still tired

[WorriedUser]

hello, I was diagnosed at the end of June with Hyperthyroidism, and subsequently tests confirmed Graves’ disease.

I am due to see the consultant end of this month, so will have more bloods done just before. I take Carbimazole and Propranolol and my last bloods indicated that my levels were starting to come into range (FT3 and FT 4 were anyway!) but not quite there yet.

Most of my symptoms have subsided, but I’m still quite tired… is this common, or should I expect to feel better with more energy? I know it’s only been a few months, but as my levels were going the right way, maybe I was expecting more…

Would love others experience please.

Free T3 August 2024 - 7.0 pmol/L

Normal Range 3.1-6.8

Free T4 - June 2024- no reading taken

Free T4- August 2024 - 30.4 pmol/L

Normal Range 10.8-25.5

Serum TSH Level - June 2024- 0.02 mlU/L

Serum TSH Level - August 2024- 0.02 mlU/L

Normal Range 0.27 - 4.2

Meds since June: Carbimazole 20mg once a day

Proponanol 40mg x 3 a day

[Regenallotment Ambassador]

I’ll let a hyper expert help you with what to expect on Carbimazole but I did want to ask how your vitamin levels are?

A significant amount of my Hashi’s fatigue was due to low D, low folate, low ferritin and low B12.

As Graves is an autoimmune condition reading up on what might work for you with autoimmune diets might be something to look at.

that and …rest, are able to delegate a few jobs or get some R&R?

[WorriedUser in reply to Regenallotment]

I haven’t had my vitamins done since June. Vitamin D was low, so I’m on supplements now. I’ll ask for another test.

[SlowDragon Administrator in reply to WorriedUser]

How low was vitamin D

How much vitamin D are you taking

Please add folate, B12 and ferritin results and ranges if you have them

[WorriedUser in reply to SlowDragon]

Taken in June 2024

Vit D 40 nmol/L

Normal range- 50-174

I have been taking 1 table of 1000 each day.

Vitamin B12

260 ng/L

Normal range 180-999

Ferritin

138 ug/L

Normal range 13-150

Folate

12.3 ug/L

Normal Range 3.89-26.8

[PurpleNails Administrator]

“TS3 and 4 were anyway”

If that’s FT3 It would be low, if TSH then too high.

20mg might need adjusting, it depends how your levels changed.

Are you due another test soon?

[Jazzw in reply to PurpleNails]

I didn’t read it that way—I thought maybe WorriedUser meant to write “TSH and FT4 were anyway”.

WorriedUser do you have laboratory reference ranges for your blood tests? It’s quite difficult for us to tell what’s what without them.

[WorriedUser in reply to Jazzw]

Yes.. on my OG post.. I’ll repost here.

Free T3 August 2024 - 7.0 pmol/L

Normal Range 3.1-6.8

Free T4 - June 2024- no reading taken

Free T4- August 2024 - 30.4 pmol/L

Normal Range 10.8-25.5

Serum TSH Level - June 2024- 0.02 mlU/L

Serum TSH Level - August 2024- 0.02 mlU/L

Normal Range 0.27 - 4.2

Meds since June: Carbimazole 20mg once a day

Proponanol 40mg x 3 a day

[WorriedUser in reply to PurpleNails]

Yes sorry FT3… I wrote in a hurry!

I have another blood test end October… Will wait and see what that says.

[PurpleNails Administrator]

So FT3 with that range -

FT3: 4 pmol/l (Range 3.1 - 6.8) 24.32%

Is showing quite a low FT3.

[tattybogle in reply to PurpleNails]

latest fT3 is 7 not 4 purplenails ~ i think the "4 "was in reference to fT4

[PurpleNails Administrator in reply to tattybogle]

Thanks, I wasn’t aware of edits & worrieduser did confirm FT3 to me. FT3 of 7 would be over the given range.

[pennyannie]

Hello again :

You will be very tired - one does not bounce back from Graves Disease.

The body has been in a ' heightened state ' and there is something of a brain / body mismatch -

With your brain suggesting several activities - but with your body too weak to get off the sofa

It is a waiting game, so be kind to yourself and just do things you enjoy and try not to stress about ' stuff ' :

The Carbimazole and beta blocker are now pretty much controlling your metabolism, most of your symptoms have been relieved and now it's a case of finding a dose of Carbimazole that keeps you stable -

and we need to aim for your T4 and T3 back in the range - at around midpoint -

hopefully resulting in you feeling - neither hyper nor hypo -

while we wait for your immune system to calm back down again.

