This is definitely topping the list of debilitating symptoms for Graves’ disease and Hashimoto’s Thyroiditis.
And very understandably so.
Fatigue can turn life into a daily struggle.
Simple chores become insurmountable obstacles. And all the fun things in life such as playing with your kids, going out for dinner and drinks with friends, going on trips or even exercising become luxuries.
What may be worse is that fatigue is an invisible symptom.
People that haven’t experienced fatigue themselves typically don’t understand it. And may confuse it for laziness. Or for simply needing a good night of sleep. (For tips on sleep read this).
But sleep alone won’t be enough to overcome this.
So what to do about fatigue?
If you have an autoimmune thyroid condition and experience fatigue, one of the first things to consider is paying a visit to your doctor.
Have him or her check your thyroid levels. Because for some, getting their thyroid levels back within range (if they were out of range) can help them regain their energy.
For many others, however, this doesn’t do the trick.
So what to look at if you’re always feeling tired despite having normal thyroid levels and getting enough sleep?
Even though you may not be familiar with your mitochondria, they play an important role in your overall health.
And a huge role in your energy levels or lack thereof. Considering that your mitochondria are responsible for the about 90% of your energy production.
What are mitochondria?
As you know, you’re made of cells. Trillions of cells that make up your building blocks. Each cell has a different job or task to perform. And they do this with the energy they receive.
Your cells receive their energy from your mitochondria.
Mitochondria are like little power plants inside (most) of your cells. Some cells that have more work to do and thus require more energy, contain more mitochondria. Examples are heart cells, liver cells, and lung cells.
The mitochondria’s main job is to transform chemical energy, from the foods you eat and from the oxygen you breathe in, into ATP (adenosine triphosphate).
ATP is a form of energy that your cells can actually use to perform their jobs. To grow, maintain, repair, eliminate waste etc.
ATP is crucial for your cells, your organs, and for you.
How well your mitochondria work matters. And this is directly linked to what you eat.
What you eat provides fuel for your mitochondria. And they work best on high-quality fuel. In the form of vitamins, minerals, and antioxidants.
In addition, they also need to be protected from toxins such as lead, mercury, and arsenic. As these are very damaging to your mitochondria. 
If your mitochondria don’t get all those nutrients or if they’re exposed to too many toxins, your ATP production suffers. And as a result, you’ll produce less energy and more waste in the form of free radicals.
Your mitochondria can become starved and can even begin to collapse.
How do you know whether your mitochondria are starving?
Several factors make it very likely that your mitochondria are dysfunctional. These include:
- Experiencing fatigue;
- one of the most common signs that your mitochondria are desperately in need of vitamins, minerals, and antioxidants.
- Eating a diet high in refined sugar and refined white flours. Sugar is a so-called anti-nutrient, meaning that it takes more nutrients to process refined sugar than it actually contributes. It robs your body for instance of magnesium. A key mineral which is needed in over 300 biochemical reactions in your body, including the production of ATP. Yet, it’s estimated that about 70-80% of the world population is deficient in this mineral.  The problem with refined white flours is that these foods are generally low in nutrients whereas they are high in calories. They make you feel full and leave little space for highly nutritious foods. You’d be eating a lot of empty calories.
- Regularly taking prescription or over-the-counter medications. Many deplete your B vitamins, minerals such as magnesium and coenzyme Q10 supplies. These medications include common medications such as beta blockers, acetaminophen (Tylenol), diuretics, birth control pills, medications to lower stomach acid, NSAIDs (nonsteroidal anti-inflammatory drugs like ibuprofen), and aspirin.
- Using statin drugs. These can help lower cholesterol and inhibit the body’s production of coenzyme Q10, an important nutrient for your mitochondria.
- Having a chronic disease. Including autoimmune disease (such as Graves’ disease), heart failure, fibromyalgia, mood disorders, epilepsy, and memory problems. A chronic disease may actually be the long-term effect of malnourished mitochondria. 
