What is this frequent tiredness without much physical output about?

[Ohlife2020]

A bit of background information:

I'm 47. Stopped working 5 years ago since my maternity leave. I'm not as active as I used to be (I have never been, but even just the usual movements in an office kept me in good shape back then). In between the early childcare years and up to late last year, I've been busy mentally, but my physical output was just about some housework and nursery runs twice a day often involved a bit running.. From around 5pm, I'm often on my feet non-stop (cooking and all the evening routines) for 3-4hours until kids go to bed.

Low mood: I was fine until last autumn. Since last autumn, I experienced very low mood (had been a while but got really bad in December) and just lack of motivation to do anything, which didn't help me to keep physically active.

I then had problem with my knees and put me off to even try any lengthy walk for a few months.

Fatigue and coldness: I just feel constantly tired and cold. When the living room was kept above 18C-19C, I have to wear a thermal legging under my trousers and a pure wool jumper underneath a fleece hoodie to keep myself sane, just indoors.

Lips crack in the corner: This was a mystery which I first had in mid summer last year. It just would't go away. Tried various products but in vane. It really hurt when I ate and drank or anytime when I opened my mouth. It mysteriously went away. It came back last month and I read online B12 deficiency could cause it. Got tablets dissolving into water for b12 supplment and had it twice before the crack quietly disappeared.

I had a blood test last summer with a result of :

Serum ferrintin 25/ug/l (normal range 14 to 148)
Serum folate: 7.7ug/l (normal range 2.9 to 50)
Serum B12 746ug/l (normal range 160 to 925)
An overly high TSH level - 7.49mU/l (normal range 0.30 to 4.20)

What I can't get is: Can long-term low physical activity cause all the above, or even just simply the constant fatigue and coldness I experienced?

The borderline iron level is not clinically low to trigger GP to do anything. Do I have to get top-up by myself all the time?

Underactive Thyroid indicator may not be severe enough to promote the GP to act. I'm doing another blood test this month, but not sure where it would go.

Just fed up to be so tired all the time. I don't like physical exercise, but if it can help, I will make the effort. But then, is lack of physical exercise the culprit of all these issues? What's wrong with me in general???

Oh, no... Does it mean I still have months to wait?... I really can't live like this for another month. Just miserable everyday...😭

Graves' Disease gives an overactive thyroid. Hashimoto's gives an underactive one.

Yes your GP should prescribe levothyroxine, you do NOT need a specialist to do that. Your TSH and FT4 values are now screaming hypothyroid at the top of their voices. You desperately need thyroid hormone. Please go back to your GP and insist!

Also OP, with hypothyroidism, be very careful with exercising, it won't help you, it'll make you feel worse.

You are hypothyroid and your ferritin/iron levels are on the low side. I bet your Vitamin D is too.

Visit your GP and ask for levothyroxine. I think you will need 6 weeks on 50mcg and then it will likely be increased. I am at my best if TSH is under 1.

Also ask for advice about iron supplements (available from Holland & Barratt). 2000 to 3000 IU of vitamin D a day would be a good idea October to April - 1000 May to September. Range is from 50 but optimal levels are 100 or just over.

You are doing the hard yards in your mid/late 40s and may be perimenopausal also.

I'd start with the Levo, iron and vit D and see how you feel by late summer then consider HRT.

If you have the money it may be worth seeing an endo privately who will run the key bloods (bloods are pricey privately and they will want their own run). It's likely to cost about £750 but you will get time, advice tailored to you, well titrated medication and a letter to your GP setting out what you need in an optimal basis moving forward. It sounds a lot but really it's equivalent to £65ish pcm and if you have the money will have an exponential impact on your quality of life.

Good luck.

@RosesAndHellebores thank you. That's very helpful suggestion. I started thinking might need to take this to private diagnosis. Lose all faith by now. And I'm feeling miserable everyday day since last week.

@CrunchyCarrot it says online moderate exercise would help. I sort of blamed myself from being inactive in the past few years and maybe that has brought out all the symptoms. (Does it sound anti science?)... Yes, trying for some moderate exercise, pilates and yoga classes. But not sure. I only feel better at the time and once I'm back home like now, the exhaustion started creeping back to take over.

