Thyroid UK
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Excessive fatigue or is it normal?

Hiya I'm new on here. I was diagnosed with an under active thyroid when I was 3 years old, I'm now 42 and on 100mg Levothyroxine which I take first thing in the morning. I've also been prescribed 10mg Cipralex, this helps with my anxiety and calm the IBS I sometimes get.

I work 40 plus hours a week. I was placed on a 13 hour shift yesterday, today I cannot get myself moving. I can't do my weekly shop or enjoy my days off. This is a continuous cycle. I've had to ring in to my boss and plead I cannot work tomorrow because of my 13 hour shift the following day.

My body feels heavy with muscular aches and pains. Its getting me down as I feel useless.

I have regular blood tests, take iron with vitamin C, also a fybogel each night to ensure its not constipation.

My question is, is this normal? Should I be able to work 40 hours plus a week plus run a home while on these meds or is it normal and am I generally over doing it? I'm a single woman with a teenage lad in college ;-).

All advice and opinions appreciated.

10 Replies

Welcome to the forum, Debs72.

It isn't normal to be so fatigued. It sounds like you may be undermedicated. If you get your recent thyroid bloods results with the lab ref ranges (the figures in brackets after your results) from your GP receptionist and post them in a new question members will be able to advise whether you are optimally medicated.

The other thing you should do is to ask for your ferritin, vitamin D, B12 and folate to be tested. They're often deficient/low in hypothyroid patients and can cause musculskeletal pain, fatigue and low mood.



I am sorry you have been underactive since you were 3 years old. As Clutter says, you may be undermedicated and if you post your recent thyroid blood test results with the ranges someone will comment.

Theoretically, if we are on optimum medication we should feel we have normal health and be able to do everything others would/could do.

100mcg maybe too low for you and the addition of T3 may be very helpful.

When you get a blood test you should not take levothyroxine before it. You should have the test as early as possible and take medication after.

You take levothyroxine on rising with one glass of water and don't eat for around an hour. If you do eat there should be a two hour gap either side of levo so stomach is empty and food doesn't interfere with uptake of levo. Medication and supplements should be taken 4 hours apart.

Pains, aches, fatigue sound undermedicated. From now on always get copies/print-outs of your blood tests for your own records and so that you can post here if you have a query.

I hope you feel better soon.

1 like

Hiya thank you for your responses. The GP said my thyroid levels were borderline, meaning to lower the dose to 75mg, but he said he wouldn't risk doing that on just one borderline result.

I usually take my tablet 1 hour before drinking my first cup of coffee in the morning and I don't eat for at the very least 3 hours after.

My body felt really achey and sluggish up until after 2pm, then all of a sudden the pains and sluggishness went and I feel fine now, just a little confused to why this happens.

This morning I took my tablet at 7am.


I don't think I could survive 3 hours after wakening before I ate. As also suggested in other responses, get a print-out of your latest blood tests with the ranges and post on a new question for comments.


Welcome to the group, Debs. Have you considered the possibility of changing to taking your Levo last thing at night? When I was on Levo that is what I did and found it was more effective.

But you have been on Levo for a long time now, and so you really need to know if you are utilising it properly, it does sound to me as if you are not. I am a bit surprised that it has been suggested it might be reduced!

It would be good to find out what your actual results are, to know what they think is borderline. Also, do you know why you are hypothyroid? Have you had any antibody tests?

Many people who have been managing fine on Levo for a few years seem to be finding suddenly that it is not working as well as it did, and this is a fairly common situation. Have you been aware that you are suffering more symptoms than you used to? Can you recall a time when you felt fine on Levo?

I was in the same situation as you, a single mum with a teenage son, I did work full time, but not those kind of hours. To a degree with this illness it is good to have a regular and consistent level of energy expenditure, because you are taking a fixed amount of thyroid replacement, it is a bit like a diabetic, we have to balance what goes in and what goes out, to avoid a crash. Those long working days must be really exhausting for you.

