# Fatigue, weight gain, brain fog.... oh my!



## sweet_steph (Jul 6, 2014)

Hi all, 

I am in the first 2-3 months of working on my thyroid, and I am pretty overwhelmed. I am working with my family doctor and a nutritionist. I have been recommended to an endocrinologist, but it doesn't look like I will be able to get an appointment until September or so, and I hate to think I will have to continue to feel this way until then. I am having a great deal of fatigue, brain fog (trouble concentrating), feeling bloated, and weight gain, among other things!

I have eliminated gluten, dairy, soy, peanuts, and raw cruciferous vegetables for 6 weeks (this is week 5). In my smoothies I use dynamic greens to avoid the spinach and still get in my veggies. I have continued to use whey protein at this time. At each meal/snack I try to keep it balanced with protein, a healthy fat, and healthy carbs. I do not eat any processed food/carbs anymore, and haven't for some time.

I am taking a lot of different supplements with certain meals. I am taking bifido balance probiotic, L-Glutamine, Natural Calm magnesium, Vitamin D3 (5000 IU), Fem Prenatal Packets, Buffered Vitamin C, Fish Oil, GLA, and Chaste Tree Extract. (If you need to know when they are taken/how much, etc. let me know and I can break that down). I am also on 50 mcg of Synthroid.

Are there any other recommendations you would have for battling the fatigue, brain fog, weight gain/bloating? Any books or other resources you would recommend? Cookbooks?

I have cut back on intense workouts for now.

My doctor was reluctant to test for my TPO AB at my 6/25/2014 dr visit, but luckily went ahead and tested.

**TMI Warning*** I have not had a menstrual cycle in 4-5 months. I am nervous of infertility issues in the future (I am 30).

Here are my numbers:

Result Range

4/16/2014 TSH 6.72 .27-4.20

4/24/2014 TSH 4.44 .27-4.20

Free T4 1.06 .93-1.70

T3 Uptake 1.0 4.4-11.4

T4 6.0 4.5-11.7

(Started Synthroid after 4/24/2014 visit)

6/25/2014 TSH 1.97 .27-4.20

T3 Free 5.84 4.26-8.10

TPO AB 415.00 <35

I am sure there are many other questions I have, and some additional info to offer, but this is all I can think of right now as it is all a little overwhelming at this point. Any advice, suggestions, etc you can offer will be much appreciated. I look forward to hearing from you! :confused0081: :scared0015: :confused0031:


----------



## Andros (Aug 26, 2009)

Welcome to the board. 4th. of July rather slow around here so expect more responses next week.

How much Synthroid are you taking? According to your FREE T3, you do not appear to be converting very well. Free T3 ideally should be above the mid-range of the range given by your lab. And I do strongly recommend that you get an ultra-sound if you have not had one.


----------



## sweet_steph (Jul 6, 2014)

I am taking 50mcg of synthroid. After reading some posts on here I am going to request an ultrasound of my thyroid when I can finally see an endocrinologist. What will the ultrasound show?


----------



## jenny v (May 6, 2012)

I think you definitely need a bump up in your Synthroid, maybe to 75mcg. An ultrasound would be good with antibodies that high, it will show if there are any nodules, goiter, abnormalities, etc. Even if nothing shows up, it's good to get a baseline ultrasound to compare to future results and note any changes.


----------



## Lovlkn (Dec 20, 2009)

> (Started Synthroid after 4/24/2014 visit)
> 
> 6/25/2014 TSH 1.97 .27-4.20
> 
> ...


What did the doctor who ran these have to say? You are still hypo - I imagine you do still feel quite hypo/

I agree that a dose increase is needed - call your doc if they have not suggested an increase and ask for one.


----------



## sweet_steph (Jul 6, 2014)

Those were the results from my family doc, and he didn't seem to think it was that bad. He didn't want to test my antibodies, but my nutritionist suggested it. So, luckily we did. He said my free T3 was normal but since my antibodies were so high he was recommending me to an endocrinologist. 
I was beginning to wonder if me feeling pretty terrible was just in my head since no one seemed to think those numbers were that bad. My friend's bf is also a doc and when I asked him he said "oh it'll just burn out and you'll be on synthetic thyroid no big deal". 
And right now I can't get an endo appt until the end of September so I don't know what I can do to be proactive and help in the meantime.


----------



## sweet_steph (Jul 6, 2014)

What should the numbers look like to be within a good range?


----------



## Andros (Aug 26, 2009)

Most of us function best w/TSH @1.0 or less and the FREE T3 @ about 75% of the range provided by your lab.

Get that ultra-sound!


