# Hashimoto's and Tiredness



## Viv22 (Sep 3, 2013)

Hi All

I've recently been diagnosed with Hashimoto's and whilst every week I feel a slight improvement, I have this unbearable fatigue. By the end of the day, I literally cannot put my left foot in front of my right foot. I want to go home and sleep but I have things to do. This is really getting me down.

I have taken to eating sugary things to wake me up and I realise that this is like poison and makes me feel worse so am trying to make a conscientious effort to avoid sugar but this is extremely difficult for me.

I am waiting to see an auto immune specialist as it is suspected that I may have Sjorgen's too but it feels like I am wasting my life away.

Is there anything anyone can suggest please.


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## Andros (Aug 26, 2009)

Viv22 said:


> Hi All
> 
> I've recently been diagnosed with Hashimoto's and whilst every week I feel a slight improvement, I have this unbearable fatigue. By the end of the day, I literally cannot put my left foot in front of my right foot. I want to go home and sleep but I have things to do. This is really getting me down.
> 
> ...


Are you on thyroid medicine? If so, what kind,how much and how long have you been taking it?

Have you had an ultra-sound? How about your ferritin level which is usually quite low in those of us w/autoimmune?

Ferritin (should be 50 to 100; the closer to 100,the better) 
http://www.thewayup.com/newsletters/081504.htm


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## Viv22 (Sep 3, 2013)

Thanks for the response. I am on 100 mg Levothyroxine which I take last thing at night.

I have not had an ultra sound.

I do not understand my blood tests but there are several abnormalities. I would like to send a copy of my blood tests but not sure how to send this. Is there somewhere I can private message?

Thanks


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## bigfoot (May 13, 2011)

Fatigue is part-and-parcel with this stuff. Been dealing with fatigue here for years. You're right, sugar and caffeine should be avoided. It's possible your adrenals are burned out, and it's also possible there is something else going on here.

When you post labs here, all you need to do is show the date, test name, data, and range. We don't need (or want) any personal data. No lab location, no name, none of that stuff. Keep it totally anonymous. For example:

1/2/13:
TSH 3.0 (0.3-5.4)
Free T4 1.0 (0.8-1.4)
Etc...


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## Viv22 (Sep 3, 2013)

I take Vitamin C daily, vitamin B12 and Ferrous Sulphate.

Here are my results:

Autoantibody level - (NMP) - Normal - No Action
Nuclear autoantib screen test NEGATIVE
Parietal cell au4oantibodies NEGATIVE
Antimitochondrial autoantibody NEGATIVE
Microsomal autoantibodies NEGATIVE

Anti smooth muscle autoantibody POSITIVE +
Associated with viral, drug-induced or autoimmune hepatitis. (Repeat testing is not normally required in established autoimmune hepatitis).

Serum vitamin B12 571 ng/L [174.00 - 1132.00ng/L]
Serum Folate >20 [4.20 - 18.7]

Thyroid Peroxidase Antibody Level >600	[0.00 - 34]

Cortisol Level Abnormal (9 AM) 713	[138 - 690]

Serum Free T3 level abnormal 
Serum free T4 level 22.6 pmol/L [10.30 - 24.50pmol/L]
Serum free T3 level 4.5 pmol/L [3.50 - 6.50pmol/L]

Glomerular filtration rate - (NMP) -Normal - No Action
Serum creatinine 69 umol/L [44.00 - 80.00umol/L]
Glomerular filtration rate 82 mL/min
GFR calctd abbtd MDRD Af Am or 99 mL/min

Serum C reactive protein level - (NMP) - Normal - No Action
Serum C reactive protein level 2 mg/L [0.00 - 5.00mg/L]

Bone profile - (NMP) -Normal - No Action
Serum albumin 44 g/L [35.00 - 52.00g/L]
Serum alkaline phosphatase 42 u/L [35.00 - 104.00u/L]
Calcium level 2.28 mmol/L [2.15 - 2.50mmol/L]
Corrected serum calcium level 2.24 mmol/L	[ 2.15 - 2.60mmol/L]
Serum inorganic phosphate 0.92 mmol/L	[0.90 - 1.45mmol/L]
Serum total protein 74 g/L [66.00 - 87.00g/L]
Serum globulin 30 g/L [18.00 - 36.00g/L]
Serum sodium 142 mmol/L [136.00 - 145.00mmol/L]
Serum potassium 5.1 mmol/L [3.50 - 5.10mmol/L]
Serum urea level 3.6 mmol/L [2.10 - 7.10mmol/L]
Serum creatinine 69 umol/L [44.00 - 80.00umol/L]
Serum Chloride 111 [95 - 105]

Serum ferritin - (NMP) -Normal - No Action 39.9 ug/L [13.00 - 150.00ug/L]
Erythrocyfie sedimentation rate - (NMP) - 33 mm/h	[1 - 12]
Raised, referred to rheumatologist

