22 Surprising Reasons Why You're Still Tired with Hashimoto's

Autoimmune Hub
May 16
3 min read

… and how to start getting your energy back.

A women exhausted in bed — Fatigue is one of the most common symptoms of Hashimoto's

If you have Hashimoto’s and you're still feeling exhausted, foggy, or burnt out, even though you're on thyroid medication - I want you to know this: You're not lazy, you're not imagining it, and you're definitely not alone.

Fatigue is one of the most stubborn and frustrating symptoms of Hashimoto’s. But here’s the thing: your energy isn’t just about your thyroid. It’s actually a reflection of many interconnected systems in your body - and when one (or more) of them gets out of sync, your energy tanks. This article lays out 22 reasons why you might still be tired with Hashimoto's, even if you're taking medication.

As a nutritionist who works exclusively with women with Hashimoto’s, I see this every day. And most importantly — I help them fix it.

Here are 22 Reasons Why You're Still Tired with Hashimoto's and what you can do about them.

🧠 Nervous System & Adrenal Triggers

Chronic stress or trauma – Your body is stuck in “fight or flight.”
Cortisol dysregulation – Too much (or too little) cortisol leads to crashes.
Poor vagus nerve tone – Impacts digestion, rest, repair, and mood.
Lack of daily calm – Your nervous system doesn’t get time to reset.

🔋 Thyroid & Endocrine Triggers

Low T3 (active thyroid hormone) – Not enough fuel in the tank.
Imbalanced medication timing or absorption – Reducing effectiveness.
Oestrogen dominance or perimenopause - Hormones and thyroid are connected
Low progesterone – Can lead to anxiety, poor sleep, and fatigue.
Blood sugar imbalances – Energy rollercoasters through the day.
Insulin resistance – Blocks energy at the cellular level.

🦠 Immune & Inflammation Triggers

Chronic inflammation – Your immune system is always “on.”
Food sensitivities (e.g. gluten, dairy, soy) – Causing hidden stress.
Histamine intolerance or overload – Headaches, fatigue, brain fog.
Autoimmune flares – Ongoing tissue damage and exhaustion.
Latent viral infections (e.g. EBV) – Quietly draining your system.

🍽️ Gut & Liver Triggers

Poor gut health or leaky gut – Nutrient malabsorption and immune stress.
Low stomach acid – Affects protein and mineral absorption.
Liver sluggishness – Impacts hormone and toxin clearance.
Constipation or poor detox – Recirculating toxins and hormones.
Overgrowths (candida, SIBO, parasites) – Gut bugs stealing your nutrients.

💊 Nutrient & Lifestyle Triggers

Deficiencies in iron, B12, vitamin D, selenium, or magnesium
Lack of sunlight, movement, or joy – Yes, joy is medicine too

So… where do you start?

The good news is that every single one of these can be worked on — step by step, with the right support.

You don’t need to tackle all of these at once — that would be overwhelming (and probably make you more tired!). But what you do need is the right roadmap and the right support.

That’s exactly where I come in. This is what I do, and I’d love to help guide you through the process of rebuilding your energy, your clarity, and your confidence.

You don’t have to guess anymore.