What causes fatigue despite my normal TSH values?

Question

Hello doctor,

I am 25 and have had hypothyroidism for three years. I am taking 75 mcg (micrograms) of Levothyroxine, and my TSH is around 2.5. My doctor says my lab results are normal, but I still feel tired and am losing a lot of hair.

I go to the gym four times a week, but I often crash and can barely finish my workouts. Could my thyroid levels be suboptimal for someone active? Should I check my reverse T3 or cortisol levels?

Kindly help.

Thank you.

Answer 1

Hello,

Welcome to icliniq.com.

I understand your concern.

Even though your TSH (thyroid-stimulating hormone) level is technically within the normal range, it might not be ideal for you, especially considering your ongoing symptoms and active lifestyle. Sometimes, a different dose of Levothyroxine or adding a small amount of T3 (Liothyronine) can help, but any changes should be made under your doctor’s supervision.

It may also be useful to check your reverse T3 levels, as high reverse T3 can mean your body is not effectively converting T4 into the active T3 hormone. Additionally, low cortisol levels can contribute to fatigue and other symptoms, so a cortisol test might be helpful to rule out adrenal issues. Nutrient deficiencies, such as low iron, vitamin D, or B12, are also common causes of fatigue and hair loss, so getting a blood test to check these levels is a good idea.

I hope you are satisfied with my answer. For further queries, you can consult me at iCliniq.

Thank you.