11 Strategies to Overcome Hashimoto’s Fatigue

DR. IZABELLA WENTZ / JUNE 28, 2019

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Fatigue was the most debilitating symptom I experienced with Hashimoto’s. It started eight
years before I was finally diagnosed in 2009, after I contracted mono (the Epstein-Barr virus)
in college. I needed to sleep for 12 hours each night to be able to function, and by “function”
I mean after hitting the snooze button on my alarm clock for two hours (ask my poor
husband), I would drag myself out of bed and then had to drink 4-6 cups of caffeine every
day to keep myself awake. I often had Red Bull and Pepsi for breakfast and was the epitome
of “wired but tired.”

I saw numerous doctors, and I was offered antidepressants and stimulant medications used for
narcolepsy and ADHD, but no one thought to check my poor little thyroid. I then came across
“chronic fatigue syndrome,” and was discouraged that there was “no cure.” I slept half of my
early twenties away thinking that I had better just deal with it, since no one could help me
anyway.

When I was finally diagnosed with Hashimoto’s, part of me was relieved. I thought that I
would finally get more energy. But this was not the case. Sure, the thyroid medication helped;
instead of sleeping for 12 hours, I only needed 11 hours of sleep. But I didn’t stop there. At
the time of my diagnosis, I was working as a consultant pharmacist and had become
accustomed to researching emerging healthcare information. Finding a way to get myself
better became my mission.

It took me almost three years after my Hashimoto’s diagnosis to get my energy back, and I
hope that some of the strategies that I used will help you get yours back too.

If you are dealing with Hashimoto’s fatigue, I’d like to share with you a few tips:

 The optimal TSH number for fatigue resolution

 The thyroid hormone that can block energy production
 The three types of fatigue-inducing anemia your doctor may miss
 Supplements that can reduce thyroid fatigue
Strategies to Address Fatigue
1. The Importance of “Normal” TSH

Conventional endocrinologists often refer to the TSH test as the “gold standard” test for
diagnosing and treating thyroid conditions. One major symptom of hypothyroidism is low
energy. So, it’s important to make sure that your TSH is within the range of a healthy person
without thyroid disease (not within the range of an elderly person or someone
with subclinical thyroid disease).
TSH stands for Thyroid Stimulating Hormone, which is produced in the pituitary gland in
your brain. The pituitary gland tells your thyroid to make and release thyroid hormones into
your blood. A TSH test measures how much of this hormone is in your blood. In advanced
cases of Hashimoto’s and primary hypothyroidism, this lab test will be elevated. (Read my
post about interpreting your TSH test for more information). In the case of Graves’ disease
and hyperthyroidism, the TSH will be low. Keep in mind, however, that people with
Hashimoto’s and central hypothyroidism may have a normal reading on this test.
The National Academy of Clinical Biochemists indicates that 95 percent of individuals
without thyroid disease have TSH concentrations below 2.5 μIU/mL. However, as of 2017,
the official reference range for the TSH test in most labs in the U.S. runs from approximately
0.5 to 4.5 or 5.0 (μIU/mL). A patient with TSH levels within this range is considered to have
normal thyroid function.

However, many labs have not adjusted that range in the reports they provide to physicians
and have kept ranges as lax as 0.2-8.0 μIU/mL. And, many physicians only look for values
outside of the “normal” reference range provided by the labs. They may not be familiar with
the new guidelines. This is one reason why patients should always ask their physicians for a
copy of their lab results. Despite some lab tests stating that a TSH of 8 or 5 μIU/mL is
“normal,” most people feel best with a TSH between 0.5-2 μIU/mL.

In 2001, the results of the Basel Thyroid Study conducted at the end of the 1990’s were
published. Tiredness and fatigue remained as the cardinal impairment in hypothyroidism, in
spite of thyroid hormone therapy. An editorial in Thyroid, written by Peter Andreas Kopp in
2014, found that patients remain symptomatic (that is, they may experience symptoms like
fatigue) despite having “normal” thyroid hormone levels.
Similar to the opinion of Kopp, Mary H. Samuels, a professor of the Oregon Clinical and
Translational Research Institute, stated: “It is a common clinical observation that some
otherwise healthy patients with hypothyroidism continue to complain of fatigue, poor mood,
inability to concentrate, and vague cognitive difficulties (often described as ‘brain fog’)
despite normal TSH levels.”