If any of these apply to you, your mitochondria aren’t functioning as well as they could be.
The good news?
You can improve your mitochondrial health.
Serious about overcoming fatigue? Start to feed your mitochondria a proper diet.
- Eat the rainbow. Focus on eating all the different colors from vegetables and fruits. As far as possible every day. Because their colors contain antioxidants which are great for mitochondrial health. Eat yellow/orange for beta-carotene, red for lycopene, green for chlorophyll, and blue/purple for anthocyanin. Preferably eat them throughout the day with each meal.
- Focus on eating organic produce. The main reason is to reduce exposure to pesticides and insecticides and thereby protecting your mitochondria. Organic foods were also found to be more nutritious than their conventional counterparts as well as have higher antioxidant levels. For some foods it’s more important than others to eat organic. See The Environmental Working Group’s Clean Fifteen and Dirty Dozen overviews for guidance.
- Make an effort to find pasture raised eggs and meats. This is important not only for social reasons, but also for health reasons. Animals, just like humans, store most of their toxins in their fat to protect their bodies’ vital organs. The lower the quality of the meat, the likelier that the animal is more toxic. If that’s the case, you’re best off consuming only the leaner parts. The higher the quality of the meat, the more beneficial it becomes to also eat the fattier parts of the animal. A great resource for grass-fed, pasture raised, wild-caught and free-range meats and fish is US Wellness Meats. Consider eating pasture raised liver, heart, and kidneys as these are very nutrient dense foods filled with all of the B-vitamins, vitamin A, iron, zinc, selenium, essential fatty acids and more. Vital nutrients for your mitochondria as well as your immune system.
- Eat real foods. Avoid artificial ingredients like artificial food colorings, artificial flavors, food additives, artificial preservatives, etc. They are known to disrupt the health of the mitochondria. [source]
- Reduce your intake of refined sugar and refined white-flour foods. Sugar is a problematic food for everyone. As for the refined white-flour foods, use them as fillers. For example, I learnt from a friend with an Asian background that in Asian cultures rice is used as a filler. She’d start with eating the vegetables, proteins, etc. Then, if she still feels hungry, she’ll have some rice.
- Choose the smaller fish which are generally lower in mercury levels. Eating fish can be very healthy for your mitochondria as they contain (high levels of) omega 3 fatty acids. Yet, mercury is very damaging to your mitochondria. This guide gives an overview of both omega 3 fatty acid and mercury levels per fish. Wild salmon, sardines, mussels, rainbow trout, and Atlantic mackerel seem to be best.
- Consider supplementing certain nutrients. Getting your nutrients from food first is recommend. Yet, supplementation may speed up the healing process. If you have Graves’ disease you may be low in many of the nutrients that are essential for your mitochondria. And you may consider supplementing CoQ10, the B-vitamins, including B12, vitamin D, vitamin K, magnesium, omega 3 fatty acids, and L-carnitine. As always, do this in consultation with your doctor! Especially if you’re currently using medications. As supplements may interact with those.
- Drink plenty of fresh filtered water. Last but certainly not least. Water provides hydrogen to your mitochondria, which is important for their energy creation. And water binds to free radicals and gets rid of them. Start your day with 12oz of water with or without lemon to help you and your cells rehydrate. And drink of plenty of water throughout your day.
Your mitochondria play an important role in your health. And they’re at the core of fatigue.
Improving or upgrading your diet is a great start to support your mitochondria. And overcome your fatigue.
What one thing can you start doing today?
If you can implement just one thing, that would already be a great start. Then slowly build up from there.
Aim for progress, not perfection!Marie Forleo
 Wahls, T. “The Wahls Protocol”, (New York, New York; Penguin Group), p. 30
 Know, L. “Mitochondria and the future of medicine,” (White River Junction, Vermont; Chelsea Green Publishing, 2018), pp. 157-158
 Wahls, T. “The Wahls Protocol”, (New York, New York; Penguin Group), p. 34