Hypothyroidism and work

Hi I have had hypothyroidism for approx 10yrs. I am a vet nurse working 40+hrs/wk and am currently struggling with extreme tiredness,brain fog, and painful muscles and joints. Last year I went to occ health and as a result I was put on the same shift(11-8pm) but I just feel I do not have a work-life balance as just so exhausted all the time and need to do something about it. So just under a month ago I applied to drop a day which was refused on grounds of financial burden on the business which I do not get because my salary would drop and even if they found someone to cover me it would just be what I have dropped surely!?does anyone know where I stand legally with disability discrimination act?is hypothyroidism covered by this,I'm crap with legal stuff!!thanks

44 Replies

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  • Is it worth pursuing the reasons behind your worsening symptoms rather than dropping work days? You've a right to a quality of life. Is it time for a review of your medication? My experience in the workplace is they'll just make your life difficult.

  • I agree with jodypody, if you are adequately medicated you shouldn't be having these symptoms. Have you had a recent thyroid blood test? If so can you post the results on this forum? Then members can advise. I don't have much knowledge about whether thyroid disease is considered a disability, but conventional wisdom in the medical profession is that if you take the medication you should be able to live a normal life. Of course many in this forum wouldn't agree with that! I don't know if this helps but please do get your blood checked and medication reviewed. Painful muscles and joints are often a sign of under medication. LB

  • Yeah thanks for the advice I am under a private consultant(because nhs wouldn't test my t3) and turns out my body can't convert t4 to t3 which is why I was feeling so crap and they weren't listening(started to feel it was all in my head!!) I am currently trialling upping my meds but consultant thinks something else going on so doing more tests if this doesn't work. I just want a better work life balance and my job is very tough and tiring without a chronic condition. Another nurse at work has uat and she is part time-she said she could never work full time in this job. I just think life style is important part of managing thyroid and dropping one day will help.

  • Have you had your vit D, vit B12, folate, iron and ferritin tested? These are often low when you're hypo, but they need to be optimal for you to be able to absorb and use the hormone you're taking. Vit B12 should be around 1000 - ignore the stupid ranges - and the rest at least mid-range.

    Another reason for bad conversion is low adrenals - have you had those tested?

    If you cannot convert T4 to T3, there's absolutely no point in adding more t4. It will just pool in the blood and cause problems. You need to add in some T3.

    I have no idea about the legal position of thyroid in the UK, I live in France, but it's certainly considered to be no big deal over here! You cannot get the consessions you would get with something like heart disease. When I had the nerve to try to apply for something, I was told in no uncertain terms that I 'wasn't as sick as I though I was'! Despite sitting there looking like death, barely able to move, with blood pressure sky high, etc. No compassion whatsoever!

  • Yeah I'm on 20,000 units of vit d once a week and levels good at mo,haven't had others checked tho so will ask that. I am on t3 as well(sorry I didn't say that)had to go private to get that tho as nhs wouldn't even test my t3 levels!yeah it's awful how thyroid disorders are downplayed really in everything-esp when your thyroid controls so much!!

    Thanks for advice

  • As you're paying your doctor to be helpful, it will definitely be worth getting your Adrenal glands checked. Once exhausted (and yours almost certainly will be, with the thyroid difficulties you've been having) they find it hard to reboot without help. Unfortunately all 3 tests for low Adrenals are a bit suspect. But talk to the doc about supplementation there as a priority. It is amazing what a difference raising Adrenal function can make.

    Low iron and B12 can also have a major impact. I'm surprised your doc hasn't had those tested, as you were having a panel done anyway.

    The suggestion to try NDT is also a good one. Although I bet you don't want to have to start from scratch on a new med right now!

    You have more freedom to choose your treatment with this private doctor - but it sounds as if you're going to have to ride him/her quite hard in order to get the best treatment for your money :-)

    Are you paying British prices for T3?

  • No thankfully I get it on nhs. My gp just goes with what consultant says and he says I need t3 so they prescibe it!

    I had acth test and came back my baseline was low but I reacted well to synactin. Been one 1m trial of hydrocortisone but didn't feel any better.

