Tiredness

[Kymtn]

Any advice please, for the past year I have contacted my doctor advising of extreme tiredness, they blood test and each time it comes back as over medicated and so they drop my levothyroxine dose and I become more tired. Is there something more to this as I don’t seem to be getting very far? Thanks.

[greygoose]

Depends what they're testing. If they're only testing the TSH, then yes, there is a lot more to it, and your doctor is very ignorant. Can you post your blood test results, with ranges, and let's have a look?

[SlowDragon Administrator]

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

Ask GP to test vitamin levels

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)

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

thyroiduk.org/getting-a-dia...

Medichecks Thyroid plus vitamins including folate (private blood draw required)

medichecks.com/products/thy...

Thriva Thyroid plus antibodies and vitamins By DIY fingerpick test

thriva.co/tests/thyroid-test

Thriva also offer just vitamin testing

Blue Horizon Thyroid Premium Gold includes antibodies, cortisol and vitamins by DIY fingerprick test

bluehorizonbloodtests.co.uk...

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

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

thyroiduk.org/getting-a-dia...

monitormyhealth.org.uk/thyr...

See my replies to this post yesterday on similar situation

healthunlocked.com/thyroidu...

[fuchsia-pink]

Please remember you are ONLY over-medicated if your free T3 is over-range. If you are on thyroid meds and your TSH becomes suppressed it's absolutely nothing to worry about, and - on its own - absolutely NOT a reason to reduce your meds. In fact it's very likely to make you feel worse as your free T4 is likely to drop.

Can you get your doc to do full blood testing - TSH, free T4, free T3 and key nutrients - ferritin, folate, vit D and B12? And if s/he won't, treat yourself to private tests - lots of posts here about what is available, with discounts available on the Thyroid UK site (and on a Thursday from Medichecks for some tests). Good luck x

[RockyPath]

As my endocrinologist once observed about my extreme fatigue that refused to respond to levothyroxine increases, “Maybe it’s something else.”

MTHFR Is the enzyme that permits energy production from folate via methylation. But a very common genetic variation makes about 40 percent of Northern European people unable to break down folate for the methylation cycle, which is essential to energy production. Doctors get a 45-minute lecture on methylation in school and promptly forget about it.

Supplementing with folate when you have the MTHFR variant leaves more folate floating around in the blood, doing absolutely nothing beneficial. Only one form, l-methyl folate can be used, and the required dose is often quite high, compared to what is found in multivitamins — 10 or 15 times more. To complicate matters, there’s an obscure unit of measurement.used with l-methyl folate. And the methylation cycle in your cells requires the rest of the b vitamins for Co-factors during methylation and the Krebs Cycle ( your cellular energy system) Another medical school lecture forgotten.

For the past three years I struggled daily with a deep energy deficit and no amount of testing and supplementing of vitamins, minerals, amino acids, fats, proteins, hormones, herbs, glandulars, prebiotics, probiotics, dietary intake adjustments, was doing anything ultimately useful. I did find that I could only convert LT4 partially, and the more given the more I produced reverse T3 in response, along with some T3. That was quite debilitating. I had a long scuffle with the endocrinologist to get him to look at reverse T3 in the blood work.Now I take both LT4 and T3, but that hasn’t solved the extreme fatigue— and prompted the endocrinologist’s comment about something else.

Nothing helped until I tested my genome and found MTHFR. But that was short lived. L-methyl folate was fixing my Krebs Cycle! But there was something more: none of the practitioners I saw realized the brain is the body’s biggest energy consumer. Its a furnace, capable of literally draining the body of resources, and because we cannot feel what its up to, we have no way of recognizing what its up to, and how to help it, Sadly, all my providers knew about the brain injury, An MRI showed the glial cells gathered at the site, it showed the atrophy of the caudate from the injury, but in their minds it was like a bruise on my wrist, Meh,

I had one low-energy electromagnetIc pulse of five seconds sent between electrodes on my scalp and I could feel my body release the guarding i had been carrying in my body since the dreadful motor vehicle crash three and a half years ago, My brain was able to get unstuck and start working like it did before the injury. And I had my energy back, just like that. On the day before I could barely walk around in my street, and forget about stairs, get me to the elevator. The day after the LENS Neurofeedback, I was striding down the road to the grocery, lifting weights, climbing stairs vigorously, doing planks, squats, yoga ....

Putting a little bit about yourself in your profile helps to give a more complete picture of your situation and challenges.

Sometimes recent bouts of antibiotics deplete the gut biome and cripple the ability to extract nutrients from what we eat. Sometimes potentially pathogenic species of yeasts and bacteria thrive in the post-apocalyptic world of the gut after a surgery or series of infections and courses of oral antibiotics.

There are many interesting variations in how our personal energy systems work, and what they need to run at their best. Doctors easily overlook every last one of them. 😳

[myfanwy1945]

I had the same problem with my GP. I ended up seeing a doctor privately who diagnosed me. I found that Thyroxine only worked properly when I started taking vitamin D3. There are still private doctors around, perhaps you should get an appointment with one. It was the best money I ever spent.

[Kymtn]

Thank you for your replies.

This was the conversation

Dr.

If anything your recent thyroid result shows over treatment so the thyroid is certainly not the cause of tiredness. Tiredness is a common symptom and the rest of your tests are normal so it is like due to life events/mood rather then a physiological cause that I can treat. If your thyroid test remains the same next year we will have to reduce the dose to 50 mcg. Regards.

Hello Doctor, thank you for your reply. Would it be possible for me to see the blood test results with ranges please?

Were the tests for TSH, FT4 and FT3 and both TPO and TG thyroid antibodies tested, and also vitamin D, folate, ferritin and B12?

Dr.

This is not indicative of hashimotos disease, it's thyroid over treatment (borderline). If you wish for more detail you will need to apply for online results access via reception. I am happy to reduce your thryroxine now if you wish. Regards.

PS not all the tests you mention were done but all tests that need to be done have now been done. Further tests are not indicated.

[SlowDragon Administrator in reply to Kymtn]

You are legally entitled to printed copies of your blood test results and ranges.

The best way to get access to current and historic blood test results is to register for online access to your medical record and blood test results

UK GP practices are supposed to offer everyone online access for blood test results. Ring and ask if this is available and apply to do so if possible, if it is you may need "enhanced access" to see blood results.

Link re access

healthunlocked.com/thyroidu...

In reality many GP surgeries do not have blood test results online yet

Alternatively ring receptionist and request printed copies of results. Allow couple of days and then go and pick up.

Important to see exactly what has been tested and equally important what hasn’t been tested yet

So like thousands of members on here you will almost certainly need to get FULL Thyroid and vitamin testing privately

What vitamin supplements are you currently taking?

Thyroid levels should be retested 6-8 weeks after any dose or brand change in levothyroxine

For full Thyroid evaluation you need TSH, FT4 and FT3 plus both TPO and TG thyroid antibodies tested. Also EXTREMELY important to 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)

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

thyroiduk.org/getting-a-dia...

Medichecks Thyroid plus vitamins including folate (private blood draw required)

medichecks.com/products/thy...

Thriva Thyroid plus antibodies and vitamins By DIY fingerpick test

thriva.co/tests/thyroid-test

Thriva also offer just vitamin testing

Blue Horizon Thyroid Premium Gold includes antibodies, cortisol and vitamins by DIY fingerprick test

bluehorizonbloodtests.co.uk...

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

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

thyroiduk.org/getting-a-dia...

monitormyhealth.org.uk/thyr...

Come back with new post once you get results