Tips to combat fatigue due to Hashimoto's Thyro... - Thyroid UK

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Tips to combat fatigue due to Hashimoto's Thyroiditis

Mistycal profile image
22 Replies

Hi all, this is my first post on here and I'm looking forward to supporting each other on here. 🙂

I am currently suffering from severe fatigue/ lethargy (possibly due to Hashimoto's) and wanted to ask if anyone could recommend some helpful tips in feeling more energetic? I am taking 100mcg Levothyroxine per day, iron and Vitamin D tablets but not seeing much change in my energy levels. Thank you x

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Mistycal
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SlowDragon profile image
SlowDragonAdministrator

Welcome to the forum

How long have you been on 100mcg levothyroxine

Do you always get same brand of levothyroxine

Do you have recent test results and ranges to add?

How low was vitamin D, how much vitamin D prescribed and have levels been retested

Same question for iron and ferritin

Important to regularly test B12 and folate too

Have you had Hashimoto’s confirmed by testing thyroid antibodies?

Mistycal profile image
Mistycal in reply toSlowDragon

Hi SlowDragon. My serum free T4 level was at 3.0 pmol and TSH level was 96.97. I stayed a week in hospital on 14/07 and got discharged on 22/07. They said I was suffering from Subacute Thyroiditis and put me on antibiotics which I have now completed its course. I was originally on 50mcg Levothyroxine in June but this got increased to 100mcg whilst I was in hospital but since returning home I have felt severe tiredness and low energy. My Vitamin D levels are at 25. I am anaemic and was prescribed iron tablets for this.

Lalatoot profile image
Lalatoot in reply toMistycal

Your body needs time to recover. You have been very poorly. It takes time with thyroid hormones for them to adjust levels and then for the body to adapt to the adjusted levels. Resting and eating well are initially the best. When you feel you can gentle pottering about and exercise but don't overdo it.

Mistycal profile image
Mistycal in reply toLalatoot

Thank you Lalatoot. I'm on sick leave till the middle of August so been trying to take things easy and work out ways I can help myself ❤️

SlowDragon profile image
SlowDragonAdministrator in reply toMistycal

A Ft4 so low and TSH so high is going to take some time to recover from

You are going to need to pace yourself carefully

How many weeks have you been on 100mcg?

Bloods should be retested 6-8 weeks after dose levothyroxine was increased to 100mcg

Is the 100mcg levothyroxine the same brand as previous 50mcg?

For full Thyroid evaluation you need TSH, FT4 and FT3 plus both TPO and TG thyroid antibodies tested.

Also EXTREMELY important to regularly test vitamin D, folate, ferritin and B12

Low vitamin levels are extremely common, especially if you have autoimmune thyroid disease (Hashimoto's) diagnosed by raised Thyroid antibodies

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 .

Last dose of Levothyroxine 24 hours prior to blood test. (taking delayed dose immediately after blood draw).

This gives highest TSH, lowest FT4 and most consistent results. (Patient to patient tip, best not mentioned to GP or phlebotomist)

Levothyroxine is an extremely fussy hormone and should always be taken on an empty stomach and then nothing apart from water for at least an hour after

Many people take Levothyroxine soon after waking, but it may be more convenient and perhaps more effective taken at bedtime

verywellhealth.com/best-tim...

No other medication or supplements at same as Levothyroxine, leave at least 2 hour gap.

Some like iron, calcium, magnesium, HRT, omeprazole or vitamin D should be four hours away from levothyroxine

Mistycal profile image
Mistycal in reply toSlowDragon

I've been on 100mcg since the week beginning 13th July so just a few weeks. The packaging is different to the original 50mcg I was taking.

I have been considering taking Levothyroxine at night as right now I am waking at 6am, taking my tablet then going back to sleep and unsure if this is affecting anything?

I'm also concerned I am developing chronic fatigue. My tiredness feels very different to usual tiredness. I feel zapped off all energy even if I've been to bed early and wake up drenched in my own sweat,something ive never had before.