    Will ask for iron and b12 to be tested then thank u

  • I am on 20,000 units of vit d once a week and levels good on that. Haven't had others checked tho so will ask about that. Had ACTH stim test to see my adrenal function and my baseline was low but after synactin my body reacted well and I went to within normal ranges. That was done last year as a group of tests but Dr didn't want to change too much at once and had just started my t3 so decided to trial that at the time. When I went back in may just gone feeling shit he decided to trial me on hydrocortisone tablets for a month to see. Felt wore tho I think...all shakey. So now I'm trialling upping my t4 and t3. Thanks for advice.

  • How much HC, and when do you take it?

    The ATCH test will only tell you if you have Addison's, it won't tell you if your adrenals are just struggling. For that you need a 24 hour saliva test. But you won't get that on the NHS, I'm afraid.

  • Where do u get a 24hr saliva test done?

  • Blue Horizon, I think. But I Don't know much about private testing because I Don't live in the UK. You could post a new question and ask those that do. :)

  • Hi u sound like me a few years back I was really lucky to see Dr p he got my meds changed to t3 as thyroxine didn't work as I have a conversion problem to ! Also I take Nutri adrenal extra I started on 4 aday also NUTRI vit c 1000 I started on 2 twice a day 1 nutri thyroid and 1 q10 30mg with in 2 was my brain fog went my memory was back and I felt so much better I'm still on them but if I leave a day or so my memory goes so looks like I'm on them for life but worth it as they really make a massive difference to my life I had body aches as well they have gone to im also gluten free as much as I can be I sllep well and go swimming most mornings at 6.30am which I couldn't do b4 I was on 7 liothyronine and now down to 4 so maybe buy your thyroid and how to keep it healthy by author Dr Barry durrant peatfield its a brilliant book and will definatly help u it did me

  • Hello AnnaBean,

    Sorry to hear of your situation,

    If you aren't converting, upping meds will not help. You will just feel over medicated (racing heart, hot, unable to sleep well).

    Conversion problems can be down to cortisol issues which is needed to transport the T3 into cell for active use. Cortisol raises your cellular level of glucose which works with your cell receptors, ATP and mitochondria to receive T3 from the blood. Cortisol problems occur when the body is continually stressed.

    Perhaps you can get your cortisol levels checked. Doctors test cortisol levels by taking blood but members have found private saliva tests to give a clearer picture.

    The adrenal glands can be supported through use of glandulars or adaptogens, both which are powerful and should be used with caution.

    If you are medicated on Levothyroxine, you could ask your endo for a trial of T3 to be added to your T4 but I think finding the underlying cause would be more of a long term solution.

    Have you had Vit B12, Vit D, Folate and Ferritin levels checked? All require optimal levels to aid thyroid hormone med absorbtion and conversion.

    Hope. You feel better soon,

    Flower007

  • Legally a disability is recognised as any long term condition that has a significant impact on your life. When managed properly thyroid disease shouldn't (ideally I mean) do this. Citizens Advice would be a good first step although your GP is supposed to judge your fitness for work and could recommend you are currently only fit for part time duties until the results of the additional tests are considered. If you had a fitness for work certificate in this way your work would need to take action. Make sure you are tested for lupus and MS and polycythemia which all have similar symptoms to those you highlight although have you considered stress as a factor? All the best.

  • After being 'surgically hypo' my Endo said we will never get replacement 100%. So to me that is a long term impact. I'll never be 'me' again.

  • Yes sounds like it. That's a tough place to be I wonder if in your situation that is recognised.

  • Nope. It is 'skated over' shall we say :(

  • Thanks for the advice will ask my dr to test me for those too. Thanks again

  • Much more important is why your not well

    do you have copies of blood tests ?

    did you take your levothyroxine in the 24hrs before a test because that skews results and GPs then do not get your dosage right

