I’m on Thyroid Medication but Still Feel Tired!

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Originally published on 4th April 2016
Last updated on 2nd November 2018

Are you on thyroid medication but still don’t feel well? A lot of thyroid patients feel this way. They might even question if their thyroid medication is working at all. 

Many people are often left confused and wondering:

  • Why am I feeling extremely tired on Levothyroxine?
  • My thyroid meds make me tired!
  • Does thyroid medicine make you sleepy?

Their doctor puts them on thyroid medication and tells them they are now adequately treated. They may even do a blood test and tell them that their levels are ‘normal’. So then why do they still feel tired?

Can thyroid medicine make you feel tired?

There are a few reasons you can still feel unwell and I’m going to explore these below.

Your Thyroid Levels Aren’t Optimal

Most doctors will put you on T4-only medications like Levothyroxine and then test you via blood samples and tell you “you’re now all OK” and ‘fine’.

The problem is, most doctors just test your TSH alone and this isn’t accurate when getting the full picture of your thyroid health.

In order to know if your thyroid levels are actually optimal, you need a full Thyroid Panel doing, and this should include at the very least: TSH, Free T3 and Free T4. Reverse T3, TPOAB and TGAB are also hugely beneficial. You need as many doing as possible to accurately see how you’re doing on your thyroid meds. If your doctor won’t order the full thyroid panel, do know that it is relatively inexpensive and simple to order these tests yourself. UK thyroid patients can order them from here and a worldwide link can be seen here.

Most thyroid patients seem to feel best when their levels are also optimised and not just in range.

It can be tricky getting your doctor to test a full thyroid panel, but ordering tests yourself is also an option. I can’t stress how important it is to check all of these levels and ensure your levels are optimised as opposed to just ‘in range’.

Your Medication Isn’t Right for You

Some people do OK on Levothyroxine or Synthroid, the T4-only medications, but many equally do not. You may be on this medication and still feel tired. 

A study in 2018 demonstrated that Levothyroxine was associated with a lower quality of life in those with Hypothyroidism. [1] So you may well do better on a different type if you’re still not feeling well on T4-only meds like Levothyroxine.

Other thyroid medication includes adding T3 to your T4, or switching completely to Natural Desiccated Thyroid. I’ve covered all of these in detail here and here.

Especially if you have a full thyroid panel tested, and your T3 is low, you should explore the possibility of a conversion problem and maybe adding that T3 in. This can be done by adding T3 to your T4 (Levo), or switching to NDT, which has it in. These can be discussed with your doctor.

I support people finding what medicine works for them, and Levothyroxine simply doesn’t help a lot of people.

Thyroid UK reportsed: “Levothyroxine treatment provided total relief of symptoms in 7% of the respondents and significant relief in 41% of respondents. However, 6% of respondents received no relief from symptoms and 40% only slight relief.
NDT provides the most relief of symptoms providing 29% with a total relief of symptoms and 57% with significant improvement. However, 10% only received slight relief and 2% no relief of symptoms.” and that is a huge difference. [2]

If your current doctor isn’t open to exploring other medication options, you may wish to explore other types of medical professionals which may be able to help. See types here.

There’s Something Else at Play

Other deficiencies or issues are common if you also have thyroid problems. These can include the below, so they’re worth exploring if you still don’t feel well.

Vitamin Deficiencies such as D, B12, Iron, Ferritin etc. can all give you similar symptoms to low thyroid function, so it’s worth checking these if you are tired a lot, have hair loss, bruise easily, are fatigued etc.

Adrenal dysfunction can also cause havoc in thyroid patients too, without us even realising. Symptoms include fatigue, waking up still feeling tired, not being able to cope with stress very well and craving sugary and salty foods. The most accurate way to test if you have adrenal fatigue is via a 24-hour saliva cortisol test, to check cortisol levels. If your doctor won’t do this, you can very simply order it yourself and complete it at home. If your doctor won’t check your adrenals, you can very simply order testing yourself from here and here. They should ideally read as stated here.

The book by James Wilson is helpful too.

You’re Not Addressing Your Hashimoto’s

Most of us with hypothyroidism have Hashimoto’s to thank as the cause, yet don’t even know it.

I’ve created a whole piece on Hashimoto’s here, and ways to treat it include obviously getting your thyroid levels right (TSH, Free T3 and Free T4,Thyroid antibodies) and for a lot of patients, cutting out gluten. They claim it helps their fatigue. More ways to help your Hashi’s are listed here.

Addressing the autoimmune condition that may be causing your hypothyroidism and getting it under control can help with fatigue and managing symptoms.

Getting my Hashimoto’s in to remission seriously helped in management of symptoms.

You May be Taking Your Thyroid Medication Wrong

Many patients take their thyroid meds an hour away from any food or drink, excluding water. The reason being to stop anything else from affecting its absorption. You shouldn’t really eat or drink anything for an hour either side of your thyroid meds, as well as take other medication, and you should avoid taking calcium, magnesium, contraceptive pills and iron close to it in particular. Take your thyroid meds at least four hours away from these.

