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8 Ways to Stay Energized When You Have Hypothyroidism
Tired of feeling tired all the time? Extreme tiredness, fatigue, and just feeling wiped out — these are common symptoms of an underactive thyroid gland. The best move you can make to get a bounce back in your step when you have hypothyroidism is to get your thyroid hormone levels back on track. Talk with your doctor about how to get this done with hormone replacement medication.
Most experts agree that once hypothyroidism is diagnosed, medication should be tweaked until your thyroid-stimulating hormone (TSH) levels move into a range of 1 mU/L to 3 mU/L , says Victor Bernet, MD, an endocrinologist and assistant professor at the Mayo Clinic in Jacksonville, Florida. Be patient as you target getting TSH levels into that range. It can take some time — even a few months.
Jan Hoffman, MD, an endocrinologist in Wichita, Kansas, also points out that it’s important to confirm that hypothyroidism is actually what’s causing you to feel exhausted. “Sometimes people equate being tired with their thyroid medication being out of balance, but there are other things that can make you tired in the first place,” he says.
Dr. Hoffman often screens people for vitamin D deficiency, for example. He says this vitamin deficiency is very common in his area of the country (at a high latitude, where there is less sun exposure) and can cause ongoing tiredness. He also tests people for connective tissue diseases, anemia, and inflammatory illnesses — all of which can cause fatigue.
If you have a definitive diagnosis of hypothyroidism, you’ll have to wait for your thyroid hormone levels to adjust with the replacement medication. While you still may feel tired for a bit, Dr. Bernet says not to be discouraged. You can still make a difference in how you feel from day to day. Try these strategies to manage fatigue when you’re living with hypothyroidism.
Take Your Thyroid Replacement Medication Consistently
Thyroid hormone replacement medication helps most people with an underactive thyroid feel less tired. Even those with severe cases of hypothyroidism usually get some relief from symptoms within six months of starting treatment, according to Hoffman. It’s important to take your thyroid medication as prescribed. That means taking it at the same time and in the same way every day. You should take your medication on an empty stomach and wait at least 30 minutes to an hour before eating. According to the American Thyroid Association, the best time to take your medication is first thing in the morning. If you take other prescriptions or supplements, talk to your doctor about how to time these with your thyroid medication.
If you happen to be among the group that continues to feel tired despite meeting TSH goals, Hoffman suggests adjustments to include both the T3 and T4 hormones in your medication plan. “This is a practice that’s increasingly accepted,” he says. Talk with your primary care doctor or endocrinologist about trying this approach if you haven’t been getting good results from your current medication plan. However, adding T3 hormone may not be a safe option for everyone, including pregnant women, women planning pregnancy, people with heart disease, or older adults.
Watch What You Eat
While there’s no specific hypothyroidism diet, eating a diet rich in fruits and vegetables, whole grains, and lean proteins can help give you the energy you need to get through the day with some pep in your step. You may also want to limit or avoid certain foods that may get in the way of your body’s ability to fully absorb the replacement hormones. These include large amounts of soy products or foods high in fiber, according to the Mayo Clinic. Also cut back on added sugars, which can actually add to the fatigue you’re feeling.
Certain medications and dietary supplements can also affect how you absorb your thyroid medication, so check with your doctor before starting these. To avoid issues with absorption, Hoffman tells his patients to take the thyroid medication when they first get up in the morning, and then get ready for the day before they eat breakfast. Another tip: To keep your overall energy up, avoid eating large meals within a few hours of bedtime. Doing this can lessen the quality of your sleep and your energy the following day. Instead, opt for a lighter dinner and a small snack before bed.
Try Cognitive Behavioral Therapy (CBT)
This type of therapy may help you better deal with your emotions by changing negative thought patterns and replacing them with more positive ones. In studies looking at physical activity, CBT, and fatigue — including one published in the journal Health Psychology — researchers observed that CBT appeared to help people feel like they were more active or capable of being active. CBT assists by helping you learn how to notice fatigue-related thinking that can make you feel you’re just too tired from the effects of hypothyroidism to do anything.
