exhausted & on my knees here - any ideas what's wrong so I can go back to dr armed.

[ErnesttheBavarian]

Have hashimotos thyroid disease (underactive)

Diagnosed 3 years ago. basically I feel shit almost all of the time. I wake up feeling knackered and drained, have big bags and dark circles under my eyes, my skin is extremely dry, my eyes are extremely dry (have to put drops in several times a day inc 1st thing before I open my eyes otherwise it feels like I'm ripping the cornea off). I am also constantly constipated and did I mention exhausted? I started drinking loads of water (3L+) but made no difference to anything.

But my blood test results come back "good". I have now seen 3 different doctors (2 gps and an endocrinologist) and they all say how good my results are. I say but I feel like death. And they say but your results are good.

I nearly cried when it happened today for the 3rd time. So, when I go back to the doctor for the results, and they say they are good, I would really like to be able to at least suggest something maybe they didn't think of.

Or do I just accept this is as good as it gets, or does anyone have any magic suggestions for beating feeling totally exhausted and dry and scaly too?

ps also have coeliac disease if that counts for anything.

Yes your TSH and t4 look good but your t3 looks low to me. I suspect you need some t3. I would suggest going over to the Thyroid UK health unlocked forum for advice. I had very similar results/symptoms to you and I am now very well on a combination of T3 and T4 (Armour Thyroid).

Passing GP here.

If you were seeing me I would start with. Proper history and examination. Blood test aren't everything-they won't tell you if you have a heart problem or sleep apnoea for example. Then some targeted bloods. The dry eyes mean I would be doing some testing for thing like Sjögren's syndrome for example.

The blood results look foreign. I guess you are not in the uk

i'm in Germany. The gp did an ECG and said every this was fine.

Thing is, I saw my old gp with this complaint many times (every time I went for another prescription or blood test for thyroid (taking 100 mg thyroxin). I've also seen an endocrinologist and now this other gp 3 times and they all just say my results are fine.

So what am I supposed to do? Genuine question. the gp literally said yes its difficult but she couldn't see any reason for me to feel so tired. and said there wasn't any more she could really do other than an ultrasound of my thyroid and stomach nut she didn't think it would show anything so it was a waste of time really.

So what do I do?? Maybe I'll try and dig out the endocrinologist blood test, they were more detailed.

Anyway, thanks again. bed time.

I'm afraid thyroid disease is very badly understood by both endocrinologists and GPs. Probably most suffered do respond well to thyroxine, if they are allowed to take a sufficient dose. Unfortunately there are a minority who don't respond well to the convential approach, and these patients are often faile by current practices.

I would urge you to read up as I'm afraid often those of us who don't react well to thyroxine monotherapy (T4 only) are often left to get on with it.

I was very lucky that I did my research and had a supportive GP. I am now well as a result, unfortunately not every one is as lucky as I was. My endo was very sceptical (and threatened to eat his hat if I improved with a t3/t4 combo. Five years on and he now has an increasing number of us well with this combo and he has had to forgo the hat-eating. He is surprised but pleased.

I would urge you to do some more research.

Sorry about typos I'm on my phone.

Ok. Time to unlock my brain then.

Has she examined you? eg listened to your heart and lungs, examined your abdomen and lymph nodes. Has she asked you questions? eg questions about bowel and bladder function, chest pain, palpitations, breathlessness, the pattern of your sleep, stress levels, depression screening etc.

IMO there is an over-reliance on tests and sometimes there's a need to get back to basic history taking and examination. Of course this takes time and skill and is more difficult than sending you away with a blood form.

However it may be that there's nothing physically wrong that can be found. I probably see 2-3 people a day who's main complaint is tiredness. Most of these people don't have a physical cause that I can find. Many are stressed or trying to fit too much in to too little time. Often there is poor sleep hygiene. However I'm sure some have illness that I have not found so I do encourage second opinions if needed but it sounds like you have had that. Also modern medicine doesn't have all the answers and there's always the possibility that you have an illness that either hasn't been discovered yet or for which there is no test.

Good luck with things.

I wondered about sjorens too.

It sounds like ME. My friend spoke to a Mickel Therapist (you have to pay) which helped her a lot.

Has she examined you? eg listened to your heart and lungs, yes
examined your abdomen and lymph nodes no.
Has she asked you questions? eg questions about bowel and bladder function, chest pain, palpitations, breathlessness, no
the pattern of your sleep, stress levels, yes
depression screening etc no.

I am trying to be proactive here. I mean I don't want to just be handed a case full of pills. Really, far from it. But I exercise, I don't drink alcohol or eat gluten or many sweets so my diet is pretty good. I think I sleep well and have good sleep hygiene. I am prepared to do or avoid doing anything to feel better. I would just like a reason and ideally a solution!

Maybe I need to try and reduce what I do. So the suggestions re Sjögrens as far as I understand it, there's no actual test and no treatment other than using artificial tears etc so is there any point in mentioning it? Not sure about that, only my eyes and skin are dry. My mouth isn't nor anywhere else iyswim

Low TSH, picking up that there's lots of T4 available (Frei) but low FT3, which suggests that you are not converting the T 4 very well, if at all. Some people have a gene that prevents them from doing that. You can test for this, but it's not standard.

Advice from others re B12, folate, vitamin D and ferritin is good. Have a look at this: www.stopthethyroidmadness.com/ducks-in-a-row/

To feel better you need to raise your FT3, which you can do either by improving conversion, which is where the ducks in a row comes in, or taking T3 as well as, or in some cases instead of, T4.