SlowDragon profile image
SlowDragonAdministrator in reply toMistycal

Night sweats often linked to low B12

Request GP test B12 and folate NOW

low vitamin levels are EXTREMELY common. Improving low vitamin levels by supplementing can significantly improve symptoms

How much vitamin D has GP prescribed?

With vitamin D at 25nmol .....Should have prescribed a loading dose - that’s 300,000iu over 6-8 weeks

Levels should be retested at end of that 6-8 weeks to see what level has improved to ....often this doesn’t happen

GP will often only prescribe to bring vitamin D levels to 50nmol.

Some areas will prescribe to bring levels to 75nmol

leedsformulary.nhs.uk/docs/...

GP should advise on self supplementing if over 50nmol, but under 75nmol (but they rarely do)

mm.wirral.nhs.uk/document_u...

NHS Guidelines on dose vitamin D required

ouh.nhs.uk/osteoporosis/use...

But improving to around 80nmol or 100nmol by self supplementing may be better

ncbi.nlm.nih.gov/pubmed/218...

vitamindsociety.org/pdf/Vit...

Once you Improve level, very likely you will need on going maintenance dose to keep it there.

Test twice yearly via vitamindtest.org.uk

Vitamin D mouth spray by Better You is very effective as it avoids poor gut function. There’s a version made that also contains vitamin K2 Mk7

It’s trial and error what dose we need, with hypothyroidism we frequently need higher dose than average

Government recommends everyone supplement October to April

gov.uk/government/news/phe-...

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

betterbones.com/bone-nutrit...

medicalnewstoday.com/articl...

livescience.com/61866-magne...

sciencedaily.com/releases/2...

Vitamin K2 mk7

betterbones.com/bone-nutrit...

healthline.com/nutrition/vi...

Importance of vitamin D for fighting Covid

moxafrica.org/post/the-vita...

Calculator for working out vitamin D dose required

grassrootshealth.net/projec...

SlowDragon profile image
SlowDragonAdministrator in reply toMistycal

Are you taking vitamin D with food (ideally high fat meal) at least four hours away from levothyroxine

When you start self supplementing.....after end of GP prescribed vitamin D....mouth spray vitamin D is often much better absorbed and doesn’t need four hour gap nor taken with food

SlowDragon profile image
SlowDragonAdministrator in reply toMistycal

read.qxmd.com/read/25281396...

Low B12 symptoms

b12deficiency.info/signs-an...

ncbi.nlm.nih.gov/pubmed/186...

There is a high (approx 40%) prevalence of B12 deficiency in hypothyroid patients. Traditional symptoms are not a good guide to determining presence of B12 deficiency. Screening for vitamin B12 levels should be undertaken in all hypothyroid patients, irrespective of their thyroid antibody status. Replacement of B12 leads to improvement in symptoms,

SlowDragon profile image
SlowDragonAdministrator in reply toMistycal

How low was iron and ferritin levels

How much ferrous fumerate have you been prescribed...2 or 3 per day?

What’s your diet like?

Are you vegetarian or vegan?

Eating iron rich foods like liver or liver pate once a week plus other red meat, pumpkin seeds and dark chocolate, plus daily orange juice or other vitamin C rich drink can help improve iron absorption

List of iron rich foods

dailyiron.net

Links about iron and ferritin

irondisorders.org/Websites/...

drhedberg.com/ferritin-hypo...

This is interesting because I have noticed that many patients with Hashimoto’s disease and hypothyroidism, start to feel worse when their ferritin drops below 80 and usually there is hair loss when it drops below 50.

healthunlocked.com/thyroidu...

Thyroid disease is as much about optimising vitamins as thyroid hormones

NWA6 profile image
NWA6

Hi 👋 if you have your latest thyroid results we might be able to see where you’re at? You need FT3/4 most importantly.

If you don’t have recent tests or GP doesn’t do FT3 then Medichecks have 25% off untill 3rd August. If you do this get the B12, folate, ferritin and Vit D tested at the same time.

