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Saturday, 27 June 2020

Brain Fog

Levothyroxine 100 microgram tablets

Another blogger recently described being in a very familiar place but feeling he had never been there before. He was unsure of the way home. It must have been an alarming sensation.

I’ve had similar experiences: inability to think or concentrate; forgetting things; feeling lost; mental fatigue. Secretly, you think you might have dementia.

A particular incident stands out. I forgot where I had left my car. It was usually in one of three places. If early to work, I would go for one of two car parks nearby. If later, I would use another a ten-minute walk away. I always remembered which.

One evening I walked back to the wrong car park. I set off for the distant one but just before getting there remembered the car was in one of the others. Annoyed with myself, I turned back. But which of the others was it in? Was it in either? I could not remember. No, it was in the more distant one after all. I turned round again. Or was it? I must have walked there and back twice.

Confused, I returned to work and sat quietly for a time, perhaps half an hour. I phoned home to let them know I was late, without saying why. Eventually, I decided the car must be in the distant car park after all. After quickly glancing round the two nearer ones, I set off again and found it, by that time one of just a few still there. What a relief. 

It was not the only incident. There was the time I missed a regular turning off the motorway and drove for some distance without realising. There were two or three mornings I dropped the children at school and was flashed by other motorists for vacantly crawling along at fifteen miles an hour. I tried to make a cardboard model for my son but could not make sense of the instructions. Out on a work visit, I got lost for much too long in South Manchester and later sat in someone’s office unable to take in much of what they were saying (I made appropriate noises and hopefully got away with it). There were times when my walking felt awkward and disjointed. I fell asleep all the time: like, at half past nine in the morning.

I kept it to myself. You do. Although Mrs. D. did observe bluntly: “There must be something wrong with you when you need to go to sleep at half past nine in the morning.”

In due course I mentioned it to the doctor. I was there about something else but mentioned about feeling extremely tired recently. I didn’t tell him everything: I was too afraid of failing the “What year is it? Who is the Prime Minister? Can you read this address? By the way, what was that address I asked you to read five minutes ago?” examination. He thought it best to do a blood test.

And the result: underactive thyroid. He was surprised. I don’t look like an underactive thyroid. I tend to be underweight. It is four times more common in women than in men. Yet, I had high levels of thyroid stimulating hormone (which means the pituitary is trying to compensate for the underproduction of actual thyroid hormone). It should normally be between 0.4 to 4.0 milliunits per litre. Mine was nearly 10.

I have had to take Levothyroxine every day since. It takes several monthly tests and dosage adjustments to get it right, and then needs to be checked annually, but once it right is you become aware of odd things such as how brittle your nails had become, and that the outer ends of your eyebrows had thinned to nothingness.

That was fifteen years ago. It seems to be sorted now. Either that or I’ve still got it and am too far gone to know.

As the saying goes, every cloud has a silver lining. Hypothyroidism is one of the things that gets you free NHS prescriptions before the age of 60. It’s a bit of a cheek really. It is disturbing to be diagnosed with a “chronic condition” in your fifties until you realise it is hardly any inconvenience at all. Far more serious things don’t get you free prescriptions. Cynic that I am, I suspect that when the list of exemptions was drawn up in the nineteen-fifties, there must have been some government advisor with an underactive thyroid. 


Lots of other things can cause brain fog too, such as stress, lack of sleep, hormonal changes, dietary deficiencies, food allergies, medications and quite a number of medical conditions. For example, see: https://www.healthline.com/health/brain-fog

37 comments:

  1. For several years I took carbamazepine to control trigeminal neuralgia (which I have as an unpleasant side-effect of something else). Brain fog descended, and I lived with it for several years, until it got too much for me. I gradually weaned myself off them and rely on the heavy doses of painkillers. I hardly go anywhere, so can cope with the occasional yelping from pain in my face, which reacts to cold - anything less than 10degrees will set it off, indoors or out. I've had a few very serious attacks since the original one over 20 years ago, but I will put up with a lot rather than go back on carbamazepine again.