Full blood count - FBC - (NMP) -Normal - No Action
Total white cell count 8.1 [10*9/L 3.90 - 11.1010"`9/L]
Haemoglobin estimation 131 g/L [118.00 - 148.00g/L]
Please Note:Hb and MCHC are now reported in g/L
Haematocrit 38.3 % [36.00 - 46.00%]
Mean corpuscular volume (MCV) 88.0 fL [82.00 - 98.00fL]
Mean corpusc. haemoglobin(MCH) 30.1 pg [27.30 - 32.60pg]
Platelet count 328 10"9/L [140.00 - 400.0010*9/L] 
Neutrophil count 5.0 10*9/L 1.70 - 7,5010*9/L
Lymphocyte count 2.4 10"9/L 1.00 - 3.2010*9/L
Monocyte count 0.5 10*9/L 0.00 - 0.8010*9/L
Eosinophil count 0.1 10*9/L 0.00 - 0.5010*9/L
Basophil count 0.0 10*9/L 0.00 - 0.1010*9/L


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## Andros (Aug 26, 2009)

Viv22 said:


> I take Vitamin C daily, vitamin B12 and Ferrous Sulphate.
> 
> Here are my results:
> 
> ...


I am thinking you are hurting. TPO; very high, ESR; very high. These 2 items are suggestive of many things and while you have had a lot of tests as listed above, I don't think this is sorted out yet.

Here is some stuff on the ESR and you might want to bookmark this site so you can look other stuff up.
http://labtestsonline.org/understanding/analytes/esr/tab/test

For that reason, I am glad you are seeing a rheumatologist.


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## bigfoot (May 13, 2011)

Thank you for posting that! That must have been quite a bit of typing, but it's greatly appreciated.

Yes, your TPO is waaay up there. Hopefully you can get a thyroid ultrasound, at least as a baseline. And your Smooth Muscle Antibody test shows positive, along with a raised Cortisol and raised Sed. rate. Did they run a Rheumatoid Factor (RA) or any liver numbers (such as AST, ALT, etc.)?

I would think that seeing a gastroenterologist for a consult, as well as a rheumatologist would be a good idea. You want to rule out things like autoimmune hepatitis (which can cause some wicked fatigue) and rheumatic issues. A lot of autoimmune diseases like to run in packs -- where there is one, there is usually more. So it can become a matter of addressing a few things as individual pieces of a larger puzzle on the way to getting you feeling better.

hugs6


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## CA-Lynn (Apr 29, 2010)

Yes, the two things that stand out to me are the TPO. The ESR is INDIRECT inflammation, which can be useful information. But the good part is that your CRP is normal [this measures DIRECT inflammation].

The words of advice I give you: hang tight until you see a specialist. Nap whenever you want. Don't try to fight it. Just let your body rest. Right now inside there's a little war going on, so surely you have battle fatigue.


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## Viv22 (Sep 3, 2013)

Thank you all for your words of wisdom. I will take everything on board and try and get some positive action.

This sure is a long uphill battle and I find that if I do not point things out to my GP, it is not dealt with. Maybe it's just processes being worked through but it feels like it is taking a very long time to get back to full health.

My eyes are hurting again today (like some sort of movement going on behind the eyes) and I am very tired again.

I got some Gymnema Sylvestre which is a herbal tablet that apparently stops you craving sugar so will try that out for a bit.

I will persevere. Thank you.


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## Andros (Aug 26, 2009)

Viv22 said:


> Thank you all for your words of wisdom. I will take everything on board and try and get some positive action.
> 
> This sure is a long uphill battle and I find that if I do not point things out to my GP, it is not dealt with. Maybe it's just processes being worked through but it feels like it is taking a very long time to get back to full health.
> 
> ...


Be careful w/ that Gymnema Sylvestre; it can drop your glucose really really low!


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## Viv22 (Sep 3, 2013)

Gosh that's all I need now... Thanks for the tip!


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## Viv22 (Sep 3, 2013)

I had a call from the GP this morning. She says that I am hyper and that my medication must be reduced with immediate effect. Apparently this is the second blood test in 2 weeks that has come back as hyper. Do you think this is why I am so tired maybe? I am to start on the reduced dose of 75 mg Levothyroxine tonight. I really hope this is what my problem is at the moment. I want to feel normal and energetic again. I feel so useless. Going home everyday and just lying on the sofa - what a waste!


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## Danniswirl (Feb 23, 2013)

Get your adrenals tested via saliva test. When you have autoimmune issues it seems to go hand in hand. I hope you feel better.


