Thyroid UK
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Crashing again

From getting up this morning untimid-afternoon i had what i refer to as a crash. Symptoms are lethergy, nausea,no appetitie, uncomfortable around trunk area,feeling very very ill.

Am i describing what people call adrenal fatigue? On meds fo runderactive thyroid and will be starting on nutri adrenal meds soon diagnosis made after talking to Dr, P. The reason that i struggle with the diagnosis is that my symptoms are vague yet profound.

15 Replies

Hi Personally, I would alter take meds until I knew the cause, lots of blood tests etc. For thyroid start with TSH, T4 and Free T3 ,. Then recheck the other tests we list.

If you then think it is your thyroid, see an Endo , pick a good one yourself and then ask for a referral,. The reason is they are the most widely knowledgable of the specialities as a general Endo covers so much They can also do the only really good Adrenal tests, 24 hour urine test + cortisone, script at midnight, blood test at 9am Endo`s usually consider that the thyroid as good as possible first, if needed, then Adrenals if still needed...

I would also ask the GP to do LFT`s, liver, U`s and E`s , kidney, and also a FBC, full blood count. Ask for a print out of everything, + ranges very obvious then reading the results,useless any way without ranges as all Labs differ.. Liver and kidney and loads of things can cause these symptoms.It could also be Gall bladder, it is not classic for this, but need not be , it is autoimmune too. An ultra sound would show this, usually, not fool proof.Have you considered caeliac disease, autoimmune? The blood test is not reliable so, if you think it is this you ould need to try the diet ,strictly for 6 weeks and see.Not nice!

Best wishes,



Hi and thanks. You mentioned gall bladder....i do have a diseased gakk bladder caused by crohns disease,it never occured to me that it could be causing some of my probems. what made you mention it?


Hi It is an autoimmune disease and very common with thyroid disease. it need not cause the well known symptoms, pain usually radiates round to the back after a while. Makes you lose weight and is horrible actually.Can be hard to diagnose, usually starts with an ultra sound but depends how it is lying. and who does the scan. Grit gets stuck in bile duct and can make you yellow, but that is normally passed in time. The best person for gall Bladder , Pancreatitis, ( I have autoimmune) both)is a Hepatologist or Hepa surgeon, they are all brilliant only at top hospitals where they mostly do transplants.If you have a problem with stones or disease of the Gall Bladder, and do not have the surgery, in time it becomes cholocystits, which is terrible and very much life threatening. I have had this for 4 years, acute and chronic, varies,, originally hopeless so called top Gasto, My hepa diagnosed it eventually when referred to him and my pancreatitis worse pain, as have liver,,kidney disease ( never drunk or smoked), I am unlucky as it is so dangerous and I can only have palliative treatment for it,now., 6 weeks hospital with a very risky ( for me) drain, as too ill for surgery. Moral is ,do make sure, gall bladder surgery is OK fairly simple and quick. surgery.

I hope that is some help. Crohns also horrible, it is autoimmune. All my abdomen is rotten, quite common to have several things wrong ,if one is.

I hope that is what you wanted to know.



What is the autoimmune disease that affects the gall bladder?

Dont have pain in stomach only discomfortbut get pain between shoulderblades,weight loss,lack of appetite abd a feeling ofbeing very ill.


Hi it is certainly typical of gall bladder. It is always classified as autoimmune, I think , but not sure that Crohn`s is too. A lot of people have a little grit , it is when it moves or grows bigger , usually a problem. Miy gall bladder now disintergrated , according to my Hepa surgeon and ultra sounds,. but still have all the stones and more.There are masses of autoimmune diseases, last time a consultant counted, I had 12 Referred pain with the other symptoms is classic, later more problems an hour or so after eating and night time.The only other similar thing is Pancreatitis ( more painful etc) and autoimmune Hepatitis,, , but always yellow with that, also when I had it for 9 months, very ill. No treatment except avoiding the cause for that.

Best wishes,



Did you get your B12 and folate tested yet yorkshiregirl44? If I remember rightly you had macrocytosis.

H x


hampster 1 I had the active B12 test as I have what I think symptoms tingling and crawling on scalp face and numbness and some neurological involvement result 93.8 ref range 25.1-165.0 blue horizon says please note change in reference range/units due to change in methodology.

I was disappointed I really thought I would be out of range .Do you consider 93.8 a good result? Or would it be considered a gray area?


The official grey area is 25.1 to 50.0 according to Biolab - or Abbot have a simple division at 35.

But had you taken any B12 in the month or two before the test?



I'll have to double check my hubby's test result tomorrow but I think that St Thomas' Active B12 "grey area" is now 25 - 70, and they automatically do the MMA test if in there.

