“Well I know I’m tired, but we do have three young children in diapers and I’m not sleeping well. It’s probably just normal exhaustion.”
My wife’s explanation certainly made sense, but it was so easy to check a thyroid level that we went ahead anyways. And low and behold, it showed that besides her “normal exhaustion” she was also hypothyroid (having an underactive thyroid gland). Once this was treated at least some of her exhaustion eased up. The rest had to wait until our kids (eventually seven of them) were all sleeping through the night.
So how does hypothyroidism usually show up? It has many symptoms, most of which are very non-specific. They include fatigue, dry skin, cold intolerance, constipation, weight gain, hair loss, depression, and menstrual disturbances.
And what causes it? Worldwide iodine deficiency remains the foremost cause of hypothyroidism. But in the U.S. where iodine intake is adequate, autoimmune thyroid disease (also called Hashimoto’s disease), is the most common cause of hypothyroidism. In Hashimoto’s disease one’s own immune system is slowly attacking and knocking out their thyroid gland.
Hashimoto’s disease sometimes also shows up with temporary throat pain, