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Thyroid UK
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Cognitive issues, thyroid related?

Hi I’m just wondering if anyone has similar symptoms to me or can offer me any advice. I have an under active thyroid and take 100/75 levothyroxine on alternate days so not on a very high dose and all my results are within range. My weight is ok and I have been able to lose weight on a weight watchers recently and I don’t suffer any hair loss. I have been tested for Hashimotos but have been told I don’t have it and ive had a scan and been told my thyroid has shrunk. I have recently been diagnosed with silent chronic migraine ( no headache with it) but I’m not sure if I believe this to be true. I am off work at the moment due to how much I was struggling with life in general! I get very stressed and overwhelmed very quickly, I have very little stamina for simple household tasks, muscle weakness, even gentle exercise can make me really ill, aches and pains, dizziness, hoarse voice to the point it’s an effort to talk sometimes, anxiety, and the worst is that I cannot concentrate and sometimes cannot write things properly or find words. From reading other stories online I believe this could all be thyroid related. I am desperate to find something that will help, I can deal better with the physical symptoms but the cognitive ones are ruining my life 😢 if I can’t think straight I will lose my job and then everything else 😔 I’m just wondering if anyone may have any suggestions of what may help? I’ve just had a course of B12 injections and have started taking 400mg of magnesium citrate and 200mg of B2 and have had a good dose of vitamin D.

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Hi Eliza,

I’m sorry to hear you’re feeling so rough. Please could you post all the results you have including the ranges? You can ask your surgery for them. Then I’m sure someone will have a look for you.

Sarah

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Hi Sarah

A while ago I had lots of results (ranges in brackets) including:

Ferratin 64 (15-300)

TSH 3.09 (0.35-5.5)

Free T4 10.8 (7-17)

Free T3 4.8 (3.5 -6.5)

SHBG 36 (18. -136)

I rang and was told my results were fine but I thought my TSH was high so went to see the doctor who agreed and lowered my thyroxine. My latest results only gave me

TSH 1.92

T4 10.1

T3 4.6

I am confused that my TSH is better but my T4 and T3 have gone down.

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Are you sure your doctor lowered the dose of levo because your tsh was high? That makes no sense.

Did you have both the bloods taken fasting and early in the day before taking your levo?

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Hi I just had a rethink because someone else said that! I think then that I came down from 100 to 75 then got put on 100/75 on alternate days, that probably makes more sense!

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It's free T4 and Free T3 that are important,not TSH and high TSH means levo should be INcreased. Thyroid shrinkage/destruction is often due to Hashis/autoimmune thyroid disease and there are two types of antibodies: TPO and TG. Were both tested?

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I don’t know, she just said I didn’t have the antibody. I really need to be a bit more pushy I think 😂 The only info I can find about your thyroid shrinking online is in relation to hashis. I want to know if I do have that because I know your risk of other autoimmune disease is higher so I’d like to be on the lookout! Also I’ve heard that there are things that you can try diet wise etc if you have that. I may have got confused with the Levo dose actually then, it may have been that I came down from 100 to 75 then up to 75/100 on alternate days because my TSH did come down to 1.92! I think I will ask what I was tested for then! Thank you 😊

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Your TSH is liable to jump around independant of your dose, when you have Hashi's, so you should not be going by that. The important numbers are the FT4 and FT3 and they are much too low.

You cannot rely on antibody tests to prove you DON'T have Hashi's - in this case, at least, you can't prove a negative. Did your doctor even test the antibodies before pronouncing that you didn't have it? They often get... shall we say, 'confused' about these things. The scan gives better information, and it sounds as if you do have Hashi's. The diet change you're talking about is a 100% gluten-free diet, to reduce antibodies, which often makes people feel generally better. You can also try taking selenium. But, what you really need is a suppressed TSH - if you can wangle that, because doctors tend to get a bit hysterical when they see a suppressed TSH, because they don't really understand what it's all about!

But, above all, you do need an increase in dose. It doesn't look as if you have a conversion problem - which is one great blessing! - but neither of your Frees are high enough at the moment. Most people need their FT3 up the top of the range to feel well. So, a 25 mcg increase in levo would probably help you enormously. :)

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Thank you :) I'm back in to see my regular GP on Friday but I did have a word with a doctor from the surgery this morning who thinks it is a reasonable request to try an increased dose, so fingers crossed...!

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Well, that's good, then. :)

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Do you have the results for your B12 - before you started the injections ? What was the course of B12 jabs ? - every other day or otherwise ?

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Hi Marz

Yes it was 180 (range 150 to 900) I had tablets for 3 months and it hardly went up so then had loading doses, 6 injections every other day then was told I should be fine now for a few years. The only thing I noticed was that my breathing got a bit better (I also get very, very out of breath after hardly having done anything).

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That b12 level was definitely too low. I’m not convinced by the advice that you’ll now ‘be fine for a few years’. Are you vegetarian or vegan? I’m wondering why it was low

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If you have cognitive issues - then the B12 injections should continue until symptoms are no longer there. There are Guidelines for Folate and Cobalamin ( B12) Deficiency that your GP should have read and followed. Did you have your Folate tested - as it works in the body in a VERY important way with the B12 ?? It is possible you will also be LOW in VitD and Ferritin - have they been tested ? Low Iron and Ferritin could be the cause of your breathlessness. Folate works with B12 for the formation of new red blood cells so this will cause lack of breath as oxygen is transported in iron in the red blood cells ...

Jarrow Methylcobalamin B12 lozenges work well for some - keep them under the tongue until dissolved. I would also suggest a B12 Complex to keep all the B's in balance and provide Folate or Folic Acid - the first is natural and the FA is synthetic.

onlinelibrary.wiley.com/doi...

The Guidelines are in the link above - and you will see No.1 point is to observe the clinical signs first - which would be irrespective of the blood test :-)

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Thank you for that I will have a proper look into it. I have also had low folate about 3 times over the last few years. The doctor did ask me for a stool sample to see if I had absorption issues but it was apparently fine and she’s no longer looking into it. My last folate result was 6.5 the range just said > 3 so she said it was fine this time. They weren’t even going to treat me for the B12, I had to go in and ask because when I phoned up for my results they just said they’d been filed as fine!!!

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You should be supplementing B12 to maintain levels along with the folate - with a GOOD B complex like Thorne Research - as often suggested here on the Forum :-) Please remind your GP of the Guidelines - and NEVER accept FINE !!!

I see you have had a good dose of VitD - sorry missed that before ! So what was your level before the good dose and how much did you take ?

grassrootshealth.net

vitamindcouncil.org

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Ah well I’m not sure what my level was because they don’t seem interested in that kind of thing and when I asked about it I just got told to take a standard multi vitamin from the supermarket 😂 my mum lives in France and is prescribed Vit D because she has under active thyroid (my dr didn’t believe this) she takes a high dose every 3 months so she brought me one of hers! I thought I’d just take that for now then I’ve got some D3 1000 IU to start on. I opted for the high dose of B2 because that is meant to be good for migraine but I think I will switch to a B complex after this lot. It is just so hard to know what you need to take, there is a lot of information online but I don’t know if it is trustworthy and it is all so complicated! Thank you I will have a look at the one you have suggested. 😊

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The links above are about VitD in general - and not specific products. Thought you may want to learn more. Both American so beware the measurements differ from the UK ! Taking too much VitD can be unpleasant - hence it is important to know your levels so you can assess the correct dose. I have also read that taking a large amount once a week or once a month is not as effective as taking it daily. When taking large amounts of VitD3 it is important to also take co-factors - Magnesium and VitK2-MK7

I think your Mum will be taking large amount of VitD because her levels were low - which is often the case when Hypo - so not quite the same :-(

Do you mean B12 rather than B2 ??

You can always ask here about which vitamins and minerals to take - lots of very knowledgeable members. However they will almost always say - get tested first :-)

You can always tell a Hashimotos person - they rattle ! Oh you must always ask for Copies of all results then you can see for sure which anti-bodies were tested. GP's often say fine because they DO NOT understand Hashimotos in most cases !

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I did speak to the doctor about taking extra supplements, she knew I was considering high doses because of the migraine diagnoses. I wanted to be tested but she just said that my levels should all be okay because my diet is ok 😠 I did mean B2, this is supposed to be good for migraine prevention.

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One thing you must understand, right from the start, is that doctors know nothing about nutrition. They just don't do it in med school. Asking a doctor for advice about diet is like just stopping any stranger on the street and asking them - you might strike lucky and they might know what they're talking about, but the odds are they won't.

One of the problems hypos face is that their low T3 causes low stomach acid, which causes low B12, which causes even lower stomach acid, etc. etc. etc. You are not what you eat, you are what you absorb. And hypos absorb very little. So, rather than listening to your doctor on this point, read the posts on here - especially those by SeasideSusie and Marz, and get your nutritional information from them. :)

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' Brain Fog' seems to be very common amongst hypothyroid people. You could be low in the Active hormone i.e. T3 which is converted from T4 and you may not be on sufficient. All vitamins and minerals have to be optimum too.

I'd suggest you get a Full Thyroid Function Test which GP usually wont do as they've been told TSH and T4 is fine and keep the TSH within the range. In fact we need a TSH of around 1 or lower. We also need a Free T4 and Free T3 blood test and these should be towards the upper part of the range. I shall give you a link and read about these two Frees.

All blood tests have to be at the very earliest, fasting (you can drink water) and allow a gap of 24 hours between last dose of levo and test and take afterwards.

We also have two labs which will do home pin-prick tests and if you decide to do this make sure you are well-hydrated a couple of days before and arms warm when you draw blood.

You need TSH, T4, T3, Free T4, Free T3 and thyroid antibodies.

GP should test B12, Vit D, iron, ferritin and folate.

Get print-outs with the ranges (we are entitled to our results). Some surgeries charge a nominal sum for paper.

thyroiduk.org.uk/tuk/testin...

thyroiduk.org.uk/tuk/testin...

T4 is an inactive hormone and has to convert to T3. T3 is the only active thyroid hormone and is needed in our millions of T3 receptor cells so that our metabolism works smoothly. Brain and heart have the most T3 cells.

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Thank you for that info! I did get my results but the last ones weren’t very comprehensive! I’ve put them in another reply above. I will have a look at those things, thank you.

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You may need to increase levithyroxine to150 per day and it will help you. Are you sleeping in the night all the way through. If you were at weight watchers you are not taking in enough calories to sustain your energy levels.

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I tend to go through phases with my sleep but I also have a 6 year old who goes through phases of waking multiple times in the night 😂 when I was on 100 she told me it was too high 😔 I had to start the ww because I had put weight on and couldn’t afford to buy a whole new wardrobe, I really needed to lose the weight ☹️

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