Still Tired

[Sparkyman]

My TSH is level at 1.  Currently taking 100MCG of Levothyrozine and 5Mcg of Cytomel.  I get adequate sleep but wake up tired.  If I sleep in, I still wake of tired.  I have been having chronic Sinusitis.  Endocrinologist states that I will always fight fatigue with Hashomoto's.  Tired of being tired, I am 44 and work out 5 times a week at lunch.  Exercise is the only thing that helps me.  I tried a morning class but can't consisitently get up and go.

Please advise

[TamraW]

If you have Hashimoto's and are suffering from severe fatigue, some things to consider:

1. Many Hashis don't feel better until our FT4 and FT3 levels are in the top 1/3 of the range.

2. Sometimes FT3 levels can be deceiving and a reverse T3 test will show that you have a T3 deficiency.

3. Many Hashis have low adrenals and they will need their adrenals checked and treated if deficient.

4. Many Hashis have another auto-immunity, nearly half have Sjrogen's, according to Dr. Ridha Ahrem.  

5. You could have an issue with certain foods that trigger the antibodies, such as caffeine, gluten, sugar, soy, yeast, dairy, etc...Try eliminating one food at a time to see if you feel better.

6. Many Hashis are low in D, B12 and iron and will need to supplement.

7. Finally, when the antibodies flare up, this can also cause fatigue.

I cut my morning fatigue down by eliminating sugary cereal, cutting back on coffee, and eating a high protein, no gluten breakfast. Also, my frees are in the top 1/3. My TSH is a 0.04 because my endo treats the symptoms and frees and not the TSH. Your doctor is asking you to accept your fate, be a good patient and quit complaining. Ask your doctor if he would like to be fatigued for the rest of his life. Consider a second opinion.

Here's the website where I found my new endo:

http://www.thyroid-info.com/topdrs/

:) Tamra

[Sparkyman]

So are you feeling any different since you began your supplement?

[Sparkyman]

Free T4 .86     Range .58-1.64
Free T3 3.15   Range  2.3-3.90
TSH  .46         Range  .34-5.60
Total T3 1.24   Range      .87-1.78
ANTI TPO  87.60    Range    0-10
Thyroglobulin Anitbodies  3.00    Range   <2.2

Endo says everything OK and fatigue is something I have to deal with due to Hashimoto's

[Sue9823]

Vitamin D is in some of your food but most of it is made in the skin by the sun.  Unless you live close to the equator, most people don't get enough sun to make enough vitamin D and should take supplements.  

I live in Ottawa ON Canada.  I can not see the sun for months during the winter ... get to work when it's dark, stay at my desk at lunch and get home in the dark.  When it's dark by 4:00 that's not hard to do!  Then of course when you only get 10 days of sun in the summer ...  I see you're in NJ so I'm sure you can relate.

Most doctors suggest 1000iu of vit D daily. They;re cheap tablets I get mine for about $3 for 100.

[Sue9823]

I am now taking 1000iu of vitamin D but I don't think it's enough. I'll have my lab results again next week.  The iron supplement has to wait until I get other tests completed as low ferritin can be caused by internal bleeding and taking a supplement would mask the problem.  Deficiency in both vitamin D and iron cause fatigue each on their own so I've got a double whollop.  

Low thyroid hormones cause low metabolism so everything in your body slows down including how your body creates and uses the energy your food gives you.

[gimel]

If you will supplement those test results with the reference ranges for your specific lab, then I think we will see that your FT3 and FT4 are too low in their ranges and that is why you fight fatigue issues.  Hashimoto's doesn't cause fatigue.  Hashi's causes destruction of the thyroid glands which results in low levels of the biologically active thyroid hormones.  So you have to supplement/relace with meds adequate to relieve symptoms, without being constrained by resultant levels of TSH. Yes, physical activity is good and it is a stimulant, but it is not a substitute for adequate thyroid hormone.

[Sparkyman]

What have you done about Vitamin C and ferritin?? Has this made any difference?
I work out at my lunch time, Take a kick boxing class, It really Gets up may cardio and Temperature and after working out I feel functional.  Days that I miss a work out I drag throughout the entire day.  It is my therapy!!

[Sparkyman]

Thanks for advise.  Last Lab Results=
Free T4  .86
Free T3    3.15
TSH    .46
Total T3   1.24
Ant TPO  87.60
Thryoglobulin Antibodies   3.0

I made an appointment with GP to dicuss chronic Fatigue and Sinusitis'
Next Week,

Any additional advise is appreciated

Sam

[Jeanne49]

If you have no thyroid will vitamin D  levels be low.

[Sue9823]

I can relate to your tiredness.  I am 52 and never had my vitamin D levels checked until last summer,  when it came back a whopping 0.01.  The reference range for Vit D is 20.0 to 100.0!  Vitamin D is actually a hormone and affects the thyroid. I also have a low ferritin of 21 with a top range of 200 -300.  

You should have your doctor check these levels as well as FT3 & 4.  P.S. I WISH I could work out 5 times a week - I'm lucky I can drag my butt from the bed to the couch before noon!!!

[gimel]

TSH is a pituitary hormone that is affected by so many variables that it is not adequate as a  diagnostic for thyroid status.  At best it is only an indicator, to be considered along with the more important indicators, which are symptoms along with the levels of the actual, biologically active thyroid hormones, FT3 and FT4.  Unfortunately far too many doctors have the "Immaculate TSH Belief" and try to medicate a patient by TSH level.  Frequently that does not work.  

In my opinion the very best way to treat a thyroid patient is to test and adjust the levels of FT3 and FT4 with whatever medication is required to alleviate symptoms, without being constrained by resultant TSH levels.   Symptom relief should be all important, not TSH level.  Frequently we hear from members that symptom relief requires that FT3 is adjusted to the upper part of its range and FT4 is adjusted to at least the midpoint.  

If you will post your latest lab report results and reference ranges, members will be glad to comment further.