About non-hormonal contraception: I've had my copper IUD in for 11 years now, zero problems.
The bloodwork she had done indeed didnŽt include checking hormonal levels. IŽll tell her to get that checked out.
Apparently her Iron levels have been good the for the last few years.
While her iron levels might be good, her ferritin levels might be very low. [url=http://www.proferrin.com/causes-symptoms-low-ferritin/]Causes and Symptoms of Low Ferritin | *[/url].
I also think getting thyroid checked is a good idea--TSH, free T4, free T3.
I honestly would not worry too much about her sleep. I personally have always fuctioned better with 8-10 hrs of sleep. It's just the question of how she functions daily that could be of concern.
I was the same until I was strictly primal for a month or so really.
Now I have incredible energy.
I can sleep properly too. But not eating properly generally leads to bad sleep which sleeps to more tiredness.
I think the first step is to fully embrace the lifestyle and give it a good go and then see how she is going.
I can't do the 20% thing. 1% affects me too.
What tests did she have that revealed inflammation? A CRP or ESR? It can be very difficult to feel energetic in the context of ongoing inflammation. It is a worthwhile endeavor to figure out what is causing the inflammation.
Does she have any other symptoms - even subtle ones? Or just the fatigue?
Have her get herself checked for anemia. If she does not eat a lot of red meat her iron levels could be low. In addition if she eats a lot of wheat that can inhibit iron absorbtion.