    Go back to your doctor and INSIST on these tests then we can help much more

    Free T4

    Free T3

    TSH

    Ferritin

    Folate

    B12

    Vit D3

    they all interact and everyone must be optimum otherwise you get problems

    It could also be your body is allergic to levo and only a switch to NDT will help

    but without those results we cant tell whats happening

    the Free T3 result is vital

  • Hello Anna, sorry to hear how you are feeling. Firstly can I say I felt the same until a few weeks ago on Levothyroxine, just changed to NDT which is working for me. All the pains and tiredness and brain fog gone. I can recommend Endo Dr J at Bristol spire look him up, if you need more info contact me. Changing was the best thing I ever did. I would recommend you join a union online for a very small amount a few pounds you get instant access to employment help locally through union and lawyer if needed straightaway and ongoing support. I joined when I was being treated unfairly at work, the service was brilliant and no costs other than the joining fee. I used TGWU and I think they are called UNITE now, they help you as little or as much as you want. Alternatively take a look at Nick Hanning at Dutton Gregory a law firm in Poole.

    Good luck and let us know how you get on. Lizzy

  • Hi,

    I was wondering if you mind pming me any more relevant details on Dr J from Bristol such as does he see NHS patients or private only and if so is he very expensive? I hope you don't mind me asking. I live in Yeovil and I'm looking for an endocrinologist who has the ability to see outside of the levothyroxine box.

    TIA

  • Give his secretary/wife a call for info re costs and nhs spirehealthcare.com/bristol... good luck!

  • Disability is more difficult to prove under the law than a few years ago and anyone working would probably have to pay steep fees at a Tribunal that the last Government brought and this one will not change.This was to protect small firms in particular against stupid claims of which there were a few but not as many as cases involving bad employers.

    Disability is defined in the ability to do specific everyday things ,not work tasks. Some illnesses are defined as disability e.g. Cancer.

    The inability to think clearly and fatigue could be a disability if it prevents you from doing some everyday things. If disabled under the Act the employer has to make reasonable adjustments which could include part time work.

    Advice can be found from a Union, CAB,or free Law Advice Centres if any in your area.

    If you do become embroiled in a Tribunal claim check your house or other insurance for cover for legal claims on employment issues.

  • Hypothyroidism is covered by the equality act. Employers are required to make reasonable adjustments for you. This would seem reasonable to me! I don't know for sure though. You could try citizens advice? Others may have better suggestions though. I struggled with my hypothyroidism and ended up off work sick for 5 months with depression - I'd say that's more of a financial burden and horrible for us too. Absolutely do look after yourself first and foremost. You're doing the right thing!

  • Suggest you maintain positive approach which employer's like, and say this is short term measure. If it works ok you can request it continue. Employers seem to want full time or nothing, unless it's proven part-time works for the employer. Employment legislation is so much better than in the past but employers can comply yet be difficult. Stress is a good point to focus on - it's in the legislation yet somewhat 'undefinable'. However if you get a doctor's certificate to say you're suffering stress you don't need to rely on recognition of hypothyroidism. Your employer might wrongly think it a long term disability so emphasise the 'here and now' - short term, positive approach. Teleohone an employment lawyer on lawyerdirect.co.uk or similar, and discuss it for small fee. Keep quiet on legal issues unless it gets that far. Better to negotiate what is good for firm and you.

  • Join a union immediately!

  • As regards employment law, I understand that your employers have to make 'reasonable adjustments' for any medical condition that you have. However, this is obviously open to interpretation and your employer is clearly arguing that the needs of the business trump your need for 'reasonable adjustments'.

  • Could you apply for similar conditions in a more part-time capacity?

    I also agree that the underlying issues should be investigated regarding the conversion issues, which I can see you are doing.

  • I mentioened this same thing to my doctor months ago. I could not work full time at a job because of my hypo. My doc is an Endo thyroid specialist and I don't think even she understands the negative impact it has on how we function. I have to say tho that it has helped tremendously to get off the Synthroid and switched to Armour. I don't think I was converting the T4 to T3 on Synthroid. At the same time I started taking B12, Iron, and D3 so these may have also helped

  • I went to occ health about 18mths ago with similar issues and the doc there seemed to think hypothyroid was covered by the Equality Act, as its how you would be 'without' medication that decides disability, and 'reasonable adjustments' need to be considered.

