Is it your thyroid causing your fatigue?

Exhausted all the time? Think you’ve had a Thyroid problem ruled out? Here’s why further testing may be needed…

Laura’s Pen explains why she is using Medichecks to monitor her Thyroid levels…

I’ve suffered from an underactive Thyroid since I was 13-years-old. I was diagnosed fairly quickly but, since becoming very ill again as an adult with ME, I have come to discover that Thyroid problems aren’t always properly ruled out in people with chronic fatigue as a symptom.

I have been given a product for review as part of this article. Although the product was a gift, all opinions in this review remain my own and I was in no way influenced by the company. This post also contains affiliate links, which means if you click one of the product links I will get a small referral fee from any purchase. View my full Disclosure Policy.

use voucher code LAURASPEN19 for 10% off
Click image and use discount code LAURASPEN19 for 10% off full-price tests at Medichecks

I don’t tend to talk about my Thyroid problems much, seeing as it has been fairly under control since my teenage years. But it is something I get a lot of messages about when I do mention it.

So I thought I’d write my very first Thyroid post to share my story and why I decided to do some additional Thyroid testing with Medichecks when I became ill as an adult.

While this post is primarily about an underactive thyroid, it is also important to say it can also be overactive. This is called hyperthyroidism, which can also cause fatigue. As I don’t have any experience with hyperthyroidism, I will not be covering it in this post, but you can read more about it here.

My story

I was thirteen-years-old. I was young and full of life. Or was I?

I’d started coming home after school and taking naps. This went on for a while and got gradually worse. I remember I was crashing out on the sofa from the instant I got home until dinner-time when my mum marched me to the doctors and told them something was wrong with me.

And it was. My NHS Thyroid test showed I had an underactive Thyroid. Meaning, for whatever reason, I didn’t have enough of the Thyroid hormone in my body.

They put me on levothyroxine and gradually upped my dosage until my blood test normalised. I didn’t magically get better, and I was dubious of that test result seeing as I still felt awful. But they reassured me I would feel better, and actually, with time, I did.

My mother, on the other hand, took a long time to be diagnosed, and though she suffered from symptoms well before I did, she was only diagnosed a few years after.

I should mention that another fatigue-causing condition I have that is often overlooked, and was missed in me for a few years, is pernicious anaemia. This is an autoimmune condition where your immune system destroys the cells in your stomach that produce the proteins needed to absorb b12. This leads to a b12 deficiency, which is vital for healthy blood cells.

The NHS can and should test you for this if you have the symptoms. You can find further information on pernicious anaemia here and I’d suggest discussing with your GP if you think it is an issue. However, you can have your b12 levels tested privately if needed.

The symptoms
Fatigue or exhaustion are a major symptom of hypothyrodism
Photo by Kinga Cichewicz on Unsplash

Fatigue is not the only symptom of an underactive thyroid, and so I thought it would be useful to show you the full range of symptoms so you can see if it fits with your own.

Symptoms include tiredness, sensitivity to cold, weight gain, depression, weak and aching muscles, dry and scaly skin, hair loss, pain or numbness in the hands and fingers.

But the full list of symptoms is too vast to list here (it would be an article of its own). Instead, I’d highly recommend checking out the full symptom checklist for hypothyroidism (which is the proper name for an underactive Thyroid) symptoms on Thyroid UK’s website.

As you will see, the possible symptoms are wide-ranging and are ones that will be very familiar to those with ME or Chronic Fatigue Syndrome (CFS) diagnoses as well as those with many other fatigue-causing conditions.

There is a huge overlap between hypothyroidism and the symptoms of some of my other conditions: ME/CFS, Fibromyalgia and even Endometriosis (for which fatigue is a huge issue for me).

Anecdotally, there seems to be a fair number of ME patients with Thyroid conditions and I’ve even seen talk of it in the Endometriosis community, although it may be the case that as Thyroid conditions aren’t rare they appear fairly often in any community.

Thyroid conditions can be caused by autoimmune conditions such as Hashimoto’s and, as those with autoimmune conditions will know, one autoimmune condition increases your risk of acquiring another.

Therefore it is easy to see how many conditions can mask a Thyroid condition, whether or not they are directly responsible for it.

The problem with TSH

So why is an underactive thyroid being missed when Thyroid testing is one of the first things carried out when you go to a doctor complaining of fatigue?

There are two main issues. One is the reference ranges used for a diagnosis to take place. The ranges are a problem according to Thyroid UK, which says the cut off limits for a normal result are too high and that TSH levels (the standard thing tested by the NHS) fluctuate through the day. What matters really, is what’s normal for you when healthy, and one test cannot tell you that. Additionally, people often have borderline test results and are not told this is the case.

A thyroid problem may be missed if they're just testing TSH
Photo by Rawpixel on Unsplash

The second issue is that, generally, the NHS will only run a TSH test as standard. This stands for Thyroid Stimulating Hormone. I.e. It is not testing how much thyroxine you actually have in your body but if your body is releasing more TSH in response to a Thyroid problem. This isn’t always the best way to detect an underactive thyroid. Particularly if your problem is with converting T3 into T4 (see explanations below).