As detailed in my previous reply the NHS generally allocate a treatment window of around 15-18 months with the AT drugs with the hope being your thyroid returns to ' normal ' without the need for any drugs.

No 2 peoples journey with Graves is the same but stress and anxiety are common triggers for this poorly understood and badly treated Auto Immune disease.

Most important to keep your core strength vitamins and minerals at optimal levels -

do you have any readings for ferritin, folate, B12 and vitamin D as mentioned previously if these are not maintained at optimal levels your health issues will be compounded further than necessary.

You can find your 2 previous posts and all your replies by just pressing on your Profile icon which sits alongside My Hub - Chat - Post - Alert - and Menu which sits top right on my laptop screen now facing me.

[WorriedUser in reply to pennyannie]

Taken in June 2024

Vit D 40 nmol/L

Normal range- 50-174

I have been taking 1 table of 1000 each day.

Vitamin B12

260 ng/L

Normal range 180-999

Ferritin

138 ug/L

Normal range 13-150

Folate

12.3 ug/L

Normal Range 3.89-26.8

[pennyannie in reply to WorriedUser]

Ok - your ferritin looks a little high - but this can be a false high as it can be driven upwards by inflammation in the body - is there a reading there for CRP ?

I now aim to maintain my ferritin at around 100 - folate around 20 - active B12 125 ( serum B12 500++ ) and vitamin D at around 125.

So your vitamin D and I'm guessing this serum B12 reading and both much too low -

Have you been checked out for pernicious anemia and celiac disease as these other AI conditions can follow on from Graves ?

[WorriedUser in reply to pennyannie]

CRP (serum C reactive protein level)

4.4 mg/L

Normal range 0-5

I haven’t been checked for pernicious anaemia or celiac.

[pennyannie in reply to WorriedUser]

Ok - so inflammation is ' highish ' as one would expect as you are not well and your body struggling and under stress -

so ferritin may or may not be an issue -

everything else still stands - so worth getting these further tests run on the NHS as some AI diseases tend to ' run together ' and if this a serum B12 it is too low :

Many find they have gluten intolerance and ' tests ' need to be done eating your foods of choice - and not after you start eliminating certain food stuffs in order to ' heal ' whatever might be going on.

[WorriedUser in reply to pennyannie]

Thank you so much for your reply. I really appreciate it, and will try to be patient and rest when I need to.

[pennyannie in reply to WorriedUser]

Yes - Graves means being a patient and practising patience as it is now a waiting game - there is no quick fix - and you need to start being kind to yourself :

Might sound a strange thing to say - but very often we are the backbone holding things together for others - just speaking from my own situation - but it seems a common thread, especially with women -

I think I suggested you dipping into Elaine Moore previously - I found her sections on alternative and more holistic treatment options interesting - though it was a too late for me as I had already had RAI thyroid ablation - a treatment I deeply regret - and I became more ill after ' the treatment ' than I had ever been !!

elaine-moore.com

[Yoga54]

Morning Worried User, I have Graves’ disease diagnosed in April 2022 after suffering from hyperthyroidism with all the awful symptoms that go with it, I am now in remission and have been for the last 6 months and no longer taking medication. It takes time for your body to adjust and one blood test showed my vitamin D levels were really low so I was prescribed a loading dose for 4 weeks and I’m now on a maintenance dose prescribed by my endocrinologist indefinitely. I also take vitamin B every day and selenium for hair and nails. I would check to make sure your vitamin levels are normal and I can honestly say that some days I do get tired especially if I have been really busy or stressed out. I have learned to take things easy when I’m feeling tired instead of ploughing on. Not sure if this is connected to my Graves’ disease as I’m 56, working part time and a grandmother to a lively 4 year old but I would definitely recommend vitamins and if you’re feeling tired be kind to yourself and rest up whenever possible, I also recommend gentle exercise, I do yoga twice a week and it has been really beneficial for my wellbeing. Hope this advice helps.

[WorriedUser]

Thank you .

[artlouise]

Hello - I have found that I feel best when my T3 is closer to the lower number. Your's is still out of range (a bit) in the slow range. You might be less tired if your number was 2.0 or lower. provider I had stated that most of the patients with thyroid issues that she knew of, felt better when their T3 was closer to the lower range. Good luck!

[WorriedUser in reply to artlouise]

Thank you!