why am I so tired

[T-cell]

Hi, I was diagnosed with graves 2 months ago but it’s taken some time for me to believe it’s really graves as the only symptom I have is an elevated heart rate. I initially went to the GP because I was chronically tired. I dont understand why I’m so tired with a condition that speeds up my metabolism, shouldn’t I be bursting with energy? I Dont have access to my blood results - GP said I have no TSH and very elevated T3 and T4. I’ve started on carbemazole last week after seeing the endo. Will taking medication help my energy levels - seems counterintuitive to take a medication that will slow my metabolism when I am already tired.

[PurpleNails]

Welcome to forum.

Was you Graves confirmed by TSI or TRab Antibodies? It’s is often wrong assumed as Graves when other thyroid issues are occurring (hyper is transient)

Graves hyper levels can be draining, not everyone is hyper charged.

Low TSH & High FT4 & FT3 is how hyper present.

Are you in UK? Please but country in profile.

Try to obtain exact copy of results with lab range . If in UK you are legally entitled to them.

How much carbimazole have you been perscribed?

Carbimazole works by pausing production of new thyroid hormone. Getting levels back into range & stable will help resolve symtoms.

Propranolol can help with heart palpitations. See if GP can prescribe (can’t be given to asthmatics).

Please also join & post on main thyroid forum as much more visited forum.

[T-cell in reply to PurpleNails]

Hi, I’m in Australia, and I don’t think we are allowed copies of our blood tests. It’s certainly nothing I have ever been offered or asked for. Is it usual in the UK to be given copies of your blood tests? That’s very interesting. So I’m afraid I don't know which antibodies I have. I just know that in the first test there were no antibodies and in the second there were anti bodies. I already take propranolol to reduce nose bleeds (genetic condition). I’m on 5mg carbimazole daily. I’ll ask my endo about the blood results when I see him in 4 weeks. Thanks for the info.

[PurpleNails in reply to T-cell]

No drs never offer a copy of results. Often they prefer we don’t ask for them & just trust them. patients however are legally entitled to them. We have rights over information held regarding ourselves & i would be quite surprised if Australia didn’t have an equivalent regulation.

No harm in asking, you’ll soon be advised if they refuse to share.

5mg is a really low starting dose & that actually make me a little suspicious that the FT4 & FT3 are not significantly high. I may be wrong. It might be that it’s introduced gradually. In the UK doctors panic at low TSH they want to crush thyroid levels very quickly.

How long have you taken carbimazole? 6 weekly is standard monitoring - re test of Thyroid function (TSH, FT4, FT3). Find out how often you should be retested after starting / adjusting dose and ensure they schedule appointments.

[pennyannie]

Hello T-cell and welcome to the forum :

Can you please share your initial blood tests at diagnosis and the medical evidence of which antibodies were found positive in your bloods - as that is the proof of diagnosis needed before any medications should be prescribed - with Graves you can feel in a ' heightened state ' with something of a brain / body mismatch - in what you want to do but can't as you are totally exhausted doing nothing.

For Graves Disease the antibodies are generally written as TRab / TSI / or words to the effect of a TSH Thyroid Receptor reading with a single number result and a single cut off number.

With Graves you can have Blocking rather than Stimulating antibodies in control of your thyroid production which may well leave you feeling more hypo than hyper - though most commonly Graves is associated with ' hyper type symptom ' weight loss and eye issues.

Throughout this first phase of Graves these 2 antibodies can change places as they vie for control of your thyroid and here can also be periods of relatively normality - and given enough time Graves can burn itself out.

When the thyroid is under attack from your immune system there can be some over lap and several sets of antibodies found but since Graves is the only AI disease considered life threatening - it's treatment takes precedence.

The treatment is with an Anti Thyroid drug - Carbimazole or Propylthiouracal - and all this drug does is ' buy you time ' while we wait for your immune system to calm back down again with the AT drug semi-blocking your new own daily thyroid production and slowly your T3 and T4 levels should fall back down into range and your symptoms relieved.

A a beta blocker can also prescribed if you heart needs some protection - Propanolol is the preferred, if suitable ( if not suffering asthma ) as this also ' slows ' the rate of conversion of T4 into T3 in your body - as it is generally too high a T3 that causes the worst of the symptoms being tolerated.

The NHS generally allocate a treatment window with n AT drug of around 15-18 months with the hope being at the end of this period your thyroid resets itself without the need for any drugs and should you not ' find remission ' the suggestion is to have RAI thyroid ablation or a thyroidectomy.

We do now have research suggesting the longer one stays on the AT drug the better the long term outcome for the patient ;-

pubmed,ncbi.nlm.nih.gov/338...

ncbi.nlm.nih.gov/pubmed/306...

The most rounded of all I researched though 10 years after my RAI thyroid ablation for Graves and much more ill than I had been all my life is that of Elaine Moore - books and website.

elaine-moore.com

[Gebby57]

The reason you are tired is your hyper thyroid is over acting , your like a hummingbird moving very quickly. You’re using all your energy ❤️ I was diagnosed with grave disease when I was 24 now I’m 61. It’s definitely a journey and it takes time to get your body leveled out be patient. It’s not easy.

[Pandora777]

I get tired when my levels are off at the moment I am abroad and the sun is helping a lot. I recommend anyone who feels tired to get some winter sun🌞