I haven't experienced what you have, but I have a suggestion. Get your thyoids levels checked via a blood test. I also have Osteoporosis and other problems.I recently changed doctors and complained to the new doctor, as I had the others, about being so fatiqued that I was laying in bed (disabled, not working) all day. When I got up all I could think about was getting back into bed. I worked for over 32 years feeling extremely exhausted every single day.
I should say that years after I became disabled, I was tested for sleep apnea and I had a severe case of it, with an occurrance every 70 seconds. As the doctor said, you never were sleeping. No one thought of this as I'm slim. But there is a link between dystonia and central apnea (occuring because the brain "forgets" to tell the lungs to breathe.) Sixty percent of my sleep apnea was central apnea, the rest was airway obstruction, "normal apnea."
My thyroid test showed that I have Hypothyroidism, meaning the thyroid gland is underproducing, therby creating severe fatique, etc. I looked up the symmptoms, which are many, and I have every single one of them. Now we have to check for thyroid cancer, or nodules.
The Thyroid gland is near the "Adam's Apple" so it seems possible, to me, that the botox is somehow increasing the Thyroid's production. Then you lose that affect and go back to being fatiqued. Get it checked and let me know the results. I hope you find the answer to your fatique.
QuietOne