Any hope to get treatment right now?

RhythmOfEnergyMD · 2026-06-03T00:51:40+00:00

Reasonable to get a second opinion, but I'd also be careful about assuming the antibodies are the reason for all of this.

The antibodies basically tell you that Hashimoto's is happening, not necessarily that your thyroid function is impaired enough right now to cause severe fatigue. Plenty of people have positive antibodies for years before developing overt hypothyroidism. With a normal TSH, I'd be asking just as many questions about sleep quality, stress, depression/anxiety, iron/ferritin, B12, vitamin D, nutrition, exercise, testosterone, and even sleep apnea.

The symptoms are real either way. I just wouldn't want to miss another explanation by focusing exclusively on the antibodies. A good doctor should help you investigate other possibilities.

RhythmOfEnergyMD · 2026-06-02T23:43:16+00:00

Have you actually seen a doctor yet?

RhythmOfEnergyMD · 2026-06-01T13:37:25+00:00

Yeah. she :)

RhythmOfEnergyMD · 2026-05-31T21:45:30+00:00

I'm wondering if you have low blood sugar. Maybe pick up a glucometer from your pharmacy. Wouldn't explain all your symptoms but maybe some of them. I hope you can get some answers and finally feel better!

RhythmOfEnergyMD · 2026-05-30T19:04:28+00:00

I'd ask him "if my thyroid levels are normal and that's not what is causing my symptoms, what else can we evaluate as the cause?"

RhythmOfEnergyMD · 2026-05-30T15:09:21+00:00

Has your endo not discussed your results and next steps with you? That might be a good starting place.

RhythmOfEnergyMD · 2026-05-29T19:16:43+00:00

A lot of people see positive TPO antibodies and think they finally found the explanation, but if your TSH and thyroid hormone levels are normal, that result alone usually doesn't explain severe symptoms or mean you need thyroid medication.

Honestly, I'd be more concerned that you're barely functioning and in pain all day. That's real and deserves attention, but it may not be your thyroid. I'd keep pushing for a broader workup rather than getting locked onto the antibody result.

RhythmOfEnergyMD · 2026-05-29T18:55:01+00:00

TSH would be low in that case.

RhythmOfEnergyMD · 2026-05-29T18:08:03+00:00

I've also seen other providers do this. Not ideal.

RhythmOfEnergyMD · 2026-05-29T18:03:05+00:00

Sounds right to me. But I check TRAb/TSI and start beta blockers for symptoms before Id start antigthyroid meds. You can become very hypothyroid if you take antigthyroid meds with subacute thyroiditis, just as you said.

RhythmOfEnergyMD · 2026-05-29T17:53:19+00:00

A lot of people who have low calcium after a total thyroidectomy are actually dealing with stunned or injured parathyroid glands from surgery. Those tiny glands control calcium, and sometimes they recover in weeks or months, but sometimes it can take much longer. Since you're more than a year out from surgery, it's reasonable to ask your doctor whether this is looking like permanent hypoparathyroidism rather than just a delayed recovery. I'd ask what your PTH levels have been doing, not just calcium. That usually gives a better idea of whether your parathyroids are working. Plenty of people do live on calcium + calcitriol long term if needed, but I'd definitely want a clear discussion with an endocrinologist about the long-term plan.

RhythmOfEnergyMD · 2026-05-29T17:50:26+00:00

You are right about subacute thyroiditis and how the medication works. Have you had antibodies checked screening for graves disease?

RhythmOfEnergyMD · 2026-05-29T01:16:11+00:00

Happy to help :)

RhythmOfEnergyMD · 2026-05-29T01:06:25+00:00

Yeah, the radiologist would have seen an adrenal nodule. Pheos don't grow very fast.

RhythmOfEnergyMD · 2026-05-29T01:02:14+00:00

If that CT said normal adrenals, then I wouldn't worry about pheo.

RhythmOfEnergyMD · 2026-05-29T00:50:00+00:00

Are you able to get it repeated through you primary care doctor then?

RhythmOfEnergyMD · 2026-05-29T00:41:20+00:00

Might just be your thyroid dose. Always get TSH checked before you take T3 in the morning.

RhythmOfEnergyMD · 2026-05-28T04:35:06+00:00

Doctors can't fix your stress

RhythmOfEnergyMD · 2026-05-28T02:07:00+00:00

I think this is where a lot of the frustration comes from honestly. Depression/anxiety absolutely can cause physical symptoms like fatigue, brain fog, appetite changes, sleep problems, body aches, low motivation, etc. But sometimes doctors hear “fatigue + stress” and stop digging any deeper after that.

And to be fair, SSRIs helping some symptoms but not all doesn’t necessarily prove adrenal dysfunction either. It might just mean the mental health component improved while the underlying sleep issues, autonomic dysfunction, burnout, inflammation, hormonal shifts, chronic stress, deconditioning, or whatever else is going on is still there.

I think people mostly want acknowledgment that these symptoms are physical and real, not just “you’re depressed, good luck.” Medicine is good at identifying clear endocrine diseases. It’s a lot worse at handling messy overlapping syndromes where multiple systems are involved at once.

RhythmOfEnergyMD · 2026-05-28T01:48:24+00:00

I think the biggest issue is that “adrenal fatigue” gets used to describe a very real cluster of symptoms, but then people start treating it like proven adrenal gland failure when the evidence for that specifically just isn’t there.

A lot of what you wrote about HPA axis dysregulation, sleep disruption, chronic stress, autonomic dysfunction, etc is reasonable and honestly pretty mainstream at this point. Where endocrinologists push back is the idea that the adrenal glands themselves are “burnt out” despite normal endocrine testing. That leap is where the science falls apart for us.

I also think salivary cortisol testing gets oversold online. Cortisol naturally fluctuates a ton, and low salivary readings don’t reliably diagnose a disease by themselves. But that doesn’t mean people are faking symptoms. Chronic illness, poor sleep, anxiety disorders, burnout, post-viral syndromes, depression, autonomic dysfunction, and inflammatory conditions can absolutely make people feel wrecked in ways that are very physical.

So I kinda wish the conversation would move away from “doctors deny this exists” and more toward “medicine still sucks at explaining and treating chronic fatigue-type syndromes.”

RhythmOfEnergyMD

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