Thyroid UK

Tired mid afternoon


So a few weeks after my hemi in march I noticed that I was getting a bit more tired than normal around 3pm. If i battle through and not have a nap I seem to pick up again around 5. Last week I had my completion thyroidectomy and started on 150 mcg of Thyroxine. I know its still early days but the afternoon tiredness still continues. Is it reasonable for me to hope that things may improve in a couple of weeks time once the Thyroxine has fully taken over.

Are there other supplements/ ideas to try to counteract it?


6 Replies

Do you have recent bloods and ref ranges for TSH, FT4, FT3, vitD, ferritin, B12 & folate? Deficiences or low in range in any of the above can cause fatigue like that. The other reason could be that you need T3 (Liothyronine) in addition to the T4 you're prescribed.


Hi Clutter,

My most recent Ferritin, Folate, Vit D and B12 results are all from a few weeks ago after my hemi but before my completion. I have been supplementing with iron , the Bs, C and D for around 2 months.

I think I'll go to my GP next week and ask for repeat bloods of everything and see if that throws up anything. I should also be getting TFT tests in a couple of weeks via my endo.

It's early days yet so hopefully I can iron this out.




If you are taking B12 - it will skew any future blood tests...likewise the iron. Your recent results with ranges will give us a guide and help us to comment....

I agree it is early days - so just enjoy a little rest/nap if you can... :-)


Hi there,

These are from a month ago a few weeks after my hemi.I *was* already supplementing by this point though and had been for around a month:

My results were:

serum vitamin B12 380 ng/L (220-770)

serum folate 9.6 ug/L (2.6-17.3)

serum ferritin 26 ug/L (10-420)

Serum Vit D 109 mol/L (>50 adequate)



Your VitD looks good and almost there ! B12 is VERY low - especially if you have been supplementing. Needs to be around the 800/900 mark - although I see your lab range is lower. Sally Pachlok says we must all aim for a 1000 to prevent cognitive decline.... Also worth remembering that in Japan the range STARTS at 500 up to 1300. Anything below 450/500 can cause neurological symptoms. Ferritin - also low and needs to be around 90. So nothing much in the store cupboard :-)

Lots of useful info in the above link....

Also where there is a questionnaire which you can answer and see the colours change depending on your deficiency - a useful guide... GP's seem loathe to understand the workings of B12 and it's role in the body. When taking B12 you also need to be taking folic Acid and a good B complex. FA and B12 work together....

Hope you soon feel stronger....


I have late afternoon fatigue - 5.30 until 7 pm roughly depending when I get up. I have fibromyalgia.


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