Hypo & exhausted...something just isn't right

[Izzywizzy124]

Hello,

I've had hypothyroidism for around 5 years. Sometimes I feel ok with it, other times not. At the moment I feel awful and I'm trying to work out why.

Symptoms:

- exhaustion (running out of energy by the afternoon)

- waking up in the morning not feeling refreshed

- dry flaky scalp (I had alopecia areata too for the 3rd or 4th time about 6 months ago where I lost a tennis-ball size patch of hair, but that's now grown back)

- low libido

- struggling to lose a little weight. I've put on 0.5st in the last 5 months, although I'm very fit and active, careful what I eat (vegetarian) and not overweight, I'm just heavier than I'd like to be.

- face just looks rubbish (undereye bag on one side makes me look permanently shattered)

My main issue is that I just don't feel myself, and I feel so exhausted. I'm only 38, I shouldn't feel like this surely?!

My most recent bloods done in March by Thriva are attached here (with reference ranges).

I wonder if my TSH Is still too high as in the past I've almost suppressed it down to 0.0...something and felt ok (GP never likes me doing this but I ignore that)...or maybe the other thyroid levels could be better?

I don't know whether to try and increase or decrease (am I overdoing it?) my current Levo dose, which is 125mcg daily?

I take Vit D3/K2, B-Complex, Folate (just started a few weeks ago) and Ferrous Fumarate supplements regularly. I also take Biotin on and off. Wondering whether I should try Zinc too?

Any suggestions very welcome, I don't want to feel knocked out all the time!

Thank you

[Jaydee1507 Administrator]

Free T4 (fT4) 18.8 pmol/L (12 - 22) 68.0%

Free T3 (fT3) 4.24 pmol/L (3.1 - 6.8) 30.8%

Going by free hormone levels you could do with an increase. Your FT4 should be a little higher in range and FT3 over 50%.

If you only started folate a few weeks ago then that level may rise further. Its not high enough as yet.

Vit D you could take a little extra. Vitamin D should be around 100 - 150. Buy one that includes vit K2 to help it go to your bones. Some are available in oil or you can take it with an oily meal for better absorption. Use this calculator to work out how much to take to get your level to 100-150. wildatlantichealth.com/vita...

Do you always get the same brand at each prescription?

Do you know if you had positive thyroid antibodies? Many with autoimmune thyroid disease aka Hashimoto's benefit from a gluten free diet. A smaller percentage of those also need to remove dairy from their diet to feel well. These are intolerances and will not show up on any blood test.

Zinc is not recommended as it needs to balance with copper. Better to increase dietary intake of foods containing zinc.

[Izzywizzy124 in reply to Jaydee1507]

thank you for your reply.

No, I don’t always get the same brand of Levo. It’s usually between Teva, Wockhardt and Accord (I didn’t think Accord was great & even suspected it of causing bad bloating). I don’t have high antibodies so it doesn’t look like hashimoto’s, although many of the symptoms I’m getting are very similar.

After much Googling I wonder if I’ve been overdoing the exercise and not getting enough recovery time, which might be causing high cortisol and bloating/weight gain as well as exhaustion…just another avenue to explore. I’m going to do a cortisol test to rule that out.

I’m sure the GP just rolls their eyes secretly every time I come with a list of non-specific complaints like bloating and tiredness etc, but what can I do!

I’ll give your suggestions a try with increasing Vit D and keep going with building up the folate. I also wonder if the GP will agree to a 25mcg increase in Levo to 150mcg…let’s see.

[Jaydee1507 Administrator in reply to Izzywizzy124]

You could alsk for a 12.5mcgs increase as a trial which they might be more agreeable with. Show them the %'s of where your results are. Also take evidence along with you for keeping TSH lower.

The first paragraph in the NICE (NHS) Thyroid Disease, Assessment and Management guidelines says :

nice.org.uk/guidance/ng145

"Your responsibility”

The recommendations in this guideline represent the view of NICE, arrived at after careful consideration of the evidence available. When exercising their judgement, professionals and practitioners are expected to take this guideline fully into account, alongside the individual needs, preferences and values of their patients or the people using their service. It is not mandatory to apply the recommendations, and the guideline does not override the responsibility to make decisions appropriate to the circumstances of the individual, in consultation with them and their families and carers or guardian. "

healthunlocked.com/thyroidu...

Pick a brand of levo you think is OK and get GP to write it in the first line of your prescription.

For bloating check out the low FODMAP diet. monashfodmap.com/ibs-centra...

[Izzywizzy124 in reply to Jaydee1507]

thank you Jaydee! All great advice. I wish the GPs knew the first thing about thyroid issues. I feel like a crazy hypochondriac every time I go there 😂

I’ll go for a 12.5mcg increase - I agree they should be ok with that.