GP said I'm 'psychologically tired'

[clarence2013]

Hi all,

I was diagnosed hypothyroid last August and am now on 125mg thyroxine. There's been zero improvement in my energy levels although my GP says I'm within normal range.

Any advice? I'm considering a private endocrinology appointment.

[Moggie]

That's a new one on me - I wonder what "psychologically tired" actual means in his book and why he has come to this conclusion, probably his lack of knowledge regarding thyroid issues.

Have you got any blood results that you can post on here (with ranges) so that we can advise. If you don't have them then phone the surgery and ask the receptionist for print outs. You may have a conversion problem - which means the thyroxine you are taking is not being converted to the T3 that your body desperately needs or you may have an absorption issue, which means that your body is not absorbing the thyroxine properly or you may be low in B12, VitD or iron as all three are vital when taking thyroid medication but without seeing your results it would only be a guessing game.

Have you ever had your B12m VitD or iron tested? When do you take your thyroid medication and do you take it at least two hours before/after food and drink (except water) and well away from any other meds or supplements you may be taking.

Moggie x

[Marz in reply to Moggie]

....snap Moggie - you beat me to it !! M x

[Moggie in reply to Marz]

I've said it before Marz - great minds and all that.

Hope all is tickety boo with you and yours.

Moggie x

[clarence2013 in reply to Moggie]

Thank you! Yes this is a great site and all the information is quite complex. I'll get my results and post them on here.

Basically he said as my iron and tsh levels are now within normal ranges it must be psychological! Maybe I'm depressed or have something on my mind!.... Which of course made me upset, which of of course instantly confirmed his own diagnosis.

I take my thyroxine on waking and wait 30 minutes to have breakfast. I've also tried taking before bed.

[shaws Administrator in reply to clarence2013]

Unfortunately, many GP's do not take into account your clinical symptoms over the TSH blood test and many keep you in the so called 'normal' range but we feel best if our TSH is 1 or below. They are willing to give you Anti'd's which you cannot have a blood test for and they go by clinical symptoms.

T3 is essential for everyone whether or not hypo and the addition of T3 to a reduced T4 can sometimes make a big difference.

I'd get a copy of Dr Toft's booklet from Amazonand you can point out one or two things to your GP.

This is a good link too:-

thyroiduk.healthunlocked.co...

[Marz]

...we really need to see your blood test results with the ranges and then we will be able to offer advice. What is normal for one is certainly not normal for another - your doctor should be listening to your symptoms too. You may have a conversion problem - when T4 does not convert into the ACTIVE hormone T3. So important to have that tested too.

Take a good look around the Thyroid UK Website where you will find so much help and support about other things that need testing for you to achieve optimal health. Could be you are tired due to low iron or B12.

Keep posting and have a good read !

[clarence2013 in reply to Marz]

Free t4. 22.2 pmol/l

Iron 14.0 umol/l

Parathyroid hormone 39 pg/ml

Serum calcium 2.45

Adjusted calcium 2.29 mmol/l

[Moggie in reply to clarence2013]

Your iron is very low and your parathyroid levels would seem to be high but without your ranges - they are in brackets after the results - again it is a guessing game. Every lab has different ranges so it is really important to get the ranges as well.

Are these results before or after you took iron supplements ( I am assume that you have/are taking supplements)

Moggie x

[clarence2013 in reply to Moggie]

Free t4. 22.2 pmol/l (11.5-22.7)

Iron 14.0 (6.6-30.4)

Parathyroid hormone. 39 (15-65)

Serum calcium 2.45 (2.2-2.6)

Adjusted calcium 2.29 (2.10-2.55)

There's a great app called calcium pro where if you put your results in it tells you if you probably have a parathyroid problem. If I use one of these calcium results it says I probably do and the other def not.

[clarence2013 in reply to Moggie]

This test was done after iron tablets

[clarence2013]

Thank you! Yes this is a great site and all the information is quite complex. I'll get my results and post them on here.

Basically he said as my iron and tsh levels are now within normal ranges it must be psychological! Maybe I'm depressed or have something on my mind!.... Which of course made me upset, which of of course instantly confirmed his own diagnosis.

I take my thyroxine on waking and wait 30 minutes to have breakfast.

