I'm on 125 lethrothyroxine but feeling very tired and not sleeping well. I work full time in year R in an infant school so a full on job then 2 evenings at Tesco. I'm gluten, dairy and soya free after having severe bowel problems leading to 15 stays in hospital due to bowel obstruction in 2 years. Had 1/3 of my bowel removed last year and still take laxido daily to keep rest of my bowel working. Want to feel more alive and has anyone else had the same bowel problems? I'm new to this group
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Kerry1971
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Your T3 level is just under half way through range and many need it slightly higher to function well.
Constipation & bowel problems are common in hypothyroidism as when thyroid hormone is low, our metabolism slows up. It is possible to have reasonable test results but still exhibit hypo symptoms as the test result is only an indication of what is circulating in the blood and not what is working on an intra-cellular level.
Ask your GP to test Vit B12, folate, ferritin, Vit D and post results complete with ranges (numbers in brackets) for members to comment. Optimal levels in these are required for good thyroid hormone synthesis.
I have used psyllium husk and prune juice in previous years, although most of my gut issues resulted in alternating constipation//diarrhoea. I have also taken Glutamine with Marshmallow Root & Slippery Elm Bark for a sore upset tummy. Since being gluten free with optimal thyroid hormone, my gut issues have improved enormously.
I agree with radd that your t3 is probably too low for you and it'd be worth getting a full thyroid panel with rt3 thrown in.
It may be worth you (or a partner/friend) testing your resting heart rate at bedtime and in the morning: If you're struggling to sleep, it could be that your heart is going pretty fast. The science is tricky and I'm not very good at explaining it, but glutamate receptors being fully wired at bedtime, but switched off in the morning will result in bad sleep and not being refreshed in the morning. Good sleep hygiene is a must... so light reading, or watching something you've seen before and switching off all devices in the hour before bed!
There are minerals like magnesium and co-enzyme Q10 that work very well in the evening; so do some amino acids. The best alternative to amino acid supplements, which can be harsh on the tum, is drinking traditional bone broths as they're very gentle on a sensitive gut. In the morning, B vitamins (especially B12) can help with feeling awake. Taking digestive enzymes can help speed things up and stop you feeling tired after meals.
As well as Vit D, B12, folate and iron, there is selenium and magnesium which'll help with t4's conversion to t3.
If you have bowel problems you may not be absorbing iron well, another reason to have both your iron and ferritin ( the stored iron) tested, as being low in either can make you feel tired.
Thanks everyone. I have book a dr appointment but got to wait until November. I have been diagnosed with slow transit constipation and the nerves and muscles in my bowel don't work. My bowel was to long, floppy and loopy so kept getting volvolus where the bowel twists or folds over itself causing bowel obstruction. Removing 1/3 of my bowel last year has helped a lot. Will ask my GP to do more tests
No, your TSH is suppressed because you are on replacement therapy. TSH has no meaning once you are on thyroxine it is the doctors way of dismissing how you feel! Are you a person or a set of numbers? Decide to argue your point or continue to be 'doctor pecked'.
Vitamin B12 is absorbed through through the ileum (last section of the small intestine) so gastric surgery will have affected absorption. It's, therefore, essential Kerry that your GP ensures you do not become deficient and is, hopefully, monitoring and treating with B12 injections for life?
See the BCSH B12 deficiency guidelines on page 4 :
(Page 2). Box 1 Common causes of vitamin B12 deficiency:
* Gastrectomy—partial or total
(Page 5 ) under Summary of treatment and management of vitamin B12 deficiency
"Prescribe lifelong maintenance parenteral vitamin B12 treatment with hydroxycobalamin 1 mg intramuscularly every three months if no neurological deficit, or every two months if there is neurological deficit to all those with irreversible malabsorption or after gastric surgery, pernicious anaemia, and any other irreversible cause "
Thanks for this information. I have never been told this even by my colorectal surgeon. I had my sigmoid colon removed which is the last part of the large bowel. I will be seeing my surgeon in a few weeks and my GP too so will ask for more blood tests.
I'm horrified that you were not told of how important B12 injections are now that you are unable to absorb it efficiently!
The PA Society are very helpful if you have any problems with treatment and the HU PA forum here gives lots of support and information. Very few clinicians are clued up on PA/B12 def. so it's essential to read up as much as you can Kerry, before deficiency leads to neurological problems.
Your T3 is only 36% up in range. Generally, T3 needs to be at least 50% up in range. In your case, you should have had a free T3 (FT3) because that gives you a better measure of how much T3 is actually unbound and available to be used by the body. I suspect you would benefit from reducing levo and adding in T3 (or using NDT).
I also had bowel issues (due to celiac enteropathy) but did not have to have part of my bowel removed. What I do know, is that loss of digestive power can have very significant effects on nutritional levels, leading to poor sleep. Have you had a CMP (Comprehensive Metabolic Profile)? It has been my experience that doctors don't pay much attention to blood protein levels. But, in a case where part of the bowel has been removed, you have likely lost some ability to digest protein foods. Look closely at both your albumin and Total Blood Protein (TBP) levels. James LaValle's book recommends that TBP be in the 6.5-8.0 g/dl range, with the sweet spot being about 7.2 g/dl. You have the option of using free essential amino acids to boost TBP, and this can produce much better quality sleep. (I use the NOW Amino-9 product for this reason. TrueNutrition.com has a less expensive essential aminos blend.)
Of course, you could have other deficiencies. Absorption of B vitamins, trace minerals, D3, etc. etc. could be negatively affected by loss of bowel function.
I have always suffered with horrendous bowel problems. Seen consultants and treated with surgery for fissues and hemmorhoids after years of constipation! Was also told I had sluggish bowels and given lactulose on prescription BUT after starting a very low dose of t3 this years with my t4 (I self treated) and I measure my free t3 and other thyroid levels every 6 to 8 weeks whilst tinkering the dose i can honestly say my bowel problem is a thing of the past. I go every day!! Without lactulose and used to go sometimes once a week!! I'm not saying this will be the answer for you but might be something you want to try. You can always go back if u don't get on with it. My one piece of advise would be to start very slowly on a tiny dose of t3 and increase slowly. It took me some time to get the dose right but it was worth it. I also take magnesium at night and since my dose has got my levels in the optimal range my sleep is now also improving!
How do you test you levels every few weeks? My GP will only do it once a year. How do I get T3 medication too. My bowels were awful before I started thyroid medication but got a lot better for a few years. Then 3 years ago I got rushed to hospital with bowel obstruction. This went on for 2 years with 15 stays in hospital for a week to two weeks at a time. My bowel was so stretched and floppy that surgery was the only answer. Not had a bowel obstruction since. Was in hospital for 2 weeks when I had my surgery which took 5 hours. I'm doing a lot better now.
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