The fatigue that comes with this disease is real. I’ve had debilitating fatigue for long periods over the last 20 years that I’ve been diagnosed with hypothyroidism. When I was first getting diagnosed I felt like I was walking through sludge all day long. Tired when I went to bed and equally tired when I woke up. I was just telling someone I have really felt tired my whole life. I never tolerated the sun well, I didn’t have great endurance and my energy really kind of stunk for a long time. When I was younger I just powered through.
When I had two kids and was significantly more unhealthy I remember making my daughters 3rd birthday cake and being so exhausted by the end of the day to the point that when I sat down to take a load off, I just could not get up again. I was down for the count. I remember trying to run a 5k with my son when he was about 10 and I made it about a half a mile and I hit an energetic brick wall. I told him I couldn’t do it, I had to quit but that he should go on. I was on the couch the whole rest of the day.
I also didn’t not have a supportive spouse. I didn’t have the guts to speak up about how I was feeling and if I ever did, I got sort of blown off as a baby who just ‘couldn’t handle things’. Even a couple weeks ago I was out in the hot sun trying to bring the summer outdoor stuff to the patio and I just needed a rest so I laid on some furniture and my husband gave me a hard time. I had to remind him I have an autoimmune disease that sometimes requires me to take a break. I’m over not speaking up for myself so at least I’m fixing that piece of why my thyroid doesn’t work but that is a whole other episode.
So what can you do to fix your energy? There are many reasons why it might be in the tank. Let’s look at what they could be.
TSH. An obvious one and often difficult to get your doctor to look outside the box on the lab range here as many labs say a TSH of 4 or 5 is normal and that might just be enough for you to feel horribly tired all the time. According to some clinical groups, healthy persons should have a TSH below 2.5 uIU/L and the American College of Clinical Endocrinologiest has decided in recent years that TSH is good between 0.3-3.0 uIU/ml. Your lab likely is using its own range that is not even close to these numbers.
T3. If this is low your cells will not make energy well. If your Reverse T3 is high this means your body is making more of your T3 unusable and this can also affect energy levels. If your medication is a T4 only medication like Levothyroxine or Synthroid, maybe your body is not converting T4 to T3 well- this would look like high T4 and low T3 on a lab and can be from nutrient deficiencies or stress among other things. Ask for Free T3 and Reverse T3 to be tested in addition to TSH and the T4s. If T3 is low, ask for a combo med like natural desiccated thyroid hormone.
Anemia. Having low iron, low ferritin, low B12 can all cause anemia and can be easily found on a basic blood test called a CBC. Optimal ferritin for both men and women should be above 50 ng/mL.
Food Sensitivities. It is 100% possible to experience debilitating fatigue from foods you are sensitive too. Gold standard testing for this is elimination of suspected foods for a minimum of 3 weeks and then monitoring how you feel after a reintroduction of that food. You can do food sensitivity testing but it isn’t really reliable so my go to is doing an elimination.
How’s your blood sugar balance? If you subscribe to my newsletter you got some good info on how blood sugar dysregulation affects your thyroid a couple weeks ago. You can feel extremely tired after a meal containing too many refined or starchy carbs. You can make sure you eat protein with each meal and shoot for protein based snacks as well.
Eating huge meals. Overeating taxes your digestive system and makes you tired. Digesting your food is a big energy taker and most of us with Hashimoto’s are dealing with suboptimal gut function anyway. You may need some digestive support supplementation like digestive enzymes or even an HCL/betaine with pepsin supplement to help you digest your food for some time. Eventually, your body will work better at digesting food on its own and you won’t need to take digestive support but it can be really helpful if you are struggling with digesting your food well.
Cortisol. Adrenal fatigue isn’t really a thing. Your organs and glands don’t actually get fatigued. It is a communication issue with your brain but low cortisol can also be caused by stress. Drinking coffee in these cases can only make things worse in the long run. Taking an adaptogen like Rhodiola can be helpful to improve energy levels. Otherwise if you know you are dealing with low cortisol for sure, licorice root can be really good for this issue. It is quite stimulatory so be sure to take it before 1pm or it could keep you up.
Infections and inflammation. If you are dealing with gut issues whether it be IBS or some infection in your gut, you can be fatigued from it. Some practitoners would say a stool test will be good to find infections but if you have something like a parasite which lays eggs in cycles, you may not find anything in your stool.
Thiamin. This has been shown to be an issue for fatigue in some people. You can try a B Complex type vitamin or you can look for Benfotiamine which is more absorbable and can help with energy if you are in a deficiency. This you can test for using a SpectraCell test which tests for nutritional deficiencies.
Sedentary lifestyle. I know it is hard to get up off the couch. I have been there. But just getting up and going for a walk will start to improve your energy levels. Eventually you can do more than just walking while also being very careful not to over do it. You can try the Autoimmune Strong workouts which are a great place to start if you are new to exercise and have chronic illness. www.getautoimmunestrong.com. The more you exercise your cells will create more mitochondria which will in turn create more energy for you.
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