LiliBili profile image
LiliBili

Hi Mistycal - sorry you’ve been so poorly.

All those antibiotics will also have messed up your gut. They kill the bad bugs and the GOOD.

You will need to support your gut for a good while. The consequence of the antibiotics can also lead to leaky gut and this in turn is likely to switch on your thyroid anti bodies and general inflammation throughout your system.

Read - you can heal your brain by Dr Tom O’bryan - there’s lots of gut/brain health advice in there.

Not forgetting sleep of course. In bed by 9 or up late. Also, it’s not 8 hours, you probably need at least 10 hours of good quality sleep.

Hope you’re feeling a lot better soon 👍

Mistycal profile image
Mistycal in reply toLiliBili

Thank you for your advice and book suggestion. I will see if it's on Kindle and read. I bought the AIP protocol book by Isabella Wentz and The Thyroid Fix which were both helpful. I'm trying to get as much sleep in but been waking up intermittently during the night for no reason so not getting a chance to fall into a deep sleep. Xx

Knitter4life profile image
Knitter4life

I take 1300 mg of Ashwagandha capsules every night along with vitamin D and B complex. I am an accountant and it has sustained me. You may want to read up on these supplements. During the day, I take 30 mcg of Armour Thyroid.

Stay safe and stay blessed!

Lovecake profile image
Lovecake

I read most of the above, but not sure if folate was mentioned?

If you get new tests done add folate. When my folate drops (and it does if I’m not supplementing) then the fatigue is terrible.

I also struggle to hold on to vitD and supplement with the Betteryou spray as then I don’t have to worry about food and 4hrs from thyroid meds.

Good luck, hope you feel some improvement very soon

StarEshine profile image
StarEshine

For gut health and to support Hashimoto's make sure you take a good quality probiotic, esp after all those antibiotics. And stay away from ibuprofen and steroids, those will worsen auto-immune disease. In terms of dealing with fatigue also make sure you're eating well. I avoid gluten and eat plenty of lean meats and fish, healthy oils (olive) and fruits and veggies. Carbs make me tired, but I still have some for balance. The #1 for me, however, was vitamin D. I have taken 5,000 iU daily with my T3 for 6 years now. And drink plenty of water!

Mistycal profile image
Mistycal in reply toStarEshine

Thank you StarEshine for your helpful tips 🙂

Onlymeandyou profile image
Onlymeandyou

It’s all so confusing isn’t it, I take all the vitamin supplements recommend and feel permanently as though I am wading through treacle! My thyroid was removed due to cancer 20 years ago, I am currently taking 150 mcg levothyroxine, I also have fibromyalgia (there is some evidence the two are linked I believe) and am about 3 stone overweight, to say I am fed up would be a major under statement...........,,,,,,,.....,.

LiliBili profile image
LiliBili in reply toOnlymeandyou

Hi there - Are you watching the Dr Michael Mosley prog on channel 4 - how to lose a stone in 3 weeks- its excellent.

Ditch the carbs - the weight will drop off and I’m sure you will feel brighter.

It’s on more4 catch up if you have missed it. It’s a really interesting prog, full of facts and makes clear links between autoimmune health, immune system, diet and COVID. Wishing you better, I do sympathise

Onlymeandyou profile image
Onlymeandyou in reply toLiliBili

Thank you, interesting stuff, I will try and find this on catch up, x

Mistycal profile image
Mistycal in reply toLiliBili

Hi LiliBili. I also watched the programme and copied their pizza mushroom recipe. Came out delicious! I think if I reduce my carbs and eat more fruit and veg, it will help with my tiredness and concentration levels. Was a good result for the contestants in the end 🙂

SlowDragon profile image
SlowDragonAdministrator in reply toOnlymeandyou

Onlymeandyou

Suggest you make your own post including results

Fibromyalgia frequently linked to low Ft3

Important to get FULL Thyroid And vitamin testing

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