You can get a T4 test, which tests a type of thyroid hormone, on the NHS but this seems to depend on your GP practice. My current one tests it as standard but it is the only one of about five practices I’ve been under that does this. At others, I have had to argue for it and I know people are sometimes point-blank refused it.

Technically, you can also get a T3 test but this is much more commonly refused and, even if the GP agrees to do it, the lab will often refuse to do it if your TSH is normal. But it is always worth trying. I’d suggest reading through this information from Thyroid UK before approaching your GP.

What are T4 and T3 you ask? Here’s a quick guide to the tests available for your Thyroid

  • TSH – Thyroid Stimulating Hormone
    This hormone is produced by your pituitary gland. It stimulates the thyroid gland into producing more thyroxine. It is tested because it rises when the thyroid isn’t producing enough thyroid hormone
  • TT4 -Total T4
    This is the total Thyroid hormones bound to protein. It lowers if the thyroid isn’t producing enough thyroid hormone
  • FT4 – Free T4
    Thyroid hormones not bound to proteins. It lowers if the thyroid isn’t producing enough thyroid hormone
  • FT3 – Free T3
    T3 is the thyroid hormone actually used by the body’s cells. T4 has to be converted into T3. Some people have a problem with this conversion, which is why it is good to test this alongside T4.
  • Thyroid peroxidase antibodies (TPOAb)
    These antibodies are found raised in those with Hashimoto’s disease. They can also be raised in those with Graves’ disease.
  • Thyroglobulin antibodies (TGAb)
    These antibodies also rise in autoimmune thyroid conditions
Thyroid testing with medichecks

Now, I would suggest if the symptoms list on Thyroid UK’s website sounds familiar, going to your GP in the first instance and making sure the NHS has run their Thyroid tests on you. It may be worth checking your actual results against Thyroid UK’s reference ranges too. You can often get a print out of test results at the reception of your GP practice.

But if you have had these tests done and would like to pursue further testing, I would highly recommend using Medichecks.

I have been using them for several years for my private blood tests as they are both cheap and convenient.

They have an at-home test kit, which I reviewed in full on a previous blog. Which is great for those unable to travel or too busy to get into a clinic.

You basically just need to prick your finger with the provided lancet and fill up a small vial with the blood.

However, I should point out that many of us with conditions such as ME, hypermobility and hypothyroidism can have problems with bleeding. If you have ever had problems with this when having blood tests previously, it may be worth looking into one of the other options. But if you read my review, I suggest some tips for getting the blood flowing.

Inside the Medichecks home t
Inside the Medichecks home test box

You can also:

  • Talk to your local phlebotomy clinic or nurse and see if they would be willing to take the blood for you. Medichecks will provide the necessary kit for this if you select “Make own arrangements” for your blood test method at checkout.
  • Visit a partner clinic for a fee of (as of Nov 2018) £25. You will need to select the clinic at checkout so you can check there is one suitable in your area before confirming the order. It will tell you if an appointment is required. The London Laboratory is walk-in.
  • A nurse can visit you at home for a fee of (as of Nov 2018) £39.

The results have always been quick for me and they email you to let you know when they are ready.

You can get 10% off all full price tests (not just thyroid tests) with code LAURASPEN19 until Feb 1st 2020. Take a look at the thyroid tests available on Medichecks. 

My testing

So Medichecks were generous enough to send me a Thyroid monitoring test kit for the purposes of review. This includes TSH, FT4 and FT3.

But they also have more in-depth tests, such as Thyroid Check Plus, for those wanting to check for Thyroid autoantibodies.

I wanted to check my levels as I have been in a flare lately and have only had a check-up on the NHS so I haven’t had the full range of tests carried out recently.

I did my home test the Monday after this post was published, just after a bath to make sure my blood was flowing nicely. I then popped it in the post box.

The results came back the next day! I was impressed. I’ve had previous tests with Medichecks but this was the quickest yet. The speed will depend on the type of test you are taking.

And what did they say? My thyroid is currently well managed. My TSH was low, and my FT3 and FT4 were the upper end of mid-range. So I’m reassured to know that is one thing that is under control.

If your tests come back showing a problem, a doctor will comment on your Medichecks results and advise what to do next. I would also highly recommend having a good read through the information on Thyroid UK’s website so you are armed when going to your doctor with any test results.

If your T3 is low, unfortunately, you may have somewhat of a battle on your hand to get suitable medication. It is a very good idea to look through the link above for information on what to do next.

Get 10% off blood tests, such as thyroid checks, at Medichecks
use voucher code LAURASPEN19 for 10% off
Click image and use discount code LAURASPEN19 for 10% off full-price tests at Medichecks

Is it your thyroid? Why standard NHS testing may miss a thyroid problem

Laura Chamberlain

Laura is a writer blogging about living with chronic illness, namely Lyme Disease, Myalgic Encephalomyelitis (ME/CFS) and Fibromylagia.

She likes food, cats, bad jokes. Unfortunately, her boyfriend is allergic to the last two...

1 Comment

  1. This was an incredibly informative and important post. This information can’t be shared enough!

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