  • Thanks that good to know only 8m ago I went to occ health as I was not coping with shifts all over the place and as a result I was put on late shifts only(11-8pm) as mornings were my worst part of the day illnesswise. When I applied recently for this drop a day work told me they only have to consider 1 flexible working request per year but would consider it because of health reasons...then refused anyway. So do both of the above come under flexible working or are they reasonable adjustments under equality act????interested to hear ur view 😊

  • Hi, Anna Bean. My view ( and its just a view), is that flexible working is classed as a 'reasonable adjustment', and that its not limited to 1 request a year.

    A good document to google is 'Equality Act guidance'.

    I've also just seen a section in the following:

    equalityhumanrights.com about 'what is meant by reasonable adjustments'.

    In my case I have a slightly later starting time, and slightly reduced workload (NHS job). Good Luck.

  • Hi Anna, it's so difficult to struggle on the job with all of it's expectations when you are feeling so ill. People simply do not understand what a sluggish metabolism will do....constantly pushing you down. There is much more knowledge now and things you can do on your own as others have suggested.

    If you have time to watch, I have found these videos so helpful and why doctors are not helpful.

  • Thanks very interesting information 😊

  • I have been in a similar situation and decided that the only way to deal with this successfully and maintain good relationships with the workplace etc is to switch to a different job - I am sad about this as I am surrounded by a fantastic team of people but my need currently is work life balance, rest and recuperation, I therefore plan part time 3 days a week plus study for my foundation degree or 4 days a week without, this should enable me to live again as opposed to my 6 shifts a week currently. Maybe you need to step back and rethink to incorporate what is essentially a new you xx good luck

  • Sorry to hear that your employer is unsupportive, i dont think anyone seems to get how ill we actually feel unless they suffer with it themselves. I usually work 30 hours a week which i knew was a struggle for me but need the money so have been plodding on but a few weeks back i had a flu virus and felt terrible with it so was off work for a week. When i had a return to work interview i was informed that my hours were being dropped to 24, im not sure they can legallyly do this however im caught between the devil and the deep blue sea as i struggle to work but cant afford not too. What a situation for us to be in :( hope you get yours resolved and feel better soon x

  • Thanks,yeah they just see u carrying on and think ur fine!!

  • Lots of sound advice here, but just thought I'd add my tuppenceworth in too. :-)

    I'm currently reading 'Why isn't my brain working?' by Dr Datis Kharrazian (he wrote why do I still have thyroid symptoms when my labtests are normal, which I also read), and it's blowing my mind!! (pun intended ;-). As a result, the big question I'd be asking you now, is with you working shift work, what is your diet like? Your blood sugar levels? Do you suffer from hyploglycemia (low blood sugar), or insulin resistance (very VERY common in hypothyroidism as our sluggish metabolism means we don't clear glucose from our blood very well anyway). Or do you swing between both?

    I'm just adding this in as something new to consider as I have hypothyroidism, but I crashed on my meds due to having adrenal fatigue. I then read that you will not be able to support your adrenals to fully heal if you have blood sugar imbalances. I've been sugar free for a while now (after I did the whole probiotics thing which helped my gut problems), but I still had high Hba1c that wouldn't budge, even after a year of sugar free, two years of gluten free and being dairy free since my 20s (easily recognised trigger for my misdiagnosed IBS (non-celiac gluten sensitivity).

    Anyways, I read Dr Mark Hyman's book The Blood Sugar Solution, for help to see how to lower my blood sugar and realised I still had a high starch component to my diet, albeit a gluten free one, plus my snacks were a couple of pieces of fruit per day. Not necessarily a bad diet for anyone else, but for me and my longstanding hypothyroidism and really poor metabolism, it was just hidden sugar for me. Notice I haven't said 'carbs' though, cos I still eat plenty of carbs still on the advanced plan in that book, just through non-starchy vegetables. Please note that the advanced plan is temporary, until your metabolism re-adapts, or you could simply follow the basic plan instead. But its good solid diet advice, and not faddish at all. You can still eat meat, your food doesn't need to be raw, and quite frankly, I'm never hungry. Be warned though, there is such a thing as sugar withdrawals if you consider doing the advanced plan with all forms of sugar and starch removed to really get things going. I had two attempts myself, but the first time was more successful I think, because I'd also started taking milk thistle to support my liver (I have a fatty liver with elevated ALT and GGT enzymes). The first time, I stopped after 3 days, thinking I was really harming my body with fad dieting. I had nausea, gurgly tummy, diarrhoea, fatigue, a constant headache, itchy skin, a dry mouth and insomnia. The second time round, knowing now what to expect, actually only lasted a day (but it was still BAD), thanks, I believe, to the milk thistle.