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## Viv22 (Sep 3, 2013)

Thank you. I am having a really bad day again today. I saw my GP this morning who seems baffled with what is going on and doesn't think that this has anything to do with Hashimoto's. GPs tend to dismiss this for some reason. He says "something else is going on".

I have an appointment with the Rheumatologist at the end of October. Everyday is a struggle. I have to take one day at a time. I will ask GP to test my adrenals via a saliva test.

I wonder if I will ever feel well again. I feel so useless. I hate being this way.

Thanks again.


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## Andros (Aug 26, 2009)

Viv22 said:


> I had a call from the GP this morning. She says that I am hyper and that my medication must be reduced with immediate effect. Apparently this is the second blood test in 2 weeks that has come back as hyper. Do you think this is why I am so tired maybe? I am to start on the reduced dose of 75 mg Levothyroxine tonight. I really hope this is what my problem is at the moment. I want to feel normal and energetic again. I feel so useless. Going home everyday and just lying on the sofa - what a waste!


I sure don't believe that. 5.0 is mid-range of your lab range for FREE T3. Most of us need the FREE T3 at about 75% of the range provided by your lab. Yours is below the mid-range.

That equals tired.

You may have to find another doctor that understands this stuff.

Here is some info:

Understanding the Thyroid: Why You Should Check Your Free T3
http://breakingmuscle.com/health-med...k-your-free-t3

Dr. Mercola (FREES)
http://www.mercola.com/article/hypot...nosis_comp.htm


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## bigfoot (May 13, 2011)

Yeah, I concur. I don't understand why the lab value for Free T3 says "abnormal", yet your numbers look fine on paper. Did I miss something?

As far as your doctor, he might be right. There might be more to this story; in fact, there probably is. But that doesn't change the fact that Hashi's is autoimmune, first and foremost. And *if* you were truly over-medicated (or hyper / Graves, which is another ball of wax), that absolutely can contribute to tiredness and fatigue. The idea to see the rheumy is a good one -- although caveat emptor, specialists can be dismissive at times (just gotta go into with an open mind). Ultimately, you need someone who understands the autoimmune component to all of this, and how it relates to the rest of the body. If your GP is supportive, hopefully you can get some other tests run to start looking under rocks in the meantime.

hugs3


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## surge (Aug 15, 2012)

This is why I WISH there were autoimmune centers with doctors who concentrate on the AI variants of thyroid and we had help in educating our practionners about how complex treatment can be...Your gp wants their to be an easy solution, I mean you'd like one too, no doubt, but probably, it won't be a clear straight road. It's going to be trial and error and also trying to address issues like adrenals, as well as the thyroid.

Because your antibodies are elevated, it does make your thyroid numbers suspect to me. When I had my thyroid (I had it removed almost a year ago) my numbers never matched how I felt and even my endo after a certain point was at a loss since the way my numbers moved seemed to have no connection to the medication adjustments she was recommending. She just started asking me what I'd like to try. Kind of what I wanted, but not exactly comforting.

The eye thing does sound like Sojgren's. What's the status on that diagnosis? What prompted the extensive bloodwork? Was it the fatigue or were there other specific symptoms?


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## Viv22 (Sep 3, 2013)

Thank you everyone for your input.

I really don't understand what is going on with me. I am experiencing extreme up's and down's. I was sitting at my desk yesterday at work trying to get through the day (it's been a very tough week), suffering with this exhaustion and this weird eye and antibodies fighting inside feeling.

I was feeling very cold and tearful - maybe hypo?! I think just at the end of my tether. Wondering if I am ever going to be well again?! At about 16.30, for no reason whatsoever, I felt this strange feeling inside, almost like a light switch, and I felt almost normal again. I can remember the exact moment - I wish I could understand what is happening to me. From that point on I have been feeling almost myself again. It is so strange.

I am so obsessed with what is going on. I read everything. I think maybe it is a "flare up" or a "storm" or maybe "Hashitoxosis". If it is, why does it happen - how can I avoid this happening?

I even had enough energy to go to the gym this morning and did very gentle jogging and walking.

I have seen 2 doctors this week. My NHS GP who I told to give me a referral to see a Gastroenterologist - he seems very confused as to what is wrong with me but he said that I was only very slightly over medicated when his practice rang me last week and it should not have made me feel so bad. This confuses me more.

I also went to see my work GP who is private. The work GP started giving me a lesson on the HPA Axis. We did not have enough time together and I have to see him again next week to hear what he is going to do about it (yeah very strange but anyway&#8230 but he mentioned sending me to a Rheumatologist too. He seems to think this has nothing to do with my thyroid but says there is nothing very out of the ordinary in my blood tests. Really?! Am I losing my mind?

I'm thinking of going to see 2 different Rheumatologists - one private and one NHS. I have to wait until the end of October to see the NHS one. Crazy - they initially told me I would have a 4 month wait. I was inconsolable.

