Hashimoto’s fatigue is no joke. Actually, it’s one of the first symptoms that most women outwardly recognize as a symptom. There are other subtle symptoms that may show first but are passed off as something else. But with fatigue, so many want to nip it in the bud ASAP because it’s life altering.
Fatigue from Hashimoto’s isn’t like being tired…the fatigue is extreme. Most women suffering from Hashimoto’s fatigue struggle with getting through the day. Most need a nap or 3! And this fatigue affects your ability to focus and think clearly. The worst part – no one gets it…because fatigue is the invisible symptom!
Fatigue takes you away from spending time with your family and friends. It leaves you missing out on life. If this is you, just know there is a fix!
After reading this blog, you’ll learn how to make a dent in your fatigue by implementing the 4 items outlined in this blog.
Vitamin D Levels
Vitamin D is important to so many things in our body:
- Immune system
- Bone health
- Mood/ brain function
- Muscle health and growth
- Heart health
- Weight loss or gain
You can see that vitamin D has a hand in so many aspects of how our bodies function. And, unfortunately, about 50% of the population is vitamin D deficient. And 92% of those of you with Hashimoto’s are vitamin D deficient.
I’ve written about how vitamin D affects all the above in this previous blog so I don’t want to rehash it here. In this blog, we’re focusing on how to make some changes for your fatigue!
One of the first signs of low vitamin D is fatigue. It’s easy for us to brush off the fatigue as something else like not eating enough or lack of sleep. Both will create fatigue as well but both play a role in reducing your vitamin D levels.
Because stress can deplete your vitamin D stores. So, if you don’t have enough to begin with and your body is stressed (like it is with Hashimoto’s), you need more vitamin D than the average person.
There are 3 primary places you can get vitamin D:
- Fortified foods
The first 2 aren’t very reliable because there’s a lot that goes into turning those forms of vitamin D into usable forms of vitamin D. For most of you, especially if your vitamin D is low, a supplement is the way to go.
To test vitamin D, you want to ask for 1,25 OH-D. This is the active and usable form of vitamin D in your system. You also want a level of 50-70 ng/ml. This is the optimal level of vitamin D to ensure you have enough stores to go around…for your thyroid and for your stressed body.
If your D is low, and it likely is, you’ll need upwards of 10,000 iu per day to bring your levels back to optimal levels quickly. Once you get to the optimal level, you’ll need between 2,000 iu and 5,000 iu daily to maintain that level. As you can see, this is well above the 600 iu recommended. I don’t know why the recommended is so low. I’d venture to guess that the levels were set when more people spent time outside and sunscreen wasn’t as prevalent as it is today.
So, to help slow the progression of your autoimmune condition AND help you reduce fatigue, get your vitamin D levels tested and get on a daily supplement ASAP. You should assume that you will be on vitamin D for life. Most people should anyway.
MMA or Homocysteine
These 2 tests look at your vitamin B12 levels. When I bring these tests up with Hashimoto’s patients, I usually hear that their physician has already looked at their serum B12. Serum B12 is a crap test in my opinion.
Serum B12 looks at the level of B12 in your blood, but not what’s getting into your cells or what’s usable for the body. If you take a B12 supplement before going in for labs, your serum B12 will be high and look good. It’s not a true snapshot of what’s happening with B12.
Plus, many have MTHFR mutations to worry about. I’ve written about MTHFR in the past and you can read that blog here. Essentially, MTHFR changes the way your body can use B12 and a few other B vitamins.
Getting your B12 levels tested is important because the first sign of low B12 is fatigue. Many will also experience tingles in their hands or feet as well.
MMA stands for methylmalonic acid and looks at how B12 is being used by the cells. This one is a better indicator of what’s getting inside the cells and what’s being used. If it’s high, you need some B12 in your life. Homocysteine is an amino acid that increases when B12 is low.