[Marz in reply to clarence2013]

...Greygoose has just posted on another blog about the TSH an it being of little use once you are on medication....take a look.

[Moggie in reply to clarence2013]

Waiting only 30 minutes after eating to take your thyroid meds is really not good. Do you have cereals with milk for breakfast if so then this could be one of the reason your thyroxine is not working properly. Milk contains a lot of calcium which will block the thyroxine, it is very important to keep your thyroid meds at least two hours away from any food or drink, except water, and at least 4 hours away from an calcium or iron you are taking. Your GP should have explain this when he started you on your thyroid meds - you say that your iron is now in the "normal range" so I assume you were taking iron supplements - did you leave a four hour gap in between taking the iron and your thyroid meds?

For thyroid medication to work properly and be able to absorb itself into your system to its full potential the stomach needs to be empty, this is why a lot of thyroid patients take their medication of a night, just before they go to bed, making sure they have had nothing to eat or drink, except water, for a least two hours before hand.

There are not many GP's that truly understand thyroid issues and because of their ignorance they then try to label their patient with "mental health issues" which is totally wrong and unfair.

Moggie x

p.s. please use the "reply to this" button in blue under a persons name when you want to answer their comments - they then get an email to say you have replied to them, it stops people missing your replies.

[clarence2013 in reply to Moggie]

I don't use cows milk - soya or coconut. The pharmacist said to wait 30 ,minutes before having breakfast and 4 hours for iron supplements (which I'm not taking now). I have tried having it before going to bed but there was no improvement there- might try that again,

[Moggie in reply to clarence2013]

Did you know that soya is one of the worse things for the thyroid? and I'm sorry to say that the pharmacist has misinformed you regarding only waiting 30 minutes before eating - yes the patient information leaflet also states this BUT any good doctor or endo will tell you differently and any thyroid patent will also tell you differently.

Have a look at this link regarding soya and thyroid function.

medicinenet.com/script/main...

Moggie x

[clarence2013 in reply to Moggie]

I usually use coconut milk and have cut down on soya meat (I've read that it can actually cause thyroid problems!)

[Marz in reply to clarence2013]

...and it's mostly GM imported from the States !

[Moggie in reply to Marz]

The use of GM is becoming more prominent in this country Marz, all be it by a back door system.

Most of the cattle in this country is now feed GM (although this doesn't effect me as I am an animal loving veggie) and I buy organic milk but, to my disgust, I found out the other day that due to a shortage world wide, out chicken farmers are now having to feed their chicken GM soya so I am now going to have to find free range organic eggs. I have never bought eggs from supermarkets due to caged hen issues and usually screech to a sudden halt on some country lane or other when I see eggs for sale outside a private house.

How is the GM issue in Greece Marz.

Moggie x

[Marz in reply to Moggie]

...good question Moggie. Am afraid I do not know. I buy eggs from a Greek lad who feeds them on Purslane growing in his olive grove. All the eggs here taste good. I rarely drink milk - brought up on a Dairy Farm !! Fruit and Veg are probably all sprayed with something ghastly but all grown on the island. I soak everything in vinegar water. We eat with the seasons mostly and currently enjoying apricots. Stolen ones are best though !!

I have read about Monsanto now controlling the seeds farmers use and they have to buy from them. I signed a petition with Avaaz to try and stop them - but have not heard what happened. This was a bid to control Europe and of course Greece would have been part of that. The Greeks are brilliant at signing up to whatever in Brussels and then walking away and doing their own thing !!

Most of the local meat is grown on the island too - the sheep around us all look healthy enough and nibble on olive twigs when everything is dry - so that should be good for them !

Everything in moderation I think - remember our parents and grandparents squirted DDT everywhere. Remember Pam Ayres.....My Mother had a Flit Gun

...It was not devoid of charm......

....A bit of Flit shot out of it.....

...the rest shot up her arm !!

Done in my Somerset accent I am afraid ! I AM the Dolly on the Dustcart !!

M xx

[Moggie in reply to Marz]

British farmers are not buying into the Monsanto dream (well most of them anyway) they don't want to be controlled and told what, when and where they can grow crops and what and when to put on them so there is hope for us Brits yet.

