So yesterday, I went on a day trip with my husband and we walked around alot.
My phone recorded about 17km in total with about 26K steps.
For the last 30 days, on average I clock about 7.5K steps. It's not consistent, there were a couple of days where I might only have done 1K+ steps.
When I woke up this morning, I was totally knackered. I could barely drag my body out of bed even after 10 hours of sleep. I also noticed that my heart rate was also low like about low 60s.
I had some food and then I became more tired and had to lie down for a second nap. But I woke up still feeling fatigue.
I decided to up my T3 from 2 x 5mg to 5/10/5 for today. (I'm still taking my 100mg evening Levo dosage).
The energy levels finally returned at about 6pm+ and heart rate went up to about 80.
I'm curious about if anyone with hypothyroidism has experiences similar to this where after one day of extreme intense activity, you are simply knackered and can hardly move or do anything much the next day?
How do you deal with it? And how do you get your energy levels back?
Written by
thyroid-warrior
To view profiles and participate in discussions please or .
That’s an awful lot of steps. I originally joined this forum when I came looking for answers about exercise and hypothyroidism. I was in my 40s when diagnosed and into running and swimming. I still feel shattered the next day when I have been active, more so than I think I should. I need a recovery day - I no longer swim or run. I’m in my 60s now.
Regarding heart rates, I haven’t noticed a difference except if I have an alcoholic drink - then my resting rate goes up by several beats. 80 would be high for me. My resting rate is usually in the low 50s. I will check it next time!
Thanks for sharing Ruby1 I started monitoring my heart rate more closely because I've heard that the heart rate can also be a good indicator if thyroid levels are too low or high, instead of waiting for a blood test. During sleeping my heart rate is in the low 50s. Typically when I'm working in front of my computer, my heart rate usually falls between 70-80 (give and take). So I was a little taken aback when I saw my heart rate in the low 60s when I was sitting upright. Understanding the baseline heart rate can be a useful way to spot any changes related to thyroid function.
When I was low in thyroid hormones four months ago, the blood tests results returned normal but according to my acupuncturist, my heart rate was also in the low ranges and that's when he suggested to up the dosage.
I have graves hyperthyroidism and for the last 5 years have not been able to do much despite my thyroid hormone levels being within range with medication. I do not have the physical energy to do anything and that is made worse by brain fog, and feeling light headed, sometimes also nauseous. I pace myself, If I am able to be active one day I try to rest the next day. I try not to have consecutive active days. (My active might just be to meet a friend for lunch, not any exercise which I simply cannot do). I try not to schedule something the day after active day. No one has been able to explain why I am fatigued and brain fogged so much. I’ve speculated I might have ME/CFS but wonder if it could just be my graves hyperthyroidism causing my fatigue. I would feel much better just knowing that graves can cause the chronic fatigue I have been facing so I do not have to keep looking for other causes of my fatigue. I hope your fatigue is only one off and temporary. My fatigue came on about three years after my graves diagnosis and got worse after the fourth year.
Me too, I've just started being treated for sub clinical hyperthyroid (likely toxic nodules). This has been brewing since 2016 and if I do anything that requires energy I am exhausted afterwards, this incudes shopping, making beds etc. I have to plan a day out so that I've got a "nothing" day afterwards. It's hideous.
The meds are helping, I suspect I need an increase. It's also apparent to me how badly my menstrual cycle impacts my symptoms. I'll post separately but the low level of carbimazole seemed to be getting on top of my symptoms until 5 days before my period when it all came back.
My heartrate is the biggest issue and the fatigue is linked to those times when my HR is elevated.
Thanks yes all checked, iron is good, ferritin is high but this is probably a "feature" of the hyperactive thyroid. Vitamin D was right at the bottom of the range at 53, endo wants out at over 100 and I'm working on that.
My annual average daily steps is 12,000 and occasionally 25,000 on individual days. On 75 mcg levothyroxine with a tsh around 2.4. Im in my mid 60s and quite lean, around 72 kg. I sleep 7-8 hours a day. Diet is relatively low carb / high protein, including wide variety of dairy, meat and fish. I'm feeling a bit more tired than I used to and my tsh has been slowly creeping upwards. T3 and T4 are in bottom 25% of range. GP thinks that is ok but I'm shortly due my annual review. Definitely feel the cold more than other people my age. I'm used to being active (walking mainly).
Thanks for sharing DavePhoto Do you feel any difference during summer or winter time, I'm assuming you don't change your dosage?
Previously, I've never changed my dosage before (same dosage for all seasons) but somehow I always felt more energetic only during springtime while winter and summer, I felt less days of energy. From my understanding, it seems like making some adjustments during winter could be helpful for relieving some symptoms: thyroidpharmacist.com/artic...
I still get PEM after a “busy” day even after 4 yrs of Levo. I’ve been diagnosed with ME/CFS since my “levels” have been optimised I.e TSH slightly below range. I just know my limits so I stick to the 3 Ps approach… Prioritise/Plan/Pace. It works for me. I know I will never be as active as I was 5 years ago.
I’m still working on finding a good balance to understand my limits. It’s frustrating because I didn’t really think about this when I was younger. I've had hypothyroidism for over 30 years since I was a child but back then I lacked awareness and I suppose recovery was faster when I was younger. I’m wondering whether planning to gradually increase my activity to build up stamina for more activities could be an option to explore and how I could go about it.
I'd recommend getting a wearable which will track recovery for you... game changer
I've been able to slowly build back up to a decent level of activity and vastly improved my recovery, 2 years ago I would have to go up stair on all fours!
