Extreme tiredness

[Arielathekitten]

Hi everyone, I've been a member of the forum for a few years just for information really. However I'm getting concerned about how tired I am.

I was diagnosed with an underactive thyroid since my 1st pregnancy in 2007. I have to be truthful I was very lax/forgetful taking my thyroxine (150g) however for around the last 2 months I've been taking it every morning just as I wake up by having water and my tablets on my bedside table.

Nothing has changed in fact I'm actually more tired now than I have been for yrs.

I got my annual thyroid bloods done last week and my TSH is 4.4 which according to my Dr is good. No T3 or T4 was done.

Does anyone else get extreme tiredness even though their TSH levels are in the normal range.

I've been reading that T3 and T4 levels can affect how people feel even if their TSH is normal and you can now get medication to level out the levels.

Should I speak to my Dr regarding my T3 and T4? I've actually never been referred to an Endocrinologist, is this an option under the NHS.

Any advice would be greatly appreciated.

[Lalatoot]

On levo we usually do best when our TSH is1 or around there. 4.4 is too high. However TSH alone is not a good guide - you need at least Ft4 done too, and ideally Ft3 as these are measures of thyroid hormones. You may need your vitamins supplemented so vitamin testing would be a good place to start.Once you have vitamins and full thyroid test results plus the ranges (numbers in brackets after your result) then you will have enough information to make a start on improving your health.

Re the NHS endocrinologist - the medics generally consider hypothyroidism as something that can be managed by a GP. Unless there is something very unusual then it is unlikely that an NHS endo would see you even if the GP were to refer you.

[humanbean]

You should find this thread of interest :

healthunlocked.com/thyroidu...

[SlowDragon Administrator]

Just testing TSH is completely inadequate

Anyone on levothyroxine should have TSH ALWAYS under 2

Frequently when adequately treated TSH will be well below 1

Do you always get same brand of levothyroxine at each prescription?

Which brand

See different GP and request 25mcg dose increase in levothyroxine

Or insist on further testing

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 at least annually

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

Do you have Hashimoto’s

About 90% of primary hypothyroidism is autoimmune thyroid disease

Ask GP to test vitamin levels (and thyroid antibodies if not been tested yet)

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 antibodies and vitamins

medichecks.com/products/adv...

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 down to £26.10 if go on thyroid uk for code

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

monitormyhealth.org.uk/

NHS easy postal kit vitamin D test £29 via

vitamindtest.org.uk

[SlowDragon Administrator]

If last test was done after missing doses of levothyroxine the results will be incorrect

You need full thyroid and vitamins tested after 6-8 weeks on constant unchanging dose and brand of levothyroxine

[JAmanda]

So the aim of thyroid medication is to improve symptoms like tiredness... so if it hasn't it's a good sign you're under medicated... and then we see your tsh is 4.4 when most when on thyroid meds are best at 1 or under... so I'm not really thinking your doc knows much about the thyroid!

I would get private blood tests done and see where your T3 and t4 are in range. I pay for the blood to be taken and use Medichecks. Take the test first thing before you take meds.

But it does seem like a dose increase is necessary... because you're still suffering tiredness... is it not worth just calling the doc and asking for an increase to help your tiredness..?

[Arielathekitten]

Thanks everyone for your advice. I didn't realise that a lower TSH was better than a higher one. I'm going to contact my GP again and ask for a full thyroid blood test incl antibodies and the vitamins as I didn't realise they were important to thyroid function. If my GP doesn't agree then I will definitely go down the private blood test route. I definitely need to sort out what's happening 😐

[Marz in reply to Arielathekitten]

The members who have made helpful suggestions will not see your post unless they return to check. So will tag SlowDragon and JAmanda and then they will receive an alert 🌻

[JAmanda in reply to Arielathekitten]

Really the tsh is much less important than the T3 and t4 levels as they will tell how much thyroid hormones are actually circulating. I don't have much faith in your doc I'm afraid - just going on tsh and not even measuring t4 is really unheard of. You're not getting the full picture at all. I'd get private tests done ASAP then you can have a proper conversation with your doc.