I need to take the little one to swimming class after school. 😣just have to brave myself.

But DH is more aware of the severity of my situation now and started proactively offering help as long as he can.

Honestly if you are untreated hypo, exercise doesn't help. It is using up energy you don't have. Plus your muscles are weaker due to being hypo. Everything is weaker. Just do really, really gentle stuff.

It's good your DH is paying attention, he needs to. Bet if it was him you'd get non-stop updates on how awful he was feeling! 😂

Following as I’m also experiencing exhaustion and cracks in the corner of my mouth that come and go (although I’ve just gone back to work after maternity, have a wakeful baby and going through a very stressful time so that’s not surprising). My thyroid is slightly hyper, iron levels ok when last checked but then I was on Floradix but I haven’t taken it for a while. Sorry to hear you’re feeling the same! I don’t think it’s peri for me as I’m early 30s

Peri and young kids colliding? I thought late 40s and teenagers was bad enough!!
I have felt low on energy and taken a liquid iron supplement and felt better.

The cracks at the corner of your mouth signify a vitamin B2 (riboflavin) deficiency.

@GoodnightAdeline , it's true! My last episode lasted a few weeks and disappeared straight away after I had a few days B2 supplement.

Keep an eye on your thyroid level and ask for blood tests if you feel something off. It appears giving birth could trigger hyperthyroid but it sometimes reverses to under-active thyroid after pregnancy. And there's research, in some cases, thyroid glands could get damaged and become permanently under active after giving birth.

You are still young. But make sure keep an eye to your own health and push GP to investigate as soon as you feel not right.

It's unbelievable how much women have to carry through life and even the body is not in our control!

I always had low iron and recently this last year results have been around 80 and I feel way better for that. That was from eating more meat in my diet and generally better.

I take the better you spray for vitamin D and K2 (K2 helps absorption) and my vitamin D levels came back very good.

I don't know exactly why but I feel a lot better if I eat fresh brocolli every day.

I've also even thinking about 8-9 hours sleep. The brain basically reorganises itself during menopause, its as critical window into the future as puberty is, it goes through pruning again, and I feel like all of that needs more sleep than the 5-6 hours from my 30s (I'm 43 now).

@2024horizons how beautiful the way you describe it!

The brain basically reorganises itself during menopause, its as critical window into the future as puberty is, it goes through pruning again

Sounds very much not a disaster mode anymore😄

You are definitely hypothyroid and you need to push your GP to prescribe levo. I was diagnosed a few years ago - initially had a TSH of 4.4 so GP requested repeat bloods in 6 weeks time. When it was still high I was put on 50mcg levo daily. Last year I became quite symptomatic again (for me weight gain plus extreme fatigue), bloods showed my TSH was in range but as I was so symptomatic GP agreed to increase levo to 75mcg which brought my TSH under 2. GPs are woefully uninformed about thyroid conditions and you really do need to advocate for yourself. Also remember that within range doesn’t mean optimal and that’s where you really need your levels to be. Good luck!

I'm fed up. Period day 12, still with light bleeding after 8 solid days of heavy bleeding. And as soon as I move around, I could feel my heart beating like crazy and I'm short of breath.

I've been in bed since the kids left for school.

And I came to a conclusion last night, this is not normal. It must be the coil fitted to reverse the endometrial hyperplasia. That's the biggest change I had in my life in the last month and this extreme fatigue came about 10 days after it's fitted...

I started getting a quote from private endocrine consultation. I don't think my young male GP can handle it.

By the way, got a ton of blood tests done yesterday morning (had to travel over an hour before anyone in the house woke up for the only available time slot before next week). 7+ tubes of red juice got taken. Steak and beetroot for lunch... Waiting anxiously for the results out.

I haven't RTFT so apologies if someone else has already mentioned it. Have a listen to this...

open.spotify.com/episode/6sl8WsD3v5XfcOkTWazCNH?si=PVlrg2q5Qmy6qOIWPqdBRQ.

Its not just about exercise. The whole background to perimenopause....i listened to this today and it sounds exactly what you have described. Would highly recommend you have a listen.

Palpitations and breathlessness are signs of anaemia.

Hopefully all those blood tests will flag up what is going on OP.