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    1. It sounds a very unpleasant thing to have but I would put up with a lot to avoid brain fog too.

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  2. A familiar story. I was diagnosed a couple of years ago and am now on Levothyroxine too. I had ignored my symptoms for years thinking that it was just due to the menopause (not applicable in your case Tasker).

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    1. Male menopause? Or is that just like man-flu?

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  3. Once when Tom went into Hospital he was asked the questions to determine if he had dementia. I sat beside him while he did it and he passed with flying colours. Good job it was not me as I would not have recalled the bit they ask you to remember. I would have been labelled, lol
    The laugh is, he generally can't remember things and I can so the test isn't very accurate is it?
    Briony
    x

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    1. No, especially if you are expecting it. Sometimes they say something to you verbally and ask you to repeat it, which means you've already remembered it once. A relative of Mrs D. was asked to spell 'tablecloth' backwards.

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  4. Well, this is a timely post for me. Just received word by email from my doctor that my thyroid is not functioning properly after my pituitary surgery and so will start my thyroid medication today! I have been so extremely thirsty since my surgery 3 week ago and so I am glad to be adding medications that will help get this under control. Glad to hear it has helped you - I am looking forward to feeling better! Thanks for sharing your story!

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    1. I hesitated before sharing this post, but if it helps then it's worthhwile. Hypothyroidism alone is not a big deal at all.

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  5. I set myself little tests every day. Where did I park the car. How many things (generic things) have I got left. Stuff like that. I think what caused my previous two episodes was insidious stress caused by living in a world which suddenly changed overnight - almost beyond recognition. I don't think I need Levothyroxine just yet, but I am glad it has worked for you.

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    1. It isn't known what set mine off in the first place. It could have been stress - being manipulated into a position that brought threat of redundancy and that kind of thing, or it can be caused by an auto-immune response. I set myself the test of playing Bouncing Balls far too much - at the moment my world ranking is 27th.

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  6. Thanks for sharing this personal information Tasker. I had never heard of the condition before. It must have been such a relief to have the issue addressed effectively with simple medication.

    P.S. I hope this predictable response did not cause you undue distress or confusion or both.

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    1. Thank you for revealing your caring nature.

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  7. Good heavens, something we have very much in common. I've been on Levothyroxine for about 12 months. It's the lowest dose and I've never been re-tested. However forgetting where the car was or various other 'incidents' I'd come to assume as 'just me'!
    You have put my mind at rest as to why my, once lovely long nails, now break as soon as I look at them and the ends of my eyebrows seem to have disappeared.

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    1. I'd ask for another blood test. They are definitely supposed to retest and review annually, but at the start I believe they are supposed to do it month by month and gradually increase until the levels are right. As you can see from the image, I'm on 100s, but they started me on 25s.

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  8. An interesting and frankly rather scary explanation Tasker, but one which underlines the fact that we do need to speak to our doctor if something is worrying us. My late husband began to forget his words and kept saying it was nothing. He wouldn't go to the doctor, said it was nothing. Eventually I went with him to the doctor having made the appointment without telling him. It turned out to be a Glioblastoma - a totally inoperable
    brain tumour, and six months later he died. Had he gone earlier it would, as it happens, have made absolutely no difference.

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    1. Goodness. It must have been unbearable. I don't see mine as scary but your husband's story is. It's everything we fear, either in ourselves or in our other halves.

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  9. Thank you for sharing this as it will likely help others that may be dealing with similar problems. You were wise to mention it to your doctor. I am happy for you that you discovered what the problem is and are able to be treated for it.

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    1. Thanks. I didn't want to tell him all, but it got me a blood test.

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  10. The important lesson here is -- go to your doctor! Don't just ignore symptoms or hope they "go away." Glad you got your symptoms sorted out with a relatively easy fix.

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    1. I always feel they are busy and never want to bother them. Even though they are still free in the U.K., most of my age grew up respecting them and not wanting to make a fuss. It's difficult to know when it is justified.