It’s important to note that most of you with Hashimoto’s are low in B12. This is because most of you with Hashimoto’s also have intrinsic factor antibodies. Intrinsic factor is needed to activate and use B12 in the body. If you have low intrinsic factor, you’re low in B12.
You don’t need both of these tests…just one will do. Or, you can just take a quality B12 supplement to see if that changes your fatigue at all.
Just like vitamin D and B12, most of you with Hashimoto’s also have low iron levels. This happens because the most common autoimmune disease diagnosed alongside Hashimoto’s is Celiac Disease (CD). The prevalence is so high, studies recommend testing for CD in all Hashimoto’s patients.
In the absence of CD, about 99M Americans are gluten intolerant. Gluten creates inflammation in the digestive tract, which causes a decrease in the absorption of iron. This is why so many with Hashimoto’s feel better when they remove gluten. (As a side note, I have a 10-Day Hashimoto’s Gluten-Free course you can check out here. Those that have gone through it found ditching gluten to be life-changing for them.)
One of the first signs of low iron is fatigue. If you haven’t had your iron levels tested, now is a great time to do so. You should have them looked at annually. Ensure that when you ask your physician for an iron panel, you include all iron labs:
- Serum Ferritin
- Total Iron Binding Capacity
- Serum Iron
These 4 together will give you an overall view of your iron status. Taking an iron supplement will help but that doesn’t treat the root cause. The root cause in most is digestive inflammation.
Food Sensitivities (or Allergies)
I hinted on food sensitivities with the gluten intolerance mention above. But food sensitivities are real and are prevalent in you all with Hashimoto’s.
When you consume food your body doesn’t agree with, your immune system is activated. As your immune system ramps up, your inflammatory system comes next. And when inflammation is high, this creates inflammation in the digestive tract. I’ve written about that entire process here and included some inflammatory foods you should consider.
One common symptom of food sensitivities or allergies is fatigue! Finding the foods that are activating your immune system is key here. When I mentioned this, I always get a follow up question on food sensitivity testing. I’m a fan but I’m not a fan. Confusing, right? Here’s why…
Food Sensitivity Testing
Food sensitivity testing tends to capture the most common foods that you eat frequently. Meaning, you could be sensitive to a ton of foods but the test doesn’t capture them all because some of them you eat infrequently. Another issue is that most tests will come back with 20+ foods on them. Seeing that many foods and thinking that you need to remove all of them at once can be very overwhelming. Let’s not forget that it can feel very restrictive as well.
Not all tests are the same as well. Some look at IgG immune reactions, which isn’t very specific. Others will look at IgG4, which is more specific. And yet others look at IgA, IgM, and IgG4. This type would be more comprehensive.
But here’s the catch…food sensitivity tests teach you nothing about your body. These tests, with their faults, teach you how to follow a plan. But when the sensitivities are cleared from your body and you have new ones, you have to pay again for another test. But if you learn to listen to your body and determine your own food triggers, you won’t need to pay for a test ever. Because you’ll know how your body is reacting and how to find those foods.
Okay…off my soapbox there. Food triggers can be causing your fatigue. Finding and eliminating those triggers will help you reduce your fatigue.
That’s it! Three of these are fairly simple in that they’re just testing. But, once you get the results, you have to dive into action on them. The last one is a bit trickier and can take some time. But it’s soooo worth it…I promise!
Ch’ng, C. L., Jones, M. K., & Kingham, J. G. (2007). Celiac disease and autoimmune thyroid disease. Clinical medicine & research, 5(3), 184–192. https://doi.org/10.3121/cmr.2007.738
Mackawy, A. M., Al-Ayed, B. M., & Al-Rashidi, B. M. (2013). Vitamin d deficiency and its association with thyroid disease. International journal of health sciences, 7(3), 267–275. https://doi.org/10.12816/0006054
Sizar O, Khare S, Goyal A, et al. Vitamin D Deficiency. [Updated 2021 Jan 3]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2021 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK532266/
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The only thing to lose is fatigue!