Limit Alcohol and Caffeine
If you’re fighting fatigue from hypothyroidism, it’s easy to slip into a cycle of drinking a lot of caffeinated drinks during the day and then having a nightcap to bring you back down. Although caffeine can sometimes give you a short-term lift, such as feeling perkier in the morning, it won’t address long-term fatigue. What’s worse, this cycle of caffeine to wind up and alcohol to wind down could be sapping your energy beyond the fatigue caused by hypothyroidism. Both alcohol and caffeine interfere with your body’s ability to get into a deep, restorative level of sleep. Stick to only one or two caffeinated drinks before noon, and have just one alcoholic drink, if any, early in the evening.
Exercise to Boost Energy
You might think hypothyroidism has drained you of all energy reserves, but even adding a little more physical activity to your day can help you improve energy levels during the day and get better sleep at night. Aim for the recommended amount of physical activity per guidelines from the U.S. Department of Health and Human Services: moderate-intensity aerobic activity for at least 30 minutes at least five days a week and strength training activities at least two days a week. Since exercising in the evening can make it difficult to get to sleep, try to get most of your workouts done earlier in the day. The bottom line: the right hypothyroidism workout can help give you back the energy you’ve been craving.
Sleep Hygiene Matters
Getting enough high-quality sleep — most people need seven to nine hours of sleep every night — can help fight daytime tiredness related to an underactive thyroid. Deep sleep needs the proper “stage”: A slightly cool, dark, sound-free location. To get your body into the right sleep rhythm, establish a regular time to go to sleep and to wake up, even on weekends and holidays. Leave your phone and other digital devices in another room, and if necessary, invest in an alarm clock — not your phone — to rouse you out of sleep in the morning. If you’ve taken these steps to improve your sleep but are still feeling low on energy during the day, check out your options for a formal sleep evaluation to determine if you have a sleep disorder, such as sleep apnea, which could be robbing you of deep, restorative sleep at night.
Stop Tobacco Use
Nicotine is a stimulant. So even though smoking can feel like a relaxing routine, it’s interfering with your sleep quality and, in turn, adding to fatigue. Research is ongoing, but cigarette smoking is believed to affect the thyroid gland in various ways, according to a review. Tobacco use is believed to prompt hormone changes in your body, for example, and even stimulate autoimmune activity in some people — which could be challenging your hypothyroidism treatment plan. Explore ways to quit smoking and find better-quality sleep and more energy. But since kicking the habit can itself complicate hypothyroidism, be sure to stop smoking under a doctor’s supervision.
See Your Doctor Regularly
Bernet compares the energy you feel with good thyroid function to driving a car that’s well-serviced. “If your car is acting up and your oil is low or you haven’t changed it in a while, you need oil,” he says. This is the equivalent of taking medication to get your thyroid hormone levels back to normal. But if the oil in your car is fine, don’t add more oil. Instead, look for another cause of your engine’s distress. The same logic applies to managing hypothyroidism. If your thyroid screening suggests you’re at normal levels after treatment, but you’re still feeling tired, ask for further medical evaluation to find the underlying cause of your lack of energy. According to the public opinion and data company YouGov, only about 1 in 7 Americans wake up feeling refreshed every day of the week. But hypothyroidism is just one of many possible causes of ongoing exhaustion.
Additional reporting by Andrea Peirce.
Elise M. Brett, MD
Medical Reviewer
Dr. Brett practices general endocrinology and diabetes and has additional certification in neck ultrasound and fine-needle aspiration biopsy, which she performs regularly in the office. She is voluntary faculty and associate clinical professor at the Icahn School of Medicine at Mount Sinai. She is a former member of the board of directors of the American Association of Clinical Endocrinology. She has lectured nationally and published book chapters and peer reviewed articles on various topics, including thyroid cancer, neck ultrasound, parathyroid disease, obesity, diabetes, and nutrition support.
Elise M. Brett, MD
Author
Dr. Brett practices general endocrinology and diabetes and has additional certification in neck ultrasound and fine-needle aspiration biopsy, which she performs regularly in the office. She is voluntary faculty and associate clinical professor at the Icahn School of Medicine at Mount Sinai. She is a former member of the board of directors of the American Association of Clinical Endocrinology. She has lectured nationally and published book chapters and peer reviewed articles on various topics, including thyroid cancer, neck ultrasound, parathyroid disease, obesity, diabetes, and nutrition support.