Cold, tearful, tired in afternoon: I’ve been on... - Thyroid UK

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Cold, tearful, tired in afternoon

Girlslovescifi profile image

I’ve been on the same dose of NDT for a while and have regular, pretty thorough checks that show T3 and T4 in the upper third of the range. Over the last 3 or 4 weeks, I’ve noticed I wake with a good amount of energy and do a bit of a workout. I’m in a good frame of mind, but by lunchtime I’m cold (my temperature is often towards 36C and sometimes ventures into 35 and the only time it’s 37C is if it’s hot out) and I get tired and tearful. Now I do suffer from anxiety, so the Covid situation hasn’t helped me. I do wonder if all my symptoms are related to that and possibly adrenals, rather than thyroid. I am hesitant to get my blood taken at the clinic for obvious reasons. I am speaking to my doctor on Tuesday. Any advice?

20 Replies

Hello Girlslovescifi

Without any actual blood test results to comment on, can I just say that generally, when on NDT your TSH will be low / suppressed and your T4 low in range with a T3 high in range.

Maybe you are not converting the T4 component very well, have you checked out your ferritin, folate, B12 and vitamin D - as no thyroid hormone works well if these aren't maintained at optimal levels.

It might be worth increasing your dose of NDT as generally you treat to the relief of symptoms not a blood test result, just being mindful of where your T3 is and obviously the timing of the blood test to your last dose of NDT.

These are from about 7 mo ago. My free T4 is 20.4 pmol\L (range 11 - 23) and free triiodothyronine is 6.78 (3.1 - 6.8). My B12 is 268 ng/L (180 - 800); serum ferritin is 108 (12 - 233); serum folate (42U5.) is >20.0 (3.9 - 27). I have been taking a liquid B12 3000mcg meyhylcbalamin and 2500iu D3 ever since.

Well maybe you need to run some blood tests as otherwise it's all guesswork isn't it ?

You’re right of course. I remember after my daughter’s wedding four years ago my TSH had gone up (was on levo then), so it may be the stress of COVID. I’ll get the test done. 😷 Thank you!

SlowDragon profile image

Are you splitting your NDT into two doses?

Or only taking as single dose?

Recommended on here that all thyroid blood tests should ideally be done as early as possible in morning and before eating or drinking anything other than water .

If/when on NDT make sure to take last third or half of daily dose 8-12 hours prior to test, even if this means adjusting time or splitting of dose day before test

Is this how you do your tests?

Private tests are available as NHS currently rarely tests Ft3 or thyroid antibodies or all relevant vitamins

List of private testing options

Medichecks Thyroid plus ultra vitamin (doesn’t include folate)

Thyroid plus vitamins including folate (private blood draw required)

Thriva Thyroid plus vitamins

Blue Horizon Thyroid Premium Gold includes vitamins

If you can get GP to test vitamins cheapest option for just TSH, FT4 and FT3

£29 (via NHS private service ) and 10% off if go on thyroid uk for code

Medichecks - JUST vitamin testing including folate - DIY finger prick test

Medichecks often have special offers, if order on Thursdays

Thank you. I split my dose and always follow the protocols for testing that I learned on here. My GP has been doing more thorough tests, rather than just tsh. I will see if I can get the full range of tests when I speak to my doctor. I have relapses into eating gluten and because I’m vegan now, I’m eating more soy and walnuts. Not sure if that’s affecting absorption.

SlowDragon profile image
SlowDragonAdministrator in reply to Girlslovescifi

Soya is all forms not recommended for anyone on any thyroid medication

If vegan you will need to supplement B12 daily and regularly test iron and ferritin. Likely to need to supplement but essential to test iron levels first

Obviously gluten free diet needs to be absolutely strictly gluten free to be effective

Thank you. I do supplement with B12 and D3. Iron and ferritin were okay last test, but time for a repeat. I’ll do my best to eradicate soy and gluten in future.

Hi, slightly off your topic, but could you tell me which brand of B12 Methylcobalamin liquid you have ? I've noticed that most of the B12 liquids don't seem to be methylcobalamin.?

Thank you.

SBR Nutrition. I bought it from Amazon. £21 for 2 ounces

I tried vegan. A lot of vegan foods contain ingredients with impact negatively on thyroid absorption.

It’s not something I’m prepared to change, except omitting soy and gluten. My GP told me today that he believes a vegan diet is the healthiest. During lockdown I got into bad habits of eating ready meals that contain processed soy. I won’t be doing that any more.

in reply to Shredder

Only if you buy ready made or processed food. If you're making from scratch you can simply leave out the ingredients that interfere with levo absorption. 🙂🌱

Girlslovescifi profile image
Girlslovescifi in reply to


Hi. It all depends on the NDT ypu are taking as there are a huge number of patients that are reporting a return of hypo symptoms (including myself) as most (if not all) NDT has had quality issues in the last six or so months.

I went back to WP Thyroid as soon as it became available again.

Sadly, so did I. I bought three months supply but knocked them on the head within one week as my hypo symptoms returned with a vengeance. Sadly I maxe ghe mistake of paying more money again on Armour but thst has gone South too 😒

Oh I’m sorry to hear that! Hope you find something that helps.

Thank you , I'm having tiredness in the afternoons myself, but mine is an adrenal problem !

Thank you for replying, and all the best with your journey!!

Thanks. I also have had adrenal problems with high cortisol.

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