To ask about possible causes of chronic tiredness?

[KimberleyClark]

Background - I am 63,hypothyroid and retired. I’m tired all the time. Sleep all night, wake up tired. I’ve also gained weight. GP has done all the tests. Thyroid levels fine, thyroxine dose correct, not anaemic, liver/kidneys fine,not diabetic or pre diabetic,blood pressure perfect according to GP. I saw an endocrinologist privately. He tested my thyroid and cortisol levels ( for Cushing’ssyndrome). All fine. Any ideas?

Vitamin deficiency?

I had problems both with B12 and D.

I would ask for a referral to your local ME service and/or long covid clinic if these services are separate in your area.

Not sure if you saw this @KimberleyClark

I'd ask for a sleep study. Tired + weight gain is a red flag for it.

Oh yeah, I have sleep apnoea too.

Sleep Apnoea, narcolepsy, restless legs
Just because you think you're getting a good night's sleep doesn't mean you actually are!

I’ve had my vit d levels tested a few times. Never had any reluctance from the gp. Never had to ask for it specifically it was just covered from general symptoms.

When you say your thyroid levels are normal Op, do you know where in that ‘normal’ bracket you sit? I have family members who have hypothyroidism, and their consultant tries to keep them in the upper end of the ‘normal’ spectrum to negate all the symptoms you mentioned in your original post. It might be worth discussing with them up slightly upping your medication. Hope you manage to sort it out.

Also never had any reluctance from the GP to test my vit D levels, they suggested it in the first place and in fact as mine are still low she booked me in for another in 3 months time,
so I’ll have had it tested 3 times by then, all on their recommendation.

I am, however, sensing a reluctance from the OP to speak to her GP about this.

No I’m not reluctant to speak to my GP though it is not easy to get appointments these days. I’m not sure about the sleep apnoea, I’m sure DH would have noticed. And I have also seen an endocrinologist privately as I said in my OP - wouldn’t he have suggested it if he thought I could benefit from upping my dose?

She'd have to fit the referral criteria for a sleep study or the sleep clinic will reject it. So far, I don't see the OP mentioning any of the indicators they would be looking for.

What supplement do you need to boost this?

I’m exhausted all the time and my level is 16. GP notes say 13-150 is “normal” but wondering if this could actually be causing my tiredness!

I don’t know but just because they didn’t mention it doesn’t mean you shouldn’t get it checked - did they do a blood test for your vit D?

People have made various suggestions but your responses are all, you think this, you think that - but you don’t know so why not get all these things checked out?

What's your diet like do you eat well? Do you get lots of physical activity even if just walking everywhere?

If bloods are all ok sometimes tiredness can sadly just be one of those things particularly at 63 as you aren't on hrt. Do you have energy at all throughout the day or could you literally sleep non stop?

Yes I do eat well, don’t exercise as much as I should though been getting plenty these last few days as have my DB’s lab staying with us and been taking him for lots of walks.

Endocrinologist did not mention vit D.

I was chronically tired for a while. I started eating low carb and started taking vit D, B complex, magnesium and iron supplements.

I have so much more energy now. Quietly. I'm not on the go constantly but I no longer get home from work and need to sleep before I do anything else!

Your ferritin should be around 90-100. 16 is far, far too low and you will feel horrible and tired. You need either an iron supplement or to eat more red meat/sea food such as mussels.

I have an underactive thyroid as Isaid. Carbs are essential for the production of thyroid hormones so I don’t think it would be a good idea to go low carb.

I tried taking Floradix iron liquid for a while but it had no effect other than staining my teeth! Will try magnesium though. I currently take turmeric, Vitamin D and glucosamine for my dodgy knees. Also a low dose (10 mg) citalopram for anxiety.

@KimberleyClark I am hypothyroid myself and like you am always exhausted. One of the key symptoms is unrefreshing sleep. No matter how much you have you will still feel tired.

With hypothyroidism there are usually many deficiencies that go hand-in-hand with it. You need to get these checked: Vitamin D, Vitamin B12, folate, ferritin. They need to be at optimal levels not just low in their ranges.

Do you have your actual thyroid results? You are legally entitled to them. Your GP may tell you your results are 'fine' but in fact they could be far too low. The only way to get to the bottom of this is to get as much data as you can. Most endocrinologists are specialists in diabetes and know precious little about the thyroid. Many go on just your TSH value when you really need FT4 and FT3 measured too, along with thyroid antibodies (TPO and TG).

If you want more eyes on your results then do try HealthUnlocked in the thyroid forum, it's busy but you will get a lot of information there.

Without minimising it is often season related. When it is so cold and horrible we all want to have naps and stay cosy inside,. You might find as the days get longer and the weather milder you perk up.

I've had low ferritini/ iron infusion, low vitD/treated vit D and honestly energy levels remain unchanged whether these levels are low or normal The only thing that helps me is plans and forcing myself to be active. It kind of has a placebo effect, the more you do the more you feel able to do.

If you've got a dodgy knee, is it getting particularly swollen? Inflammation can make you feel very weary, even to the point of a flu like exhaustion.

Thank you!

They did prescribe me folic acid as my folate level was 3.8 which was mildly low. Ive been taking them for 2 months and not really seen any improvement.

My red blood cell count was mildly low as was my haemoglobin concentration. GP said this was to be expected because my folate was low.