I'm fine with walking, jogging, rowing, weights, yoga etc but anything too cardio zaps my energy and slows recovery
Thanks for your suggestion TiggerMe ! Actually I got one in December after the health scare, I'm still trying to better understand the measurements (for example, heart rate) and link them to my symptoms. It feels like another big piece of the puzzle that's still lacking clarity at the moment.😅
Do you have a set of activities in your daily routine that help maintain your metabolism? I’ve been wondering if gradually increasing my daily activities could signal to my body to produce more T3 and help keep it at a more "normal" level, so I could handle more activities overall if I stay consistent with it.
HRV is excellent at showing recovery levels and when to rest, many give a readiness level to show how much you have in the tank
Walking has been the backbone of it all, gentle stroll couple of miles with the dogs and a good 4 mile stomp without, just added in pacer poles and this really ups the output! 😅 If it's not blowing a hooley I'll row 4 miles and run a few miles a couple of times a week just to rev my heart, recovery is much worse if I run less often and further, then I'll do some weights / yoga when I get back really trying to up my twisting and stretching.... thinking about it I wouldn't do anything for more than a couple of hours without a rest
I also feel that is normal for me too. Although I don’t think I could do that many steps these days. When my son got married I took an extra 2.5mcg of T3 to help me get through the day. Without the added T3 I’d be recovering in bed for 4 days. Shame we have to either go private or beg for it
happens to me , since i was treated for hypo20+ yrs ago , levo fixed me about 75% , but i never found a fix for this bit , so i've just had to learn to plan life around knowing it will happen
~by trying to prevent 'boom and bust' when possible by learning to tune into myself before i get to point of having over done it ~ doing things in stages /stopping before i want to / having a break / carry on later.
~ and by accepting the consequences next day when i couldn't / didn't want to, restrain myself.
i have been known to lie down for a nap under a nice tree in a car park and send the kids off with someone else in a group when on day's out ,so that i would have enough in reserve for things i needed to do later on etc .
i was referred to CFS/ ME service a couple of yrs after starting levo ,,, but although the counselling did give some useful tactics for dealing with it , no fix .
.... and other than this PEM (post exertional malaise)symptom , i don't fit with CFS/ME , not light sensitive, etc ect ,,, just stone dead / including brain the next day if i've overdone it the day before .
it used to put me out of action completely for 2/3 days ,, but i'm now much better at avoiding the worst of it by pacing myself when doing things .... but i will still need a quiet day/ day off after anything 'big'.
i have only recently added a bit of T3 to my levo .... was hoping this would be the missing element , but not the case so far ,, however its early days and not even found the best dose / timings of T3 yet ,,, so i've not given up hope that it may improve it a bit given time.
but for 20 yrs ~150mcg levo /top end fT4 and slightly below range TSH with levo didn't fix it.. and nothing else i tried during that time has had any significant impact on it.. the only thing (so far) that has improved it was having a personality transplant... learning the hard way that doing too much has to be paid for later~ which was very difficult to learn cos i used to be able to do 'everything everywhere all at once' ,,, and i'm very stubborn
p.s ....i also ( eventually) realised that emotional upsets / arguments / frightening events (anything that triggers "fight / flight / freeze" response ) also have the same consequence the net day ...in fact more so than overdoing it physically does .
tattybogle I didn't realize that "anything that triggers "fight / flight / freeze" response" could have the same consequence. That could explain why some days I feel more tired than other days.
When I was younger, I tend to be able to fall asleep straightaway after a workout while some people say they get an adrenaline rush and become more alert and focused. That never happened to me, in fact, I was more tired after a workout. 😂The knowledge that T3 can run out and cause fatigue explains alot about many things that happened in my life.
How do you manage preventing 'boom and bust'? Do you set a specific time for activities or how to plan or prevent anything too tiring like traveling?
it probably took a good 10 years of being puzzled before it dawned on me that Fight flight Freeze was having that effect the next day .
as for how i prevent boom and bust ,,,,, um... been living this way for so many years now that i can't remember what it's like to do anything else ,,,but i'll try and write you a more useful answer to that Q sometime tomorrow ,,,or the next day .
lol just remembered ... re 'planning' ~ over the years i accumulated a good knowledge of "pleasant layby's suitable for having a nap in the back of the van on long drives" .... having a van with a kettle and a bed in it allowed me to do a lot of things that would otherwise have been ruled out.
so , get one if these , then no planning is necessary ,,, just go to bed whenever you need to
I may be out in left field here, but I wonder if upping your T4 and/or T3 would help. Just enough to not be hyper, but enough to provide an adequate level of FT3 to enable a better recovery the day after? I have read that for those on thyroid meds, your FT3 should be in the top qtr of the range, without getting hyper symptoms.
Also, I don’t see a lot of mention on this forum of the importance of adequate cortisol levels for consistent energy throughout the day? The way I understand it, cortisol is required for the release of glucose into the blood stream which then is converted into energy in the cells if you are not insulin resistant (probably a ridiculously high level description), so if you have low cortisol, you WILL be tired when it is used up and not replaced after strenuous exercise.
And I understand that adequate FT3 levels are required for cortisol production.
Certainly I found that taking thyroid hormones when cortisol was in range rather than high or low helped, supporting the adrenals and pacing things to not cause a crash
Content on HealthUnlocked does not replace the relationship between you and doctors or other healthcare professionals nor the advice you receive from them.
Never delay seeking advice or dialling emergency services because of something that you have read on HealthUnlocked.
Suffering With Extreme Fatigue
Extreme fatigue 
Hot weather and adrenals/hypothyroid - dehydration?
Weakness, extreme fatigue 8 days. 
dr finally called