Better stop hi-jacking this poor ladies question with our chatting.

Moggie x

[clarence2013 in reply to Moggie]

No problem this is all good info x

[Moggie in reply to clarence2013]

Thanks for being understanding but sometimes one question will lead to another subject.

Moggie x

[clarence2013 in reply to Moggie]

I'll try taking the medication before bed. When do others here take theirs?

[Moggie in reply to clarence2013]

Here is a link to a poll done on here a while back and as you will see there are a lot of comments so it will take a bit of reading.

thyroiduk.healthunlocked.co...

The way I would look at things is that you are obviously still feeling awful so changing eating habits and med timings cant do you any harm and well may be the answers for you, you wont know if these things might work for you until you try. Most of us on here have changed this and that and altered other things to try and improve our situation and some have had great results.

Moggie x

[clarence2013 in reply to Moggie]

Thank you for your replies that's great x

[Hidden in reply to clarence2013]

Hi Clarence, I have just changed to taking mine at night but Moggie's link is a good place to look. Like everything else thyroid its not a 'one-fits' all result but its certainly worth a try. I am only about 9 days in and I can't say I have found it has significantly made me feel better, except I do sleep better and sometimes go right through the night. I have found that night-time, whether it makes a difference or not, is probably better suited to my habits. I can't wait for 2 hours in the morning to have my morning coffee (with milk).

However, I don't take any supplements at present so its only the milk I am trying to stay away from. After about 8.30 pm I don't eat or drink anything, except 300ml of water with my levo ay 10.30.

I have read somewhere that you might need to give it about 2 months so I have a way to go yet, if anything is going to happen.

Good luck on your journey

jan

[clarence2013]

Vegetarian

[Marz in reply to clarence2013]

.....as you are Vegetarian how is your B12 ? Low B12 can be one of the causes of tiredness. Check out b12d.org ......also needed to help matters along at a cellular level with hormones.....

[clarence2013 in reply to Marz]

I eat a lot of marmite...

I'll need to ask my GP if I've been tested for that x

[Marz in reply to clarence2013]

....when you are Hypo there are often mal-absorption problems too....

[Moggie]

Here is another good link regarding all things thyroid and also about what you should/should not be eating (including a paragraph on soya)

articles.mercola.com/sites/...

Moggie x

[Hidden]

I would have thumped him!!

Why not write him a letter stating that you're unhappy with his 'management' of your hypothyroidism, you disagree with his statement, and you want to be referred to an Endo.

No way would I accept such rubbish!!

[clarence2013 in reply to Hidden]

Than you! Yes unfortunately I got upset instead. He's ringing me this afternoon so I'm asking for a private endo referral from him.

Just reading the posts on here even someone who's not a dr can see its far more complex than a simple tsh and iron test

[Hidden]

Might be an idea to ask Louise for a list of Endos?

I know how easy it is to get upset but that just gives them an excuse to diagnose depression. GPs really seem to know very little about thyroid matters!!

[clarence2013 in reply to Hidden]

I know I could of kicked myself for it! You know that feeling when anger turns to tears and you can't stop it.....

[greygoose in reply to clarence2013]

Oh, that's very hypo! Yeah, I think I might have thumped him, too. But it's not recommended. lol

Try giving him a gentle warning: Did you know, doctor, that violence and aggression is common in under-treated hypos - especially when their doctors say stupid things that up-set them!

There's at least one of my ex-doctors that learnt that lesson!

Hugs, Grey

[clarence2013 in reply to greygoose]

He's just rung me and will be referring me to a NHS endocrinologist... Fingers crossed! X

[Moggie in reply to clarence2013]

Now you need to take matters into your own hands and find an endo that YOU want to see and not one that he sticks you with. Ask a question on here regarding NHS endo's in your area - but you will need to ask people to PM you their answers. You can also go to the top of the page and see how your local hospitals rate and see if anyone has recommended an endo in a nearby hosp and lastly you can do some google searching to see if you can find one.

Then you can go back to your GP and ask to be referred to you preferred endo and not one that you have just been allocated to.

Moggie x

[clarence2013]

I tend to drink coconut milk (Koko) and do eat eggs (though I would like to be vegan)