Andros, I'm on Levothyroxine - do you think this is the best medication for me?! I am on a reduced dose of 75 mg since the last week's "episode".

Where do I find a doctor who knows about this stuff - this is very difficult?! I remember asking the receptionist at the practice before I joined if the GP had considerable experience with the thyroid and she seemed to think he did - very generic.

Bigfoot, perhaps you could recommend the big rocks I could have my GP look under - he seems to be prone to gentle persuasion&#8230;. Seems like a common story.

Surge, I'm not entirely sure why the GP thought of Sjorgens but he seemed to be suspicious of this from the day I met him - I told him about the eye thing, fatigue, antibody fighting inside feeling (this is how I summarise it - I have no idea what this weird feeling is), my heart either beats fast or doesn't feel like it is beating at all, dry lips, mouth ulcers, sore tongue. I have an irritable bladder and bowel too. I go to the toilet and by the time I get back to my desk, I feel I need to go again. I wake up 3 times a night after 2 am to go to the toilet - and I am not a big water drinker - especially at night.

I feel like whatever had me in its grips, released me yesterday and it doesn't feel as intense. What is going on?

Thank you all for taking the time to listen to me and respond. I understand you are not medically trained but you seem to know a hell of a lot which helps.


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## surge (Aug 15, 2012)

It probably isn't one thing going on, but several things in cahoots, unfortunately. For example, my sex hormones got off balance with everything going on with my thyroid and now I only feel bad around my period. So I know that some of the mess I was feeling last year at this time had to do with that. I also know that I'm inching back (and my hormone tests all show up as normal), so I suspect I just need a little more time and support to calm down further.

For a lot of people, what they associate with thyroid is adrenal and that's just basically saying your body is stressed, which of course, yours is. There's not a lot to do to help the adrenals other than support the body as it tries to address this on its own (unless you have Addison's or Cushings, which is something else entirely...). There are some herbs people recommend and others just advocate more salt and lots of rest with little sugar and caffeine.

Some things to consider as support while you continue to explore this with other doctors:

-even if you're not celiac and not gluten intolerant, with autoimmune thyroid issues, gluten can be an interfering agent. It can also affect how well you absorb your medication. B/c most people don't repeatedly eat consistently the same amount of gluten day by day, week by week, it can also be difficult to medicate around. Consider giving up wheat while your body is struggling. It's probably not forever but giving it up for 6 weeks and evaluating might be worth investigating. I know you have some allergies and I'm not sure if wheat is one of them
-dry brushing is good for people with autoimmune issues. It's not going to make you feel amazing and cure you or anything, but again, it's about support and self care and this specifically stimulates the lymphatic system, which seems to also factor into 'flares' people experience, though we don't know how the lymph system is involved exactly
-if you're not on fish oil, get on it. As high a quality as you can afford. 
-consider buying a protein supplement that agrees with your dietary restrictions-- a whey powder or vega powder-- to drink in water at mid-morning and mid-afternoon. Protein helps build back up a depleted system. 
-drink a supporting tea, either a detox or something healing like a ginger tea or tulsi. Drink 1-2x every day. This is more hydrating fluid and also over time could help support your body.
-either take a probiotic and/or drink kefir every day to try and repopulate the gut with good bacteria.

Really all these steps are small steps and the big levers that will affect your overall health more dramatically is finding your correct dose and getting to a stable place with it + perhaps some other interventions for the other issues that do seem like they are clearly going on with you.

You can advocate for yourself with your docs, but advocate for yourself in your home life by making sure you're gentle with yourself, getting lots of rest, taking some time for gentle exercise-- like you mention in your last post--, drinking lots of fluids and finding nourishment that doesn't further irritate an angry system (I know it's tempting to just not eat, but your body needs help rebuilding. To deny food, particularly protein right now, is to deny your body the energy and nutrients it needs for that work. If necessary, meet with a dietician or nutritionist to create do-able menus for meals and snacks).

You're in an incredibly tough place. Keep reading. Keep reaching out to your doctors, sites and resources like this one, etc.


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## Viv22 (Sep 3, 2013)

Surge, Thanks for the very informative response.

What is dry brushing?


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## surge (Aug 15, 2012)

Dry brushing is just brushing your body in the direction of the heart (so not shoulder to elbow to hand but hand to elbow to shoulder) on rising.

Here's a short video demo: 




Again, this is just support-- it's not going to radically shift anything but maybe in combination with proper medication and other support, over time, it could help you feel closer to your old self...


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## Viv22 (Sep 3, 2013)

Thank you Surge. All your tips are appreciated.

On a general note, I am feeling so much better. Perhaps I am truly on the mend. I hope so!

I am seeing the private GP tomorrow and will hopefully get a referral asap to see a Rheumatologist.

I will keep you posted.


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