Taking Levothyroxine and Still Tired? Understand Thyroid Fatigue!
Learn About– Thyroid Fatigue Symptoms, Reason behind this Thyroid Fatigue, and thyroid fatigue solutions. Thyroid fatigue is the most common symptom of a thyroid condition and even taking levothyroxine doesn’t improve fatigue. In fact extremely tired on levothyroxine or thyroid causing fatigue are the very common problems we hear from people who suffer hypothyroidism tiredness.
Thyroid fatigue solutions include a comprehensive plan that needs help with Mitochondrial Dysfunction, HPA Axis Dysfunction, Reducing Inflammation, and Improving Lifestyle to improvement of support thyroid fatigue.
Let’s begin —
Thyroid problems are so common and their numbers are rising significantly. Often females in middle age are diagnosed with thyroid disorder especially low thyroid condition aka hypothyroidism. Those females were told that the treatment is taking a medicine called levothyroxine.
Patients are also reassured that all their thyroid fatigue symptoms will resolve once they start taking this medicine. Finally, these females get a ray of light when they hear that the dreadful symptoms they have been dealing with for years will be gone.
But the real question is that does that really happen? Do the symptoms of thyroid disorder go away after taking levothyroxine?
The most frequent answer I get in my clinic is that females continue to suffer through the thyroid and adrenal fatigue symptoms even after taking this levothyroxine.
The worst is that their doctor now tells them that their lab numbers are really good and that eventually, the symptoms will get better.
Unfortunately, most of the symptoms don’t get better, especially the worst symptom is — is feeling tired or fatigued, commonly called thyroid fatigue.
For these females, it took them several years first to convince their doctors that they have a thyroid condition as all their symptoms point towards that but their thyroid numbers were misleadingly normal.
After finally their numbers catching up with their disease process and now taking this levothyroxine medicine still doesn’t give them relief, they still feel extremely tired on levothyroxine.
Even research has recognized the fact that the majority of females treated with levothyroxine still suffer from symptoms.
It was estimated that at least 15 % of patients treated with levothyroxine continue to have dreadful symptoms even after treatment. And it is being felt that the actual numbers are even higher.
This has led researchers now to focus not just on the lab numbers to treat a patient with thyroid disorder but also the symptoms.
But the real question is why are you still feeling tired and fatigued even after taking levothyroxine.
Reasons behind Thyroid Fatigue
4 major reasons behind thyroid fatigue are discussed below. Thyroid causing fatigue is not a myth, learn how —
Thyroid Hormone Complexity
What this means is that the thyroid hormone production is a complex phenomenon.
To understand the thyroid hormone complexity better we need to understand the thyroid gland and hormone physiology a little, so we can understand thyroid and adrenal fatigue. It starts all the way in the hypothalamus.
How is thyroid hormone produced —
Hypothalamus which is located in your brain secretes a hormone called TRH, this TRH then goes to pituitary your master endocrine gland. The pituitary secretes TSH hormone which then goes to the thyroid gland and causes it to secrete T4 hormone. Now, this T4 hormone needs to be converted to T3 hormone which is the actual hormone that your body can utilize. This is a very simple illustration of thyroid hormone production and it is much more complicated.
But even in this simple picture, you can see that treating your body with just one kind of thyroid hormone might not work, in improving thyroid symptoms.
And this is exactly what is happening, the Levothyroxine medicine given to you is just T4 hormone.
Very Importantly — Most of the time it is thought that there should not be any problem in the conversion of T4 to T3, but it can be possible.
A research study looked at patients treated with T4 alone and saw that the ratio of T3/T4 was lower as compared to the healthy population. So that means that high T4 doses do not generally lead to high T3 levels.
So it might be a good idea to use combination T4 and T3 medicine to see if that balances the thyroid hormone status.
HPA Axis Dysfunction
Hypothalamic-pituitary-adrenal axis is defined as the interaction between the hypothalamus, pituitary, and the adrenal gland.
This is a very specialized neuroendocrine system that controls your stress response, various other hormones in the body, energy, and also impacts mood changes.
Often there is a dysfunction of this pathway in patients with thyroid dysfunction and thyroid hormone replacement via levothyroxine alone doesn’t treat this dysfunction.
And often HPA Axis is an important system that is neglected by most practitioners and this HPA Axis dysfunction leads to fatigue caused by thyroid hormone imbalance commonly hypothyroidism tiredness.
Mitochondria are the powerhouse of your body. These small organelles are responsible for all the energy production in your body.
Without these tiny structures in our cell, we will not be able to function.
Mitochondrial function is dependent on thyroid hormone status but there are other things also that affect the mitochondrial function.