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  11. It is good that you have got it sorted. Forgetting where one's car is just reminds us that we are forgetful but that a graver situation may lie at the bottom is not something we look out for.. I lose words but my daughter says I have done this ever since she has known me!

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    1. I use the wrong names for things. Last week I referred to an egg box as a milk carton. I've always done it. I argue it's when we can't be bothered with trivialities.

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  12. Having hypothyroidism, my doctor checks my blood levels every six months and being in the US, I pay for the privilege in doctor and lab fees--even with insurance. When I initially began treatment (years ago), she started me on a generic, but that didn't move my numbers--at all--so I went on the brand name one. Not free. With insurance I pay £61 for a 90 day supply (same dosage as yours now, too) which is three times as much as the cost of the generic. Extremely costly without insurance. But it does help to keep one going.

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    1. I've seen discussions about T3 and T4 and so on, and some of the brand prices are astronomical (not that they cost that much to manufacture). All I can say is thank goodness for the British NHS. People on 100 micrograms like us, or more, would quickly deteriorate without it, and probably not last much more than a year.

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  13. As good as anything I have read in ages. Such lucidity in prose would not be possible if you were losing it. Learn Italian if you feel you need a brain work-out! There's a piece online, The Independent - *Linda Grant: Who would I be if I wasn't writing this?* (June 22 2014). I once saw the Beatles' George Martin in a Glasgow bookshop asking for Linda's *Remind Me Who I Am, Again*. I'm darned if I can remember the rest of that summer's day!

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  14. I saw a clip (YouTube) of Neil Gaiman's master class. He said the first draft is like driving in the fog with dimmed headlights. Malamud said you write the second draft to find out what you're saying. Braine told his students at Purdue Indiana to write the first draft quickly because only then have you got something to reshape, like the sculptor's clay.

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  15. I am glad it is treatable and you can lead a normal life. My brother has been on epilepsy medication for almost 50 years. He became epileptic 2 months after he got married. Fits and seizures. He said the other day that some of the young doctors want to change things for him but at his age he says no, he's been stable for a long time, don't rock the boat.

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    1. That sounds common sense. Epilepsy is very serious. I'm lucky (so far) in that thyroxine is all I have. Would have liked to emulate my dad in that when he went into hospital in his eighties they were incredulous he was on no medication at all.

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  16. I had a parathyroid operation when they removed three of four nodules and since then I have hypothyroidism and also on 100mg of levothyroxine. Because of other health issues affecting me badly I never think about the hypoyhyroidism just take the pill first thing in the morning half-an-hour before breakfast or any other medication. I do know that it causes thinning hair which has happened to mine and I can't get used to it, lol. Brain fog and fatigue are also symptoms of MS and I must say I don't suffer from brain fog, yet. But is the tiredness/fatigue I feel due to the MS or thyroid? Could be either or a combination of the two.

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    1. I don't know but would guess the thyroid is the less likely cause. I never think about it much either (until I wrote this). Thinning hair! That's my explanation from now on.

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  17. My TSH was 120 when discovered, by a doctor not my primary. The primary came prancing into the room, "Well, your thyroid has crapped out!" I was so angry; for a year I'd told her something was very wrong; I'd gained 70 pounds. Try losing seventy pounds you gained in four months time. Oh, the platitudes. "You quit smoking, that's why you're gaining weight!"
    End of rant. A pill every morning and I'm off.

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    1. Absolutely entitled to a rant! That is an all too common story. Some doctors just dismiss patients as lazy when it is they themselves who don't think or can't be bothered to do a simple test. Perhaps they should do the test on themselves. I was lucky to get one who was clued up.

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  18. Wow. Were you a woman, then I might have thought you were experiencing peri-menopause as your issues sounded eerily similar to mine. -good that the doctor suggested having blood drawn.

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    1. Perhaps it's the male menopause, or maybe I'm non-binary.

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  19. Glad you got that sorted. Scary thinking about the worst. Husband has those pills too - amongst his daily collection!

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    1. At least (so far touch wood) they are the only ones I have (except for vitamins).

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