There are some good suggestions here, so I will not repeat them, but I do think it is essential that you get actual results, with ranges, and post them on here, which will enable you to get ev en more constructive support and advice.

Meanwhile, I know it is difficult but is there any possibility at all to change your working hours, or even to look for a different job? I do know how hard it is, having been through it all myself. I am married now but my son was married and settled in his own home before that, I brought him up from birth all by myself despite my thyroid problems. Being a single mum is a challenging and stressful thing- even more so when they are older!

I really do feel for you.

Marie xxx


HI Marie,

Its not my levothyroxine that is messed about with, i'm on 100mg daily, it's the Cipralex i struggle to maintain myself as it makes my memory poor and i could sleep on a washing line any time of day, when taking 5mg yes i have more energy, feel less sleepy but my anxiety returns terribly, any small situation can and does set it off.

I am looking for another day job, i work in Mental Health, 12 hour night shifts on a rolling rota, I chose to go onto nights because i couldn't cope with the negativity during the day. Not necerssarily towards me but in general. It was so bad, i started smoking again. Going onto nights thankfully i stopped this straight away and theres a lot less stress, but i've ended up being a hermit. So i don't know Marie, which is the best way forward X


I saw that, but of course as mentioned, if you are taking the same every day which we all do, then if what goes out in terms of energy expenditure varies wildly, we end up having a bit of a crash and it takes a few days to build back up again. I suspect that the cipralex also blocks the Levo a bit.

I also had terrible anxiety on Levo, it has gone now I am on T3 only. I was housebound because every time I went out I would get horrible panic attacks.

Mental problems - depression, anxiety, agoraphobia, even paranoia - are very common with hypothyroidism particularly if it is under treated; which is why several people have said you do need to know what your Free T3 level is, in case you have problems converting the T4 to T3. Until the T4 is converted to T3 the medication has no effect, since T4 is strictly speaking a storage form of thyroid hormone, while the T3 is the active form, which your entire body needs at the cellular level, to function normally.

Marie xx


Debs, you need the results with the lab ref range. Borderline can be top or bottom of a range. My money is on top of the range because you're very probably undermedicated.


Hi It usually means you are undertreated. YOU need a print out of tSH, T4 and free t3. It could well be the latter and that you need some T3 with the T4, levo.



People who are healthy with properly functioning thyroid glands will produce thyroid hormone as the body demands it. When people are hypothyroid they only have as much as is in the pills they take, plus any that the thyroid is still able to produce (if any).

The thyroid produces several hormones, the most abundant one being T4, and also T3.

The T4 doesn't do anything much (that I know of). It is used by the body as a raw material to produce more T3 when we need it. The T3 is the one that makes the difference between us being a sloth or being normal. If you are running out of energy, then you don't have enough T4 (levothyroxine is synthetic T4), and/or your body cannot create enough T3 out of your supply of T4.

Some people never have enough T3 when taking levo because they are not good at converting T4 to T3 for genetic reasons. Some people don't convert well because they don't have sufficient co-factors (vitamins and minerals) necessary for the body to make T3 out of T4. It also seems to me from the reading I've done on this forum that our ability to convert T4 to T3 diminishes with age - people who've done well on T4 for many years start doing really badly on it as they get older.

To allow your body to create T3 you need optimal levels of several vitamins and minerals. The ones you need to know about are :

Vitamin B12


Vitamin D



If you can persuade your doctor to test your levels of these, get the results and the reference ranges and post them on the forum.

If you are taking sufficient levothyroxine, have got your vitamins and minerals to optimum levels, and you still aren't beginning to feel better, then you probably need to get some T3 to go with your T4, or you need to take NDT (Natural Dessicated Thyroid). That's a whole other story for another day.

I've simplified the process and the explanation. There are other factors determining whether or not we feel well, including cortisol not being optimal, over-producing adrenaline, having gut issues which prevent us from absorbing our meds and nutrition, having other hormones out of whack... But start with the simple things first - the vitamins and minerals - and move on from there.


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