Reply To: 29 yo F – Graves, thyroidectomy, fatigue

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Welcome! Forums 29 yo F – Graves, thyroidectomy, fatigue Reply To: 29 yo F – Graves, thyroidectomy, fatigue

Christine Bailey

Dear Helen,

Many thanks for your question regarding your client with Grave’s disease who after a thyroidectomy is still experiencing a range of symptoms. The test results highlight much could be done to address the imbalance in vitamin D and Omega 3 fats. In addition, I note that TIBC is high. A total iron binding capacity (TIBC) test is a type of blood test that gauges whether there’s too much or too little iron in your bloodstream. High levels can indicate the following:

haemolytic anaemia

iron or lead poisoning

frequent blood transfusions

liver damage

In rare cases, high iron levels may be caused by an overdose of vitamins or iron supplements.

The symptoms of high iron levels include:

feeling tired and weak

painful joints

a change in skin color to bronze or gray

abdominal pain

sudden weight loss

a low sex drive

hair loss

an irregular heart rhythm


Many of these are similar to Grave’s. You may wish to ask her to speak with her GP who may need to do additional tests.

While I appreciate that she is on medication for T4, there is no measurement so it would be good to check this level is appropriate for her. Some of her symptoms may be due to imbalances in the thyroid. As Grave’s is an autoimmune condition I would also look at triggers which could be viral, bacterial, stress, food related. Tackling these may help to reduce symptoms and possibly the antibody levels. I presume she is not on gluten at all? You may wish to consider a Cyrex food immune reactivity test to check for any other food triggers.

As with all auto-immunity, this is an inflammatory condition so do consider adding anti-inflammatory nutrients including fish oil and GLA which would also help the skin.

About 30 percent of people with Grave’s disease show some signs and symptoms of a condition known as Grave’s ophthalmopathy. In Grave’s ophthalmopathy, inflammation and other immune system events affect muscles and other tissues around your eyes. The resulting signs and symptoms may include:

Bulging eyes (exophthalmos)

Gritty sensation in the eyes

Pressure or pain in the eyes

Puffy or retracted eyelids

Reddened or inflamed eyes

Light sensitivity

Double vision

Vision loss


If health of her eyes is a concern which appears to be the case I would consider a supplement with lutein and other carotenoids to support overall eye health.  One of the most prominent features of hyperthyroid states is a weakness of skeletal muscles that can be debilitating to the sufferer and leads to fatigue overall.  Carnitine is an essential nutrient for transporting fuel (mostly fatty acids) into the cellular “furnaces” known as mitochondria. As muscle cells burn fatty acids in a wasteful response to increased thyroid activity, carnitine turnover is dramatically increased using up cellular stores of carnitine while potentially contributing to the increased urinary losses at the same time. Increased thyroid activity increases the need for carnitine in cells and increases carnitine loss in urine, some evidence suggests that thyroid hormones could actually suppress natural production of carnitine, further reducing the availability of this vital nutrient just when it’s needed the most. If muscle cells lose the carnitine supply that helps them import fatty acids – their best source of fuel – then muscle function could be weakened.

In clinical studies, L-carnitine supplementation helped prevent or reverse muscle weakness and other symptoms in individuals suffering from hyperthyroidism.

In a case report, L-carnitine showed promise in helping prevent the possible lethal outcome of thyroid storm.

L-carnitine may help protect muscle health and strength in a variety of conditions, including hyperthyroidism.  Clinical trials investigating L-carnitine in thyroid conditions have utilized doses ranging from 2,000 to 4,000 mg daily. While these studies have focused on L-carnitine, advanced carnitine formulations such as acetyl-L-carnitine, acetyl-L-carnitine arginate, and propionyl-L-carnitine may also offer promise for individuals who suffer from thyroid conditions.

Benvenga S, Amato A, Calvani M, Trimarchi F. Effects of carnitine on thyroid hormone action. Ann NY Acad Sci. 2004 Nov;1033:158-67.

Suzuki M, Tokuyama K, Yamane A. Carnitine metabolism in thyroid hormone treated rats and mice. J Nutr Sci Vitaminol (Tokyo). 1983 Aug;29(4):413-28.

Caturegli P, Kimura H, Rocchi R, Rose NR. Autoimmune thyroid diseases. Curr Opin Rheumatol. 2007 Jan;19(1):44-8.


You may also wish to consider NT factor phospholipids to support overall energy as well.



The following supplements are suggested for you to consider in light of your relevant expertise and intimate understanding of the needs of your client or patient. They may be used in isolation or as part of a multi supplement strategy, but at all times the consideration of their use should be tied into the specific needs of the individual you are responsible for.

Energy support

NT Factor Chewables (ARG) – chew 1 twice daily

Acetyl-L-Carnitine (ARG) – take 2 twice daily on an empty stomach –

Anti-inflammatory support

EFA-Sirt Supreme (BRC) – take 2 three times daily –

KappArest (BRC) – take 2 three times daily –

Vitamin D3 Complete (ARG) – take 1 daily –

Pro Greens (ARG) – take 1 scoop daily –

Multi with eye supporting nutrients

OcuDyne II (ARG) – take 2 twice daily –


I hope this helps with your client