Confused and fed up.

[Annista]

Hi Y'all

I have had asthma for more years than I can count and although it's mostly under control I have had a difficult time with the side effects of some of the medication. For years I have been exhausted from the time I get up until I go to bed, when I don't sleep well. This means that I fall asleep in meetings at work and sometimes even when I'm working at my p.c., and although I've moaned about it to my GP he has pointed out that difficulty sleeping is one of the problems I can expect while using the various preventers and relievers that have been prescribed for the asthma.

However, after a particularly whiney conversation a blood test has been done and I have been diagnosed with hypothyroid, which is causing me some confusion as many of the symptoms identified on the Thyroid UK website could also be caused by my current asthma medication or by the asthma itself.

When I'm feeling hopeful I can make myself believe that the tiredness and lack of energy could be largely due to the thyroid problem, which might mean that I can start functioning more normally, but I have been taking Levothyroxine 50 mcg for 16 days now and I'm still falling asleep at work so I wondered if any body could give me some idea of when it would be reasonable to expect to stay awake all day, assuming the reason for the exhaustion is the thyroid problem and not the asthma medication.

At the moment, I feel that I can put up with all the other symptoms, whatever is causing them, if I can only get through the day without falling asleep every time I sit still for more than five minutes!

[Clutter]

Welcome to the forum, Annista.

It takes 7-10 days to absorb Levothyroxine before it starts to work and up to six weeks to feel the full impact of the dose. Thyroid replacement is introduced gradually to avoid shocking the body so 50mcg starting dose will probably need to be increased every 6-8 weeks until TSH is 1.0 or lower with FT4 in the upper quadrant of range. Symptoms may lag behind good biochemistry by a couple of months.

For maximum absorption Levothyroxine should be taken with water 1 hour before or 2 hours after food and drink, 2 hours away from other medication and supplements, and 4 hours away from calcium, iron, vitamin D supplements and oestrogen.

You should have a follow up thyroid test 6-8 weeks after starting Levothyroxine. Arrange an early morning and fasting (water only) blood draw when TSH is highest, and take Levothyroxine after your blood draw.

thyroiduk.org.uk/tuk/diagno...

thyroiduk.org.uk/tuk/about_...

________________________________________________________________________________________

I am not a medical professional and this information is not intended to be a substitute for medical guidance from your own doctor. Please check with your personal physician before applying any of these suggestions.

[Annista in reply to Clutter]

Thanks for the advice, Clutter. I feel a lot better knowing that I could be looking at 6 weeks before I feel much improvement.

I always have my thyroid medication in the morning before I go for my swim so it's well over an hour before I eat, but I'll make sure that I wait a full hour before eating or drinking on the days that I don't swim.

The instruction I got from my GP was 'take one tablet every morning and get another test done in mid-August' so thank you for the information about the blood test - I wouldn't have known to fast without it.

[humanbean in reply to Annista]

You must also not take any thyroid meds for 24 hours before the blood draw. Take them after the blood is taken instead. So if your blood test is on a Thursday, early morning, take your levo on the Wednesday morning as usual, but take your Thursday dose after the blood draw.

The reason for this is that doctors dose according to blood test results, they don't care about symptoms.

TSH : Not eating until after the blood draw, and getting the blood draw as early in the morning as possible (before 9am) will maximise your TSH.

Free T4 : Not taking your meds for 24 hours before the blood draw will minimise your Free T4.

Both these results are desirable if you want to either get your meds raised, or don't want them reduced.

[Hather in reply to Annista]

HI Annista, I got diagnosed last week as well, there seems to be so much to understand, I was completely unaware of the ins and outs of everything, ?I also have a further blood test in six weeks and did not know about the fasting so that was very helpful info..people have been so kind and helpful,on here which is really reassuring, as 10 minutes Drs appt.doent give much time for asking questions, as their time seems to be typing on the computer, when all,you want is to talk

And catch their eye.

HAther 😊

[vixvixvix]

Hi Annista,

If your asthma is triggered by dust and pollutants in general, it's worth investing in a good quality air purifier if haven't already.

About 1 year ago my asthma took a turn for the worse and I was having really bad quality sleep and wheezing and needed to use my blue inhaler constantly and all the doctor would say is take more preventative. I don't know why, but I decided to buy an air purifier?? Once I bought the air purifier for my bedroom, the asthma symptoms disappeared almost overnight and because the lungs are getting a good rest at home and during sleep time, 100% more resilient during the day (except when I'm around a ton of animal fluff or really strong perfume, but now it just irritates rather than need inhaler). The quality of sleep improved dramatically (because I wasn't working so hard to get the previous oxygen needed) and I woke still tired, but heaps better. Yes, the rest was up to getting the thyroid bit right... and I'm literally a different person from 6 months ago. Not perfect, but super energetic and may be 90% symptoms gone. And I no longer use any asthma medication at all.

The other thing I do is nasal irrigation to remove the pollutants from my nasal passage- amazingly i also haven't taken any anti histamine in the 2 year or so I started doing that. My sister lives in Berlin where the air is much cleaner and she was on may be 3 anti h, steroids and all sorts of meds for her asthma and just this sorted her out entirely - from being told she is on a bunch of meds for life to absolutely no asthma meds in about 6 months. Both of us still go back on the anti h regime when we're visiting super polluted areas like Hong Kong, but mostly it's fine (I live in London and that's pretty dirty).

You can find out all about air purifiers on asthma Uk, which has a list of recommendations. For nasal irrigators I'd recommend the acculife syringe thing which is much easier to use that a traditional neti and much safer than the squishy bottles (you'll get it when you look it up on the big online market!).

** Sorry, I know you're asking about thyroid meds but just thought I'd give you some personal experience on asthma which might help you if it reduces the amount of meds you have to take for it since you suggested that it's the meds causing the problem.

Otherwise, Clutter gives fantastic advice!

[Angel_of_the_North in reply to vixvixvix]

One of those negative ion thingies helped me too and I had an air filter in my bedroom - so long ago now I'd forgotten about it. Also look up Dr Steven Park who has an ebook about clearing your nose so you can breathe through it instead of your mouth - stopping mouth breathing is one of the main tenets of the Buteyko programme - and it is so hard to do.

[Angel_of_the_North]

I had asthma from early childhood and meds never gave me sleep problems - although I was always tired and could sleep for Britain. However, when I got my hormones balanced and supplemented MSM, my asthma pretty much went - I haven't need the inhaler for 5 years (from 10 puffs a day). So might be worth a try. I also did Buteyko breathing and bought a cheap Frolov device from Russia on ebay. If you have been using a sterod inhaler, your adrenals could be overstressed (I ditched mine in the 1980s and just stuck with the salbutamol as I kept getting throat infections - GP never noticed and it made no difference to attack frequency).

[Annista in reply to Angel_of_the_North]

After having 12 weeks off work in 2001 I stopped all of my inhalers and gradually improved to the extent that I forgot I had asthma. All that came to an end on 2010 when some renovations to our flats set me off for several months. I am working hard on getting back to that situation. It's just taking me longer this time!

[MariLiz]

Ask for your B12 levels to be tested, if that is low, (and it often is with thyroid problems), then your levels of tiredness and exhaustion will continue.

[Annista in reply to MariLiz]

Thanks MariLiz - yet another thing I didn't know! I'll check what's on my the form I was given to take with me and if that isn't I'll call the GP and ask for a new one.

[Annista]

Thanks to everyone for the time you have taken to help me out. You've made me feel very welcome and the information you have given me will be very useful when (if?) I get to see a GP.