Patients who are diagnosed with hypothyroidism and are being treated for it with hormone replacenment therapy, can sometimes have other imbalances that hinder the effectiveness of their treatment. Things such as adrenal hormones being low, ferritin/iron, Vitamin B-12 etc..., can cause thyroid hormone treatment, to be less effective in patients with imbalances of these and is why thorough blood and saliva testing of all levels may need to be done, to find any problems that prevent the treatment from working as well.

That is a phenomenon, that happens commonly to thyroid patients who start hormone therapy but some people in the medical field will often attribute all unrelieved symptoms to your body adjusting to the thyroid hormone replacement medication or as being emotional or physco-somatic symptoms.

Mild to moderate symptoms from adjusting to a thyroid dose, should be expected but severe reactions, especially ones that last for weeks and longer, in my opinion, can mean you have other hormone imbalances or chemical imbalances (like low ferritin, cortisol etc...) needing addressed and if they are not, the thyroid hormone therapy may serve to intensify the imbalance. For example; even the thyroid med makers have notations on their medication-inserts, websites etc..., that states "untreated adrenal cortical (cortisol) insufficiency, can worsen after beginning thyroid hormone therapy". I don't believe when patients have a bad reaction to their thyroid medication, that they are necessarily experiencing true adrenal insufficiency but it can mean they have a degree of hypoadrenalism/adrenal fatigue (sub-clinical) or some other hormone imbalance (including sex hormones) or chemical imbalance that needs corrected. For some patients, it can be something like B-12 deficiency which can cause pernicious anemia.

My doctor for example only concluded a diagnosis of co-morbid CFS (Chronic Fatigue Syndrome) with my thyroid disease, through a combination of tests, symptoms/manifestations and a process of elimination. I not only had consistently low cortical (adrenal cortisol) but also an unreliable TSH, in correlation with my thyroid hormone levels, constantly swollen lymph nodes, an EBV (virus) count that was 10 times the upper normal cut off, etc...
I feel for most thyroid patients, they are experiencing a more easily correctible problem, like adrenal fatigue or low ferritin, low B-12 etc...

Sometimes thyroid patients also need blood chemicals, B-12 levels, adrenal hormones, sex hormones etc..., tested, to zero in on what a problem might be, if thyroid treatment is not significantly relieving symptoms. Mild to moderate symptoms commonly happen to thyroid patients but ones as severe as those of CFS/Fibromyalgia, definitely need further investigation, otherwise it can seriously affect the patient's quality of life.

When you go through a doctor's Office or Hospital Lab, to get tested for "adrenal fatigue", they seldom check for anything other than true "adrenal insufficiency" because most simply do not believe in the existence of adrenal fatigue, which is a sub-clinical form and much more common. If they want to rule out adrenal insufficiency, they usually do so with an "ACTH Stimulation Test" and if this test reveals that your adrenal glands still respond to stimulation by the ACTH hormone, they believe this rules out any low adrenal problem. The fact is however, that very few people with adrenal fatigue, will fail the ACTH Stimulation Test but they still have adrenals that are not functioning normal and may need to take adrenal support supplements to help correct it.

Tests that can reveal adrenal fatigue, are both blood cortisol and saliva cortisol tests, that are taken at several times during a 24 hour period. Saliva testing however is the far more convenient of the two for multiple level-testing during the day and night. Another adrenal hormone; "DHEA", can also be tested with the same samples because it and cortisol, are the two major adrenal hormones.

If you hear saliva tests are not as accurate as blood testing, this has been proven repeatedly by medical research groups not be the case. Saliva tests, are as accurate as blood, for testing the "free levels" of many hormones and have been used in US Government (NIH), hormone studies and are also recognized by major Insurance companies including Blue Shield, as accurate an accurate method of testing. There are reputable companies that offer saliva tests online but many Pharmacies also carry them, a popular brand being made by the ZRT Labs company.

When thyroid hormone replacement therapy does not seem to be relieving symptoms as it should, these other possibilities should be considered and tested for.