Often it is presumed that giving thyroid hormone will fix the mitochondria but in reality that is not the case.
So we need to work on restoring the mitochondrial function to optimize our energy production again.
Forgetting the Root Cause- Inflammation
And the biggest reason for thyroid causing fatigue is because nobody is addressing the root cause.
The root causes which started it all the thyroid imbalance is – the inflammation in body.
The inflammation in our body is destroying the thyroid gland, that is the reason our mitochondria are being destroyed too.
Replacing the thyroid hormone with medicine like levothyroxine does not reduce the underlying inflammation hence thyroid fatigue.
So we need to work on reducing inflammation too to help improve our energy when thyroid causing fatigue.
Thyroid Fatigue Solutions
We know the reason why just replacing our thyroid hormone with levothyroxine is not going to improve our energy.
There are other factors that impact energy production in our body, and those need to be addressed to improve your energy when affected by thyroid fatigue.
Combination Thyroid Medicines
Since most people of feel extremely tired on levothyroxine alone; what I generally recommend is adding little of T3 medicine to levothyroxine to see if that helps improve the T3 numbers and also at the same time improve the energy.
The natural desiccated thyroid medications like Armour and Nature thyroid have some T3 with T4 so that might another option if the above doesn’t work.
But I think this simple step of adding some T3 helps so many patients to improve thyroid fatigue.
For reducing inflammation the best thing to focus on is on the diet.
Food has such huge impacts on the level of inflammation in your system. So following an anti-inflammatory diet is very important.
A diet that removes food like sugar, processed food, simple carbs, gluten, dairy, soy, corn is important, as these foods promote inflammation.
While at the same time introducing foods that are anti-inflammatory like more vegetables, fruits, green tea, spices like turmeric, ginger.
Here’s a good Research-Based Hashimoto’s Diet, to help reduce hypothyroidism tiredness.
HPA Axis Dysfunction
This dysfunction which is very prevalent in people with thyroid problems fatigue needs to be addressed to help with energy levels.
The most important thing for this is stress reduction and inculcating some deep breathing or meditation in your regular routine.
There are supplements that can be helpful for energy, and one of my favorite ones is Adreset, which has helped so many people with low energy.
As we discussed above mitochondria is your powerhouse and mitochondria in your body are definitely not happy in thyroid diseases.
Taking levothyroxine has not resolved the mitochondrial dysfunction so we need to focus on other things that can help with hypothyroidism fatigue.
Often we need a combination of supplements to help with mitochondria, the most common being — Coq10 and than after that we need Acetyl L Carnitine and also Alpha-lipoic acid.
The best way to take a combination of Coq10 Acetyl L Carnitine and Alpha-lipoic acid together is through a supplement called Neurochondria.
There are other lifestyle factors like good quality sleep and exercise that are also important to improve your energy.
They are often overlooked and people sometimes don’t work on these factors and this, in turn, doesn’t let their energy levels to improve.
These have several benefits in themselves and work by different mechanisms. But it will be important to focus on them too and that will also improve your energy.
Summary of Thyroid Fatigue
Feeling fatigued and tired is one of the most dreadful symptoms of thyroid disease and often these symptoms don’t improve with levothyroxine medication. The most common reason being the reason people feel fatigued in thyroid condition is not a deficiency of thyroid hormone but much more than that.
So if we make a comprehensive plan to improve energy levels people see much better results.
Related Read to Thyroid Fatigue:
References for Thyroid Fatigue :
Sarah J. Peterson, Elizabeth A. McAninch, Antonio C. Bianco. Is a Normal TSH Synonymous with “Euthyroidism” in Levothyroxine Monotherapy? The Journal of Clinical Endocrinology & Metabolism, 2016; jc.2016-2660 DOI: 10.1210/jc.2016-2660
Werneck de Castro JP, Fonseca TL, Differences in hypothalamic type 2 deiodinase ubiquitination explain localized sensitivity to thyroxine.J Clin Invest. 2015 Feb;125(2):769-81. doi: 10.1172/JCI77588. Epub 2015 Jan 2.
McAninch EA1, Jo S, Preite NZ,. Prevalent polymorphism in thyroid hormone-activating enzyme leaves a genetic fingerprint that underlies associated clinical syndromes.J Clin Endocrinol Metab. 2015 Mar;100(3):920-33. doi: 10.1210/jc.2014-4092. Epub 2015 Jan 8.
Woeber KA . Levothyroxine therapy and serum free thyroxine and free triiodothyronine concentrations. J Endocrinol Investig. 2002;25:106–109.