You may also be interested to know that of the 2,000+ people who took part in a survey I
conducted, thyroid patients reported that optimizing their TSH helped improve their
energy. Seventy-seven percent of my readers with a TSH level under 1 μIU/mL saw
improvement in energy from medication interventions, and 72 percent with a TSH between 1
and 2 μIU/mL saw improvement in their energy levels.
From a personal perspective, I felt like a sloth when my TSH was within the “normal” range
at 4 μIU/mL.

2. The Impact of Low T3/High Reverse T3

Triiodothyronine, or T3, is a hormone produced by the thyroid gland that is essential for
keeping our metabolism going. T3 is the main “energy” hormone produced by the thyroid.
When our cells see T3, they produce more energy, so it’s very important to ensure that we
have adequate levels of active T3, as T3 tells our body to grow hair, boost metabolism, and
create more energy.

It’s also important to avoid having a high level of reverse T3, which is a molecule related to
T3 that blocks thyroid receptors in cells instead of activating them. When cells see this
molecule, they slow down energy production.

Synthroid® or levothyroxine (a synthetic version of T4) is the most commonly prescribed

thyroid medication, but only contains T4, a precursor to T3, our main “energy” hormone. T4
is converted to T3 in the body, but this doesn’t always happen, due to numerous factors such
as stress, nutrient deficiencies, and others… so we often continue to feel exhausted despite
having normal T4 levels.
Ulta Labs is a great online esource for ordering a free T3, free T4, and TSH test, as well as
for checking your reverse T3 levels, without needing to get a thyroid lab request from your
doctor. The lab also bills insurance (please check with your own insurance to make sure you
qualify), and I love using it to get a discount on lab tests with my high-deductible insurance
plan.
If you continue to be fatigued while on medications, you can have your practitioner test your
free T3 levels. (In some cases, testing reverse T3 may also be helpful, although it’s not
always necessary.)

In the case that your T3 is low, or in the bottom part of the reference range, or if you’re still
symptomatic with T4 medications alone, you may benefit from adding a T3-containing
medication such as Cytomel (liothyronine) to your current medication regimen, or switching
to a T4/T3 combination medication such as WP Thyroid, Armour*, Nature-Thyroid, or
compounded T4/T3.

In my survey of over 2,000 readers, 76 percent reported improved energy while taking
compounded T3/T4, 74 percent while taking Armour Thyroid*, 74 percent with Cytomel, and
72 percent with Nature-Thyroid. Only 52 percent saw improved energy levels with Synthroid,
the most commonly prescribed thyroid medication.

The takeaway from the survey showed that getting on the right thyroid medication helps
many people get their energy back. For further information, you can read my article
about thyroid medications.
Also, be sure to download my FREE eBook on optimizing your thyroid medications!
*Note: While Armour Thyroid does not have any gluten-containing ingredients, it is not
tested for gluten content, and cannot be certified as gluten free. Armour does contain sodium
starch glycolate, which can be derived from wheat or corn.
3. Is Anemia Stealing Your Energy?

Many people think of iron deficiency as the cause of anemia, but there are actually three
types of nutrient deficiencies that can lead to anemia and are common in people with
Hashimoto’s – iron, B12, and folate.

Testing for Anemia

Your practitioner will usually run a blood test to check for hemoglobin and hematocrit to
look for anemia. While helpful for advanced cases of anemia, this test may miss some subtle
cases of anemia that can leave us feeling exhausted.

In addition to testing hemoglobin and hematocrit, I recommend

testing ferritin, B12 and folate. Always be sure to get a copy of your lab tests. As with the
“normal” range for TSH, the “normal” lab values for B12 and ferritin are often not optimal.
B12
Normal levels of vitamin B12 are between 200-900 pg/mL; however, levels under 350 pg/mL
are known to be associated with neurological symptoms. In my experience, you can have
symptoms if your levels are below 700 pg/mL, and you may still benefit from a supplement.