Oestrogen, calcium, magnesium and iron bind some of the thyroid hormones and makes them unusable, affecting how much you really absorb. If you’re on NDT, many also state that taking it sub-lingually (dissolved under the tongue) has a better effect than just swallowing it.

See a full article on how to correctly take your medication here.

Some patients on T4-only meds like Levothyroxine also state it works better for them when taken at night, instead of the morning.

You’ve Not Got The Right Diet 

You’ve got to nourish to flourish!

Eating and drinking right is key, too. Avoid alcohol where you can and there are certain foods to avoid or limit if you have thyroid problems. Many cut out gluten, or go paleo, Keto or try AIP and feel the benefits. We’re advised to eat goitrogenic foods in moderation and cut back on sugar and processed foods, also ensuring you give yourself a nice, varied diet. You can’t expect your body to work wonderfully if you don’t feed it wonderfully!

Find a thyroid cookbook here.


Once you’ve corrected all of the above, you should hopefully see some improvement. If not, you should also consider the checklist here, which you can tick off as you check each point.

Of course, if you have other health conditions, then they’ll need to be explored and managed properly, too. If you still feel ill after looking at all of the above, you may have another underlying health condition altogether, so find a doctor who will uncover this for you and medicate you properly for it.

You may need to see several GP’s or other medical professionals to explore all of these, or even order tests yourself, in order to get them investigated and crossed off. It’s important to address these as soon as possible before they get worse and have a knock-on effect with other things. I found that my GP on the NHS wasn’t particularly helpful and it wasn’t until I started seeing a functional medicine practitioner, that I really got my health back.

Do you still feel unwell despite being on thyroid medication? Share in the comments below.

Related post: 6 Ways to Create an Energy-Boosting Morning Routine as a Thyroid Patient

Be Your Own Thyroid Advocate Book CoverSee also:

The book Be Your Own Thyroid Advocate: When You’re Sick and Tired of Being Sick and Tiredwhich builds on this article in detail. Learn how Rachel reclaimed her life when thyroid medication wasn’t helping.

Freedom From Thyroid Fatigue LogoThere is also an online thyroid course exactly for thyroid fatigue. Freedom From Thyroid Fatigue helps you tackle low energy with a personalised approach, so you can wave goodbye to tiredness. 

You can click on the hyperlinks in the above post to learn more and see references to information given.


[1] https://www.healio.com/endocrinology/thyroid/news/online/%7Beb193222-2795-4321-8761-607131d2f743%7D/levothyroxine-therapy-associated-with-lower-quality-of-life-in-hypothyroidism?fbclid=IwAR0Dk8tGRAxB6at_Mc7jgDiPyp0YikRuy6ZmG6yS8CMOz3lPEj67zH_g4vY

[2] http://www.thyroiduk.org.uk/tuk/campaigns/Patient-Expereince-Survey.html

If you found this article beneficial, please take a moment to share it so we can help others get better with hypothyroidism and Hashimoto's, whilst also raising awareness.

22 thoughts on “I’m on Thyroid Medication but Still Feel Tired!

  1. I get awful side effects on any thyroid meds I try. T4 gives me severe migraines doesnt matter which brand, NDT gives me migraines and difficulty breathing and swelling throat. T3 makes me extremly tired to the point where I have to lay down 2 hours after taking it, also get alot of headaches, depression and rapidly changing moods. I get more difficulty concentrating on it than off it. After 3 months I got daily migraines from t3 and had to stop. No doctor knows what to do about me at all. I’ve changed diet to antiinflammatory, gluten and dairy free, minimum coffee. What can I do when no doctor can help me ? I look so old when Im not on meds but I cant take them.

  2. Thanks everybody that posted! Earlier this year I started to take levothyroxine after taking blood tests tsh/t3/t4. T3 and t4 were in normal range, but tsh was 12 (supposed to be lower than 5 is what I was told). By Feburary I was feeling better with just 25mcg per day, but my tsh only went down to 6. So the doctor added 1 day at 50mcg and the other 6 days at 25mcg. Blood test 6 weeks later came up as 9! So they added a second day of 50mcg. Then test 6 weeks later came back at 6. So they kept adding 1 more day. I was feeling pretty good at 3 days with 50mcg and 4 days of 25mcg, but I am currently taking 50mcg on 6 days and 100mcg on 1 day per week. I feel completely awful. No energy, hair coming out, weight gain, blood pressure going up, and I’m tired of deciding if I’m going to take a shower or cook food because I don’t have energy for both. I have a doctor appointment in a week and I don’t know what to do if my tsh test comes back as bad again. I might tell them that I’m going to take less so I can function like a human again.

    1. Listen to YOUR body.
      Everyone functions at different “test” numbers/levels
      You have enough experience with the doses
      So take the amount that makes you FEEL the best.
      Also make sure you are making enough Estrogen, if over 40
      If your Thyroid medication makes you sleep, take it at night.

  3. Hi Rachel, I was diagnosed with Hashimoto’s Hypothyroidism back in July 2020 with a noticeable goiter. I was started on low dose Synthroid. 6 weeks after starting the med my endocrinologist wanted bloodwork and all was well and I was to stay on the 50 mcg dose daily. I take it as directed, on an empty stomach with water and wait to eat/drink about an hour. Problem is the last 2 weeks I am feeling extremely exhausted, no energy or ambition to do anything and terrible joint pain/leg pain. I do not take any other meds or vitamins. I am wondering if I should inform my endocrinologist or just stick it out and see if it gets better…. I don’t want to switch to something else and I fear switching the med back and forth may be worse for me? Any suggestions would be greatly appreciated. Thank you so much!

  4. Try this for HYPOthyroidism. Not for Hashimoto or hyperthyroidsim. I was on Levothyroxine, then Armour. Kept telling Dr., “Yeah I feel better but not great.” Brain fog, fatigue, headed towards depression. Dr. wanted to put me on depression/anxiety meds. At the same time a family friend sent me Nascent Iodine to take along with Selenium. A light bulb went off and I feel great. Brain fog disappeared. Energy and mood increased. Cancelled depression medication. Just wish to help others to feel better. Please do your own research. I found it to be a miracle in a bottle for me. Hope it works for you. Try for a month….

  5. After taking synthroid I started getting upper stomach pain. Continued with meds for 10+ years. Last 2 years pain along with major fatigue and exhaustion, weight loss (106 lbs at 5’7″)took over my life. After many tests with no answers I thought I was dying.
    I stopped my synthroid and I now feel human. Weight gain of 10 lbs in a month, no major stomach pain, although I still watch my diet for gluten, I wake up and able to function without feeling exhausted. Only drawback is I don’t sleep straight through the night.
    I have not told my doctor I have stopped my synthroid as when I indicated I thought that maybe the cause she blew it off. I’m now hoping this works for the next 20 yrs. I’ll be 85 then and won’t mind death.
    Any other suggestions for keeping me synthroid free and feeling well.

    1. How long before you felt better? I went off my dose yesterday because I felt light head and tired.

      I Still feel the same- I know it takes time to get out of ones system- just wondering your timeline.

  6. I had my thyroid removed about seven years ago due to multiple nodules and cancer could not be ruled out. Been on armour felling good for many of these years and for the last year not well. My hair falling out, exhaustion, stomach issues again, moody, weight gain, and pain are just some of the bothersome issues. I told my doctor in August that I felt I had built up a resistance to my current meds but have not got anywhere with that yet. Any suggestions

  7. I’m on thyroid meds and I still feel bad all the time no energy at all.I have no thyroid at all just glands.

  8. Hi there
    I’ve been on 225mg thyroxine for over 15 years no problem. The last two years my tsh levels have been yo yo ing from 0.005 to 78. I have been feeling absolutely lousy, fatigue, hair falling out, weight gain and muscle pain in my legs but my GP won’t agree it’s because of my thyroid, my tsh is now 0.05 but I’m still feeling like rubbish and have been for months,
    I have gone away from my doctor and booked an apt to see a top endocrinologist in London. Can you offer any advice on what I should ask hi and what I should be tested for. I have hashimotos but don’t believe I have had any other blood tests done apart from the usual nhs ones. I feel at the end of my tether and am hoping this chap will be the answer to my prayers

  9. I’ve been feeling tired for the last two years and I’m only 18. My hairs been falling out excessively too and now it’s so thin. I’m on synthroid but it doesn’t seem to make a difference and I don’t know what else to do because I managed to get my doctor to do a T3 and that was hard because she only does T4 and Tsh but my levels for T3 were in the middle range. Not sure what other options are left. My T4 was on the lower end too like the borderline. But it doesn’t seem to be going up even with Synthroid. It’s only my tsh going down but my T4 not going up.

  10. Hi can you tell me what I can do for me being tired and lethargic all the time I work but through the day and at the end of the day I just want to sleep and have mood swings.
    I’am on levothyroxine 75mg lansoprazole 30mg loratadine 10mg also inhalers.

  11. 2014 rightcdide thyroidectomy, two months later my hair started falling out. Went AIP, on WP and my adrenal and cortisol fine. How can I stop my hair from falling out??????? Help!!!!!!

  12. Hi, I had my thyroid removed at the end o 2013-214 due to a cancerous tiny lump on both sides, I’m on thyroxine 150mg Monday to Friday then 100 mg on the weekend. Would I benefit trying natural I do feel tied with no energy, I get checked once a year for it. I have being researching ashwandgha it’s a herb I want to take without stopping the medication.

    1. Hi Rachel, have you had a full thyroid panel test done recently? It includes free t3 and free t4 and can show whether you’re converting your t4 medication (thyroxine) to t3. A lot of people don’t convert very well and so are left with low free t3. If this is the case, Natural Desiccated Thyroid, a medication containing t3 can indeed help.

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