    Anyway, if you also want the exact science behind what blood sugar imbalance does to your brain (hence the fatigue, brain fog, depression, anxiety etc that so many of us with hypothyroidism are dealing with), I seriously recommend you read Dr K's brain book. It also explains why us sorting our anemia issues (low iron/B12) is essential too, as that's oxygen to the brain, the other main cause for so many of our problems, along with inflammation. With blood sugar imbalance, and possibly anemia too, it may well be that your aches and pains are caused by diabetic neuropathy...

    The upside being, that these can all be corrected by diet and the right nutritional supplements. I really hope this helps you. As a vet nurse, I'm guessing you already have a pretty awesome understanding of physiology and science, and this might finally be the clue to the puzzle for you (as it has been for me). And you could potentially get your life back plus some. :-)

    EDIT: Just realised the first of the video clips Heloise shared above talks about blood sugar too! Might I just add, Dr K's book is MUCH easier to follow the why's and wherefore's though. :-D

  • Hi Kim, I would bet glucose is the basis for many of us beginning to stress adrenals. High fructose corn syrup is in so many products in the U.S. I don't use any sugar substitutes except a little xylitol but will look into more hidden sugars. Your post does point out that even when taking enough hormone, you have to correct other areas if you want to feel normal. We need more functional medicine doctors and look at all illness from a holistic perspective. That's why I have posted Dr. Clark's videos as he has 24 reasons for low thyroid. Perhaps there are even more.

  • The Disability Discrimination Act has been superseded by the Equality Act 2010.

    The advice often given is to contact Acas - their website has some useful features:

    acas.org.uk/

  • I have found workplaces to be unsympathetic/unhelpful with this sort of thing. If you are in the USA, the only real option is to get a lawyer to push for a disability determination process through the Social Security Administration, which would allow you to exit your job and be on SSDI while you are dealing with your health. But in many ways, that is unhelpful because you lose your private insurance and income is much reduced.

    Are you on T3+T4, or NDT+T3? If not, you need to get some T3 into your system ASAP to see if that will help to terminate the exhaustion. Have you asked your current doctor about this? If your doctor is a difficult person, you may need another person to go with you (a health advocate) to demand what you need and/or exit your current doctor. It is very difficult to deal with doctors when hypothyroid, too many of them walk all over their patients.

  • Hi AnnaBean. Hypothyroidism is not classed as a disability although yes I agree at times it can be very debilitating. I too suffer from hypothyroidism and also CFS. I am also a vet nurse so understand what a struggle it can be doing such a hard and demanding job with such illnesses behind you. I would agree with some of the others in seeing your GP to ensure your meds are being dosed accurately etc. Good luck xx

  • Iron is needed to convert T4 to T3, so crucial that you get it tested. You can be iron deficient without being Anemic, so don't accept 'you're fine'. Your body will prioritize blood over other organs etc. One sign that you may be low is if your hair is thinning. Your Ferritin level needs to be mid range at least. Mine was rock bottom and I wasn't converting either.

  • This most certainly sounds like low adrenal function. All your symptoms would normally be absent with proper levels of cortisol. The only way to ease this is to rest as much as possible (difficult I know when you work), not become overly anxious or put too much pressure on your system, mentally and physically and take appropriate supplements to strengthen your adrenals. It won't be quick and will depend on how busy and physically active you are and how much energy you need to survive a day. Reducing the strain on your system to support you through the day will help, mentally, emotionally and physically.

    Steroid hormones in the system, continuously, whether from mental, emotional or physical strain (and it doesn't have to be much), seriously hamper the conversion of T4 to T3, and over time resulting in hypothyroidism.

    D3 would certainly help as a pre-hormone, but you also need B vitamins and vitamin C (not both together), protein and hydration, and reduced energy output (just go easy on yourself).

    Hope this helps.

    Been there!

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