Rod's right, if you've been supplementing then it will affect the result. So can you give us some more background? Did you originally have a low serum B12 result?



hampster 1and Rod thank you for you responses, I have not supplemented with any B12, I may have had the occasional VitBco in September out of desperation.

I had Serum B12 test in April (NHS) Vit B12 494, Ferritin 49, Folate 7.2

In May(Genova). B12 542,Ferritin 50,Folate 3.3

November 2012 had a minor stroke possibly preceded by a TIA the day before my Lt side was mildly affected,unfortunately the hospital decided to switch my T3 and NDT

to Thyroxine 75 mcg since then my balance and mobility have deteriorated as I was walking unaided after the third day in hospital.

Although my Lt outside arm and leg were affected with slight numbness it has been getting worse sometimes the numbness spreads to Lt half of the back and shoulder ,this makes me think it may be caused by B12 def. or it may be due to the switch to Thyroxine. After a year on Thyroxine the endo has reluctantly agreed to give me a trial on T3 10mcg +50Thyroxine.The other problem I have is Adrenal fatigue the endo has taken me off prednisolone after a 30minute Synacthen test which she claims I have had a very good result (does not accept the ASI saliva test . Also have digestive and gut problems which are connected with B12 deficiency. May be I am clutching at straws,but I am very unwell. The GP refused to do a referral for an Active B12 test at

St Tomases/ Guys hosp.


Hampster1, Rod,I forgot to mention the lab comment (blue horizon)

The laboratory comments upon changes in the sample possibly caused by a delay in processing the sample. Sometimes a delaying in testing the samples can lead to what are known as 'storage changes' as soon as 4 hrs after taking the blood so even samples taken in a GP surgery or hospital setting can demonstrate falsely elevated levels. "Is there any point in having these tests I ask myself?


I've never heard that before, it's unbelievable. Sounds like they're covering their backs with that comment.

I have to say, sometimes the only way to know if you are B12 deficient is to have a trial of injections and see if you respond. None of the tests are perfect. It is entirely possible to have normal serum and active B12 and still be deficient, as you could have issues transporting the B12 to cellular level.

Try completing this questionaire and treatment protocol to see where you stand:

Your folate was very low in May, this won't be doing you any favours. You really need to ask your GP to retest that and if still low he should prescribe you 5mg folic acid. MMA and homocysteine would be good tests to have, do you see a Neuro? You might be able to convince a Specialist to run those tests for you.

From what you've said it feels like the switch to thyroxine has done you no favours, maybe adding the T3 back in will do the trick? I really don't know anything about being hypo so I'm going to stop there with that one!



Sorry to hear you're having such an awful time.

Are you taking t3 now or are you still on just the t4? If you're taking t3 now, out of curiosity, what time do you take it and are you taking it all in one dose or splitting it? I get something not as severe but similar when it's time for my next dose of t3. If I had a penny for every time I thought 'I must be coming down with something' and it turns out it's just time to take my pill. x


Hampster1 thanks for your reply and b12d. sites from which I will get a better insight in the b12 issue. It may be the samples were spoiled the nurse who took them did rush things,I trusted she knew what to do The lab report also said "sample time notavailable".I should have checked. You live And learn! The last time I saw the GP told her of my dizziness staggering and lurching I was told I was alright. and said it was due to the stoke. (From which the stroke doc said I re covered well).

That was back in February.I may have to change GP and I agree the switch to Thyroxine has certainly not done me any good especially as I had been on it from '95 to

2005 with worsening symptoms. The adrenal problems does complicate the situation as well. Thank you for your kind help.


Hi punctured bicycle,I take T3 5 mcg and T4 25 because when I took T4 50+ T3 5mcg daily I felt very hot in the evening or T4 75+2.5 T3. T4 seems to build up. I feel better mobility wise with T3 5&T425 I increased it three days ago taking also 2.5 of T3 at midday Ok for a few days ,but today feel unwell with palpitations in the afternoon, 86 a minute not too fast but irregular makes me feel Uncomfortable as if I need to take deep breath also BP up 159/86 and tingling on my scalp then some numbness Lt back head.

It has to be taken in account that I have adrenal problem. I am in awful situation because the NHS endo says my Synacthen test was normal has stopped the prednisolone yet on a higher dose of thyroid replacement the adrenals can't seem to cope with it .She tried me on 100 then 125 T4 but I felt dreadful.Sorry I can't help you very much I am totally confused and scared I don't want to end up in hospital because they know nothing about thyroid disorders and adrenal fatigue they don't recognise it .

Wish me luck!


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