In a study regarding the prevalence of vitamin B12 deficiency among patients with thyroid
dysfunction, it was found that autoimmune thyroid disease is also associated with the
autoimmune disorder pernicious anemia, which may lead to malabsorption of vitamin B12.
The study concluded that in order to ensure proper treatment, vitamin B12 screening is
recommended upon initial diagnosis of autoimmune thyroid disease, and periodically
thereafter.

As some people may have a difficult time absorbing B12 orally, it works best when taken as
an injection or as a sublingual (under the tongue) drop.
Be sure to get the methylcobalamin or hydroxocobalamin version of B12 rather than a
cyanocobalamin version, as they are better absorbed by most people.

I have found the liquid B12 5000 supplement by Pure Encapsulations to be very helpful for
my clients. In my survey of 2232 of my readers with Hashimoto’s, 88 percent saw
improvement in energy from B12 supplementation. You can read more about the thyroid
and B12, as well as the optimal sublingual dosing regimen that can help you avoid shots.
Ferritin
Ferritin is the name given to your body’s iron reserve protein. “Normal” ferritin levels for
women are between 12-150 ng/mL. However, the optimal ferritin level for thyroid function is
between 90-110 ng/mL.

Ferritin is one of the most common deficiencies I see in people with Hashimoto’s, and in
addition to fatigue, ferritin deficiency can also contribute to shortness of breath, restless leg
syndrome, hair loss, insomnia, strange food cravings and mood swings.

While ferritin is likely to be deficient in up to 50 percent of women of childbearing age, as

well as up to 80 percent of women who are pregnant or who are recently postpartum, I don’t
recommend supplementing unless you’ve been tested to be deficient in ferritin. Too much
iron/ferritin can also be a problem!

According to my survey, ferritin/iron supplementation improved energy levels for 82 percent

of those who responded. While most iron supplements can cause digestive disturbances, two
potential options may be better tolerated:
1. OptiFerin-C contains ferritin and has helped many of my clients boost their ferritin
levels. Calcium ascorbate, a natural, water soluble version of Vitamin C, is added to
increase intestinal absorption.
1. Thorne Iron Bisglycinate is an iron supplement that is more gentle on the stomach
and less likely to cause constipation.
I recommend testing for ferritin before supplementing, and retesting your levels within 1-3
months, to ensure that you are supplementing enough (but not too much!).
Folate
Vitamin B9 is a necessary nutrient that naturally presents itself as folate, which plays a vital
role in the formation of DNA and cell growth. In some cases, you may test normal or high for
folate, but you could still be deficient in the right kind of folate for your body.

This is the case with the MTHFR gene variation, which can impact how well your body
metabolizes folate. Both folate and folic acid are forms of vitamin B9, required for numerous
critical bodily functions. However, folic acid is synthetic, while folate occurs naturally in
foods, such as broccoli, lamb, beets, and quinoa. Some people, including some individuals
with Hashimoto’s, have a MTHFR gene variation that prevents them from properly
processing the folic acid that may be present in less expensive supplements and processed
foods. Some professionals claim this type of folic acid may even cause a build-up in the
body, leading to toxicity.
Likewise, the MTHFR gene produces an enzyme necessary to process vitamin B9 properly.
This enzyme is also important for converting homocysteine to methionine, which the body
needs for proper muscle growth and energy.

In addition to lifestyle changes, individuals with the MTHFR gene variation and high
homocysteine levels may benefit from an activated or methylated version of folate, mainly
because food alone does not provide sufficient levels. I have formulated MTHFR Pathways,
which contains all of the above-mentioned ingredients and may be helpful with reducing
homocysteine levels.
Read more about MTHFR and Hashimoto’s.
4. Discover Your Food Sensitivities