----------



## bigfoot (May 13, 2011)

sweet_steph said:


> Those were the results from my family doc, and he didn't seem to think it was that bad. He didn't want to test my antibodies, but my nutritionist suggested it. So, luckily we did. He said my free T3 was normal but since my antibodies were so high he was recommending me to an endocrinologist.
> I was beginning to wonder if me feeling pretty terrible was just in my head since no one seemed to think those numbers were that bad. My friend's bf is also a doc and when I asked him he said "oh it'll just burn out and you'll be on synthetic thyroid no big deal".
> And right now I can't get an endo appt until the end of September so I don't know what I can do to be proactive and help in the meantime.


This is not "in your head". Many docs are just not well-versed on thyroid issues. This is evidenced by the fact your own doc was reluctant to order antibody testing, and your doctor acquaintance thinks it will just burn out. That could take decades, if it happens at all. Thyroid issues are complicated, not one-size-fits-all, and require plenty of monitoring and followup, as well as different treatments. This means a simple ten minute appointment once or twice a year just isn't going to work. You and your doc need to be hands-on, think outside the box, and be open to testing and new approaches. As of several years ago, the AACE recommends a TSH range of 0.3-3.0, yet labs and doctors are still not aware of this significant change. Not only that, a TSH test is not the best way to evaluate thyroid function, and it's a pituitary hormone no less.

It sure sounds like you are doing everything else right, especially in regards to nutrition, supplements/vitamins, and exercise. So that leaves adjusting your thyroid dose until you feel well, unless something proves otherwise. You are looking to have your hormones optimized, not just "in range" or "normal". An arbitrary number on a piece of paper doesn't translate into you automatically feeling well. It's important to at least run a TSH, Free T3, and Free T4 now and going forward with monitoring. Additionally, testing Thyroglobulin Ab's and Thyroid Stimulating Immunoglobulin (aka TSI, *not* the same as TSH) is critical to make sure you have the proper diagnosis. A Reverse T3 test would be nice. I'll echo everyone else and suggest a baseline thyroid ultrasound, too. Be sure to get and keep copies of ALL lab and test data, it can be handy for future reference.

Fatigue, brain fog, and weight gain can absolutely be from hypothyroidism. (Most of us here have had that big time.) You have TPO Antibodies, and those can be suggestive of Hashimoto's Disease, which brings an autoimmune component to the table. But still, without a few more tests run, it's hard to be totally sure. Like everyone has said, you probably need an increase in your dose of levothyroxine. Keep in mind that brand-name Synthroid, like many meds, is not GF -- so if you are Celiac that can be an issue. Supposedly the generic T4 manufactured by Mylan is GF. There is also brand-name Levoxyl and hypoallergenic Tirosint as options. If one drug doesn't seem to be working for you, another might. Something to think about down the road is the combination T4+T3 desiccated meds such as Armour, Nature-Throid, and West-Throid. Many folks here have switched to them eventually with good results, but that doesn't mean you have to; just file it away for the future.

Getting back to doctors, while that endo appointment can't come soon enough, you definitely want some traction in the meantime. If your doc isn't going to work with you, I'd suggest looking online at the Armour website, Nature-Throid (RLC Labs) website, and even the Wilson's Temperature Syndrome website (not to be confused with Wilson's Disease). This should bring up some docs in your area that are a little more open-minded. Beyond that, you can call a local compounding pharmacy and see if they can recommend anyone. It is important not to get stuck and spin your wheels if you are receiving a lot of pushback. Too many docs want to tell people they are just depressed, throw them some free drug samples, and call it a day. That simply masks the symptoms and does nothing to address the root cause(s).

Ultimately, this has to be dealt with on two levels. One is to reduce inflammation, and the other is to optimize your hormones. And really there is a third: nutrition & lifestyle, but I think you've got that one covered pretty well!

hugs3


----------



## sweet_steph (Jul 6, 2014)

Wow!! Thank you for the thoughtful and informative replies y'all! I really appreciate it!! I will get to work on all of these things. I have called another endo who is accepting new patients on a limited basis and will review my paperwork and decide if I will be accepted. If so, I could possibly see her at the end of this month! Fingers crossed! I will also meet with my nutritionist this week or next, and she is a God send, and actually has Hashimoto's herself as well! 
I listen to a podcast called Dishing Up Nutrition. It is amazing! They do have several episodes on thyroid function. I highly recommend checking it out as they have so many different topics available on their episodes. 
Do you all have any cookbooks you have found that you like? Is anyone else GF, dairy free, soy and peanut free? 
I still have a lot to learn, but I feel like I'm on the right track!!!


----------



## bigfoot (May 13, 2011)

That is excellent news -- good luck with the new endo! There are some sharp ones out there, it's just a matter of wading through the rest to find them.

GF and Paleo here, and I try to limit dairy and soy consumption. That being said, I will have ice cream and cheese occasionally, and same goes for fresh sushi (using a little GF soy sauce, aka tamari). 

One book we like is called "Nom Nom Paleo". No connection to the author, but it has lots of helpful step-by-step photos for the recipes. Think I saw it at Costco recently, too. Can't miss it, it's bright red and a hardcover.


----------

