What Causes Severe Fatigue, Lack Of Focus And Severe Pain In The Feet?

Severe fatigue for 3+ years, decreased concentration and focus for the same time frame, redness and swelling of joints in hands for over a year, episodic events of severe swelling and extreme pain in feet that come on out of no where for more than 7 years, TSH (0.46) / CBC / CMP / ANA / RF Factor all within normal limits. UA WBC 5, PH 8, Epi Cells 7/htp, Bacterial Positive. Asymptomatic for a UTI. Blood Glucose consistently low or low end of normal fasting numbers regardless of continued nutrition for more than 3 years. Already dx with Endometriosis / PCOS.