Thyroid UK
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Hi, Looking for some help my daughter has been diagnoised with under actice thyroid last october

and to me its still not under control she is on 200mg and has a lot of symptoms still. one hajor one is she is tired but can not sleep. can anyone give me some advice. I should say she has other symptoms. she is freezing most of the time, sore legs, her consentration is not what is was.

8 Replies


There could be various reasons for this, including not enough thyroxine. Does she have any recent blood test results? This may help us to know if she is on too little or too much thyroxine, although blood tests are only part of the puzzle.

It is fairly common for hypothyroid patients to be lacking in certain vitamins and minerals. It would be wise for her to get her serum iron, ferritin (stored iron), vitamin B12, folate and vitamin D tested. A deficiency in any of these would make it more difficult for her body's cells to use the thyroxine and also cause symptoms in itself. Deficiencies in any of the above can cause fatigue and/or insomnia.

It is also wise for people with under active thyroid to take selenium and zinc supplements to help with the conversion of the thyroxine to the active form, T3, so that it can be used in the body's cells. If she is not converting well, this could be why she is still fatigued.

Another cause of symptoms could be abnormal cortisol levels. Cortisol is released by the adrenal glands and is essential for normal functioning, however stress, long-term illness etc (including hypothyroidism) can result in the adrenal glands not producing the correct amount of cortisol at the correct times of day, resulting in fatigue and/or insomnia to name only two of the many symptoms! If you don't have the right levels of cortisol, the thyroxine is not converted very well to its active form, and you have the same problems with fatigue because the body can't use it very well. To find out more about this you might want to do a search for "adrenal fatigue". There is a lot of information out there about it and how to recover from it. I should warn you that GPs don't acknowledge its existence but I can assure you it is real. I am almost recovered from my adrenal fatigue now and it has made such a difference to how I feel.

There is a lot of information on the main Thyroid UK website. Click on the links on the purple menu on the left hand side.

If you have any further questions about any of this please do ask. We are here to help as much as we can.

I hope your daughter recovers soon

Carolyn x


I should add that the NHS reference ranges for the vitamin and mineral tests are very wide and the lower ends of the ranges are nowhere near adequate. Here is a general guide of what to aim for in these tests in order to feel well and be able to use thyroid hormones efficiently;

Serum iron (well within range, nowhere near the bottom)

Ferritin (stored iron - 70-90 as an absolute minimum)

Vitamin B12 (above 500 - NHS reference range starts around 180 which is too low)

Folate (around 10-12 is good)

Vitamin D (above 80)

All these deficiencies are quite common in people with under active thyroid so it is worth testing if the doctor will do it. Taking a B vitamin complex is a good idea anyway. They are water soluble so you are unlikely to be getting too much by taking a supplement, but it is best to take all the B vitamins together.


Please can you just confirm the age of your daughter. Thanks.




my daughter is 16 now.


Assuming your daughter is adult, maybe when she takes the thyroxine is an issue?

A number of people have found they sleep better when taking it at bed-time. A recent poll here had interesting results and comments:

The other big question - does she take her thyroxine well away from any food, drink (other than water), supplements or other medicines? There are many interactions between thyroxine and other substances which can reduce effective absorption. A classic is iron-containing substances like ferrous sulphate or even the extra iron in breakfast cereals such as Special K. However there are many other substances - calcium or magnesium supplements or ant-acids, even milk, or coffee. Ideally two hours between taking thyroxine and most foods and drinks. Four hours for iron, calcium, magnesium.



she takes it first thinh in the morning and does not eat anything for about 2 hrs. she can not take at night as she takes medication for stomach migraines.


I am sorry your daughter is unwell, even though she is on medication. Some people are not good converters of levothyroxine (T4) to T3 (which is the active hormone we need ) and she still has many hypo symptoms.

If you can get a copy of her latest blood test results complete with the ranges from the surgery and post here for someone to comment on them.

Maybe it would be beneficial to see one of the private sympathetic doctors of ThyroidUK's list who may be able to improve her condition.

If they are able to help her the NHS may then prescribe .

I myself had insomnia whilst on levothyroxine and always felt ill but improved when I switched to other medication, which is not usually possible iin the NHS,

If she is not seeing an Endocrinologist maybe GP could refer.

Best wishes


thank you x


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