Fatigue can be experienced from ingesting a food you are sensitive to. Food sensitivities are
very different than food allergies, and many people are sensitive to specific food groups
which can result in fatigue. People with Hashimoto’s often present with gluten, dairy, soy,
egg, corn, and nut sensitivities. In fact, two of the most common food sensitivities found in
people with Hashimoto’s are gluten and dairy.
Gluten is the main reactive protein found in wheat, and casein is the main reactive protein
found in dairy. Growing evidence has shown that food sensitivities can negatively impact our
bodies and trigger a wide range of symptoms, such as asthma, arthritis, mood disorders, and
autoimmune disorders. My own clinical and personal experience has shown that non-Celiac
gluten sensitivity is one of the biggest triggers in Hashimoto’s.
Changing my diet helped with fatigue, and I regained my energy. It also helped me eliminate
bloating, symptoms of irritable bowel syndrome, anxiety, congestion, and carpal tunnel!

In my outcomes survey of people with Hashimoto’s, 75 percent reported improvement in

energy from the Autoimmune Paleo diet, and another 78 percent saw improvement in energy
from the Paleo diet.
Food sensitivity testing may be helpful in some cases, but may not be affordable for many
people. Not all tests are created equally, but I have found the food sensitivity testing
through Alletess to be the most accurate. The company offers food sensitivity testing
(96 and 184 food panels) for people to self-order. I started with the 96 food panel, which was
enough to pinpoint most of my food triggers, and I now repeat the 184 food panel on an
annual basis to be sure that I’m staying on top of potential triggers, as our food sensitivities
and reactions to foods tend to change with time.
5. Balance Your Blood Sugar

Blood sugar imbalances can wreak havoc on our energy levels as well as cause anxiety.
People with blood sugar imbalances will often have times of the day where they feel
especially tired, weak and/or anxious, such as “morning fatigue” or the “afternoon slump”.

That’s why balancing blood sugar levels should be one of the priorities for anyone who is
hoping to overcome fatigue. Balancing my blood sugar made a big difference for me, helping
me feel more energetically balanced and less anxious throughout the day. As a side bonus,
most people with Hashimoto’s will find that their thyroid antibody levels will drop thanks to
balancing their blood sugar!

Before I balanced my blood sugar, I would get “hangry” (hungry + angry) multiple times per
day. I found that the high carbohydrate foods I was eating were causing huge blood sugar
swings, and I didn’t realize these swings were causing a spike in my thyroid antibodies and
weakening my adrenals.

Practitioners, like myself, who focus on reversing Hashimoto’s, often describe blood sugar
imbalances as adding fuel to the fire in autoimmune thyroid disease. I wasn’t aware that I had
blood sugar issues when I was first diagnosed (despite being a self-admitted sugar addict).

Researchers in Poland found that up to 50 percent of patients with Hashimoto’s have an

impaired tolerance to refined or simple carbohydrates like processed sugar or refined grains
that have had the nutrients removed. This means that after consuming carbohydrate-rich
foods, their blood sugar goes up too high, too quickly, which leads to a rapid, and often
extreme release of insulin. These insulin surges can cause low blood sugar (reactive
hypoglycemia), which in turn can cause troublesome symptoms like lightheadedness,
nervousness, anxiety, and fatigue.
However, eating a low glycemic index diet can help you feel fuller longer. It can also
improve cholesterol and blood sugar levels, enhance cognitive performance, improve
energy, and reduce acne. The diet can also lower your risk of developing diabetes, heart
disease, some cancers, and can promote weight loss as well.
6. Enhance and Optimize Digestion

The digestive process is an energy intensive one. Studies have shown that people with
Hashimoto’s and hypothyroidism often do not have adequate levels of stomach acid, and
some don’t produce ANY stomach acid, making protein digestion inefficient and even more
draining of our energy.
Discovering that I had a deficiency of stomach acid was a huge “aha” moment for me! I
couldn’t believe how energetic I became when I started taking Betaine with Pepsin with my
protein containing meals.

My 10-year long debilitating fatigue was lifted practically overnight, and I went from
sleeping for 11-12 hours per night to 8 hours — just because I started digesting my food
better. I felt like Bradley Cooper in Limitless after I started taking Betaine with Pepsin.
Finally having enough energy gave me the confidence that I could overcome Hashimoto’s
and my long list of health struggles. It even helped with my brain fog, and I was able to come
up with all kinds of clever words much quicker. My humor came back.
I started writing my book about overcoming Hashimoto’s the morning after I took a dose of
Betaine with Pepsin. The restored energy gave me hope that I would be able to devote myself
to research and find the root cause of my condition, then share that knowledge to help others.

Betaine with Pepsin promotes healthy digestion and supports nutrient absorption, such a
protein, calcium, Vvitamin B12, and iron. I have found it very beneficial for anyone seeking
enhanced digestive function.

Out of 627 of my readers who took Betaine HCI and Pepsin, 59 percent said it made them
feel better and saw improved energy levels, 33 percent said it made them feel worse, while 7
percent saw no difference in their symptoms. These results lead me to estimate that 50-70
percent of people with Hashimoto’s are likely to have a deficiency in stomach acid, and the
33 percent of those who felt worse were likely not deficient in stomach acid. Those who did
not see any improvement may not have been dosed adequately, as the dosage of Betaine with
Pepsin should be individualized.

If you have a thyroid condition and continue to struggle with fatigue, you can download
my Low Stomach Acid Quick Start Guide.
7. Sunshine Deficiency

A lack of sunshine can lead to fatigue, due to two very specific reasons: vitamin D deficiency
and light deficiency.

Low levels of vitamin D can be associated with fatigue, hypothyroidism, and autoimmunity
in general. We can get vitamin D from sunshine, certain foods, and supplements, but it’s not
always easy to ensure you are getting enough. Your goal should be to get your vitamin D
levels between 60-80 ng/dl. This is especially true for those who have a history of contracting
the Epstein-Barr virus (EBV).
Vitamin D deficiency is more commonly found in people with Hashimoto’s—68 percent of
my readers with Hashimoto’s reported also being diagnosed with vitamin D deficiency, and
67 percent saw improvement in energy from increasing their vitamin D levels. Research done
in Turkey found that 92 percent of Hashimoto’s patients were deficient in vitamin D, and
another 2013 study found that low vitamin D levels were associated with higher thyroid
antibodies and worse disease prognosis.

I’ve personally found that most of my clients who are in remission from Hashimoto’s keep
their levels of vitamin D between 60-80 ng/mL.

My number one recommendation for addressing both of these deficiencies is a beach

vacation. (Please print this and show it to your boss or spouse whenever necessary—I know I
have to remind my husband every winter!). But if you can’t get to the beach just yet, the
recommendations below should work even in the darkest and coldest of winters!

Who is at Risk for Vitamin D Deficiency?

Pretty much anyone who is not a full-time lifeguard in Southern California is at risk of being
deficient in Vitamin D. Vitamin D deficiency is rampant—very common in most North
Americans, Europeans, and Australians—and affects a large number of people with
Hashimoto’s. A low-fat diet or fat malabsorption increases the risk. The best way to restore
optimal vitamin D levels is through sun exposure, safe tanning beds, and an oral vitamin D3
supplement. The secondary best sources of vitamin D are from foods like wild salmon and
cod liver oil.
Vitamin D advocates recommend 15 minutes of unexposed skin without sunscreen around
noon. Perhaps you can go for a walk during lunchtime? If you are fair skinned and not used
to the sun, you may need to start a bit slower. Be careful not to overexpose yourself to
prevent getting a sunburn.

I also recommend Blue Light Therapy Boxes. Clinically proven to boost energy and mood
naturally, as well as fight the winter blues, blue light therapy boxes allow you to get the light
you need wherever you live or work. It may take a week or so before you begin to feel your
energy return, and you will want to use your box daily for at least 30 minutes to see the best
results.
I generally recommend using the box first thing in the morning as you’re getting ready for
work, as well as in the early afternoon to give yourself another energy boost. I don’t
recommend using the light too close to bedtime, unless you’re planning to stay up late!

I have personally used this type of light preventatively during cloudy weather, as well as
whenever I feel like I need an energy boost and can’t get outside or to the beach.

8. Is Adrenal Fatigue Getting You Down?

Adrenal fatigue can make you feel like you are dragging around 50 pounds of concrete,
especially in the later phases of adrenal fatigue when your cortisol becomes depleted. Adrenal
fatigue is one of the major reasons we feel exhausted despite taking thyroid medications.
With optimal adrenal function, in the morning, cortisol spikes, giving you a natural jolt to get
you out of bed. Those in advanced levels of adrenal fatigue won’t make enough cortisol in
the morning and may find themselves having difficulty with getting up in the morning and
sustaining good energy throughout the day. A common pattern I often see is “the afternoon
person”, or someone who struggles in the morning and in the evening and has just a few good
hours in the afternoon; or the “tired night owl”, a person who feels tired most of the day then
gets a second wind at bedtime when the day’s cortisol is released.

Without sufficient cortisol levels, we may become dependent on caffeine… Caffeine boosts
cortisol levels temporarily, but does weaken the adrenals in the long term. In fact, drinking
too much caffeine can create a vicious cycle of unrestful sleep/fatigue/needing more caffeine.
Getting adequate sleep as well as weaning off caffeine (notice, I didn’t say stopping cold
turkey) can help with rebalancing the adrenals.

Try hot lemon water first thing in the morning instead. It’s a great substitute for caffeine and
helps to provide relief from fatigue.

I have found that the ABC’s can be incredibly helpful for supporting the adrenals and energy
levels.

A- Adrenal Adaptogens

B- B vitamins

C- Vitamin C

I created Adrenal Support from Rootcology, which contains a blend of the ABC’s. You
should see improvements in your energy levels and resilience within a few days of starting
Adrenal Support.
In some cases, additional adrenal testing and protocols may be indicated. I cover these in
great depth in Hashimoto’s: The Root Cause, and Hashimoto’s Protocol.
9. Is Your Liver Congested?

The liver’s function is to remove toxins from our bodies. These toxins can come from various
external sources, such as molds, or from internal sources like an imbalance of gut bacteria or
pathogens. Some of us may be exhausted because we cannot process the toxins that are
present in our bodies. The toxins saturate our liver enzymes, making us feel fatigued.

Some of the most common toxins in the environment include:

 Pesticides
 Herbicides
 Heavy metals
 Food additives
  Formaldehyde
 Solvents/cleaning materials
It’s a good idea to reduce your exposure to toxins in your environment. A few ideas include
the use of an air purifier, drinking filtered water, stopping the use of cosmetics that contain
petrochemicals, avoiding preservatives and additives, stopping the use of harsh cleaning
agents and aerosols, and eliminating molds in your home.

I have also found N-Acetyl-Cysteine, a supplement that supports liver detox capabilities, to
be worth considering.
You can also read about how supporting the liver is key to recovering from thyroid
disease. You’ll find signs and causes of toxic overload, how liver impairment is related to
Hashimoto’s, who is most at risk, and so much more.
10. Boost Thiamine and Boost Your Energy

Studies have found that people with Hashimoto’s are often deficient in the B vitamin,
thiamine (vitamin B1).

Thiamine is essential for energy production and carbohydrate digestion. Our bodies need
thiamine to make adenosine triphosphate (ATP), which our cells use for energy, and it plays a
key role in supporting the nervous system. B1 is thought to strengthen the immune system
and help our bodies withstand stressful situations. But, in order to absorb enough thiamine
into our bodies, we also need adequate supplies of B6, B12, and folate.

What’s really exciting is that taking 600 mg per day can restore energy levels in as little as
three days! That’s great news for someone who suffers from fatigue. I have written about
the thyroid and thiamine connection in my blog posts, and I still get hugs from people I
meet at conferences who have reported that thiamine has changed their lives.
I recommend Benfomax from Pure Encapsulations for best results. It is non-GMO, gluten
free and vegan. It’s one of the highest quality thiamine supplements on the market.
11. L-Carnitine for Thyroid Fatigue

L-carnitine is an amino acid that is naturally produced in the body. It helps transport fatty
acids into the mitochondria where they can be burned up and used as fuel.

L-carnitine levels may be decreased in hypothyroidism, potentially due to reduced synthesis

of L-carnitine while we are in a hypothyroid state. Taking a thyroid medication can boost the
production of L-carnitine, but it can also work as a vacuum, taking the L-carnitine from the
body and resulting in an overall deficiency.

The results of a recent study regarding L-carnitine supplementation for the management of
fatigue in patients with hypothyroidism found that L-carnitine may be useful in alleviating
fatigue symptoms in hypothyroid patients, especially in those younger than 50 and those who
have hypothyroidism due to a thyroidectomy.
In the study, 60 patients who were experiencing fatigue were given L-carnitine for 12 weeks.
A dose of 1,980 mg was given to 30 people who were taking thyroid hormones (either due to
Hashimoto’s or post-thyroidectomy), while 30 people received a placebo.

After 12 weeks, the researchers noted that the group receiving L-carnitine did indeed show
improvements in fatigue, with the most significant improvements seen in “brain fatigue.”

I have personally seen people “awaken” with the use of L-carnitine.

L-Carnitine, combined with eating a low glycemic index diet, can also help to establish a
proper blood sugar balance in the body. As we discussed above, blood sugar balance is
crucial to help overcome fatigue. Studies in both humans and animals have shown that
carnitine supplementation resulted in an improvement of glucose tolerance, in particular
during insulin-resistant states.
Red meat is the richest source of L-carnitine, but some individuals may not eat enough red
meat to meet their carnitine requirement, or may not properly extract the nutrient. For this
reason, I created Rootcology’s Carnitine Blend to combine L-carnitine and its acetylated
form into convenient capsules. Both L-carnitine and acetyl-L-carnitine can help to increase
carnitine levels in the body; however, each form may have its own specific benefits. L-
carnitine (2 grams per day) has been reported to resolve Hashimoto’s-related fatigue and has
also been found to support antioxidant activities in the body, while acetyl-L-carnitine has
unique brain-supportive properties and has been shown to help to reduce mental fatigue (and
improve cognitive function) in various studies (bye bye brain fog!).
The Takeaway
Many people endure the exhausting symptoms of fatigue every day. I know first hand how
tiredness and fatigue can impact everyday life and leave you exhausted. Overcoming
Hashimoto’s fatigue is an important step in regaining your energy and getting on with life,
and the interventions listed above may help with that. You have the power to take back your
health.

If you’re looking for more tips, I have a FREE ebook that includes a summary of the most
helpful strategies to overcome fatigue in a simple and easy-to-read format, including some of
the supplements that will make a difference right away. Sign up below to join my mailing list
and download my eBook: Overcoming Thyroid Fatigue.
I hope that this information helps you to get your energy back soon!

P.S. You can also download a free Thyroid Diet Guide, 10 Thyroid friendly recipes, and
the Nutrient Depletions and Digestion chapter. You will also receive occasional updates
about new research, resources, giveaways and helpful information.
For future updates, make sure to follow us on Facebook!
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Note: Originally published in May 2015, this article has been revised and updated for
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FILED UNDER: RECOVERY, SYMPTOMS TAGGED WITH: ADRENAL, ANEMIA, EMPOWER
YOURSELF, FATIGUE, FT3, INSULIN, LIFESTYLE INTERVENTIONS, OPTIMAL
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Comments
1. Boo says
June 10, 2019 at 11:40 PM
Hi,

what does high level of reverse T3 mean? Is there a good range?

Thanks
Best regards

Reply

o Dr. Izabella says

June 11, 2019 at 7:02 AM
Boo – thank you for reaching out. Reverse T3 is an inactive molecule related to T3 but
without any physiological activity—it is a dud that just takes up space! Under stressful
situations, T4 gets converted to reverse T3 instead of T3. You can find more
information on Reverse T3 in my book Hashimoto’s Root Cause. Here is an article you
may find helpful as well:

STRATEGIES TO OVERCOME HASHIMOTO’S FATIGUE

https://thyroidpharmacist.com/articles/strategies-overcome-hashimotos-fatigue/
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