Exhaustion levels: Hi all, My exhaustion levels... - Thyroid UK

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Exhaustion levels


Hi all,

My exhaustion levels are pretty much consistent all day long, getting a bit better now that I'm on Levo. Apart from between 10 and 11 in the morning where I can barely keep my eyes open and could pass out, sometimes have to in the work toilet or if I'm home, on the couch. Just for ten minutes mind you and then I'm OK.

I've had blood tests for diabetes and I'm all clear on this.

Is this thyroid related?

14 Replies

It's difficult to say what may be going going on without seeing your actual blood test results. Could be thyroid, adrenals, vitamin/mineral deficiency or something else. Can you get a printout of your latest bloods and post them here with all lab ranges?

Serum TSH level 6.93 mu/L 0.27 - 4.20 Abnormal 11 Jun 2018

Serum free T4 level 13.4 pmol/L 12.0 - 22.0 Normal 11 Jun 2018

TSH fluctuates between 6 and 9, looking at previous tests.

Liver tests show

Serum bilirubin level 26 umol/L 1 - 21 Abnormal 11 Jun 2018

Serum alkaline phosphatase 75 iu/L 30 - 130 Normal 11 Jun 2018

Serum total protein 73 g/L 60 - 80 Normal 11 Jun 2018

Serum albumin 49 g/L 35 - 50 Normal 11 Jun 2018

Serum globulin 24 g/L 18 - 36 Normal 11 Jun 2018

Serum ALT level 73 iu/L 0 - 41 Abnormal 11 Jun 2018

All over blood tests show as normal.

Do you need any further information?

When did you start levo and what's your dose? Looks like they haven't tested your Vitamin D, B12, folate or ferritin either. Those four are essential for optimal thyroid function.

Your liver tests are abnormal but I'm unable to comment on those sorry!

Started Levo about two weeks ago. I'm on 50mg.

I have tested for Vitamin D, B12, folate and ferritin, they are all good.

Serum vitamin B12 511 ng/L 191 - 663 Normal 11 Jun 2018

Serum folate 6.2 ug/L 3.9 - 26.8 Normal 11 Jun 2018

Serum ferritin 47.1 ug/L 30 - 400 Normal 11 Jun 2018

I was being prescribed Vit D but my levels went back to normal and the NHS "cannot afford tp pay for these"

While your results are within the lab range, they are not optimal. Your folate and ferritin are both on the lower side, they should be in the upper third of the reference range. What are your latest vitamin D results? That needs to be between 100-150 too. Your B12 is ok, but include it in each blood test you have because it shouldn't fall below ~500. Possibly start a good B Complex as well as a liquid iron supplement to raise your ferritin. Eating liver if you don't already will help too.

It's still early days for the levo. You should be due a review next month or so I imagine. Keep us posted and hopefully you start feeling better soon.

Thank you. Will keep you posted

in reply to prince_huggy

If you just started on levo two weeks ago on 50mcg you will need another blood test every six weeks with a 25mcg increase in levo until you feel well and TSH is 1 or lower.

Your ferritin and folate are too low and those who have more knowledge than me will respond as to how you can increase folate and also ferritin.

Blood tests always have to be at the very earliest possible, fasting and allow a gap of 24 hours from your last dose of levo and test and take afterwards. This helps to stop GP adjusting dose unnecessarily as they only look at the TSH and T4 and know no clinical symptoms at all. They used to diagnose upon our symptons alone before blood tests and levo were introduced.

If you can get a Full Thyroid Function Test it will give a bigger picture. This is TSH, T4, T3, Free T4, Free T3 and thyroid antibodies. Antibodies are required so that we know if we have an Autoimmune Thyroid Disease or just straight forward hypothyroidism. If antibodies are present the attack the thyroid gland and wax and wane until we're hypo. They can be helped to reduce by going gluten-free.

Always get a print-out of your results with the ranges. Ranges are important as labs differ and it makes it easier for members to comment upon them.

Also ask for B12, Vit D, iron, ferritin and folate. Deficiencies in these can also cause symptoms.

in reply to shaws

Nice one. I'll get all of this done when I'm next tested.

in reply to prince_huggy

Don't be surprised if GP only tests TSH and T4. If so, and you can afford a private test, we have to labs and Medichecks has a special offer of some sort every Thursday but both are good labs. They are pin-prick tests and if you decide to do this make sure you are well-hydrated for the blood draw. I haven't done it but many have and if you have any queries put up a post asking how easy it was to draw pin-prick blood. Labs may also make a suggestion of where to draw or GP might be willing.

Blue Horizon/Medichecks.


You should have bloods retested after 6-8 weeks on starter dose.

All thyroid tests should be done as early as possible in morning and fasting and don't take Levo in the 24 hours prior to test, delay and take straight after. This gives highest TSH, lowest FT4 and most consistent results. (Patient to patient tip, GP will be unaware)

Dose of Levothyroxine is increased in 25mcg steps until TSH is around one and FT4 towards top of range and FT3 at least half way in range

Bloods retested 6-8 weeks after each dose increase

You likely need to take daily vitamin D Aiming to improve to around 100nmol. Vitamin D mouth spray by Better You is good as avoids poor gut function. It's trial and error what dose each person needs. Once you Improve level, very likely you will need on going maintenance dose to keep it there. Retesting twice yearly via vitamindtest.org.uk

Also read up on importance of magnesium and vitamin K2 Mk7 supplements when taking vitamin D







Thank you. My Vit D levels are OK or will this change now?

in reply to prince_huggy

You need to test in few months.

What's actual current level of vitamin D?

Last time I was tested

Total 25-hydroxyvitamin D levl 68 nmol/L 30 - 200 Normal 23 Jun 2016

in reply to prince_huggy

That's too low when hypothyroid

Vitamin D council recommend 100-150nmol. On here we recommend around 100nmol

Vitamin D mouth spray by Better You is good as avoids poor gut function. It's trial and error what dose each person needs. Once you Improve level, very likely you will need on going maintenance dose to keep it there. Retesting twice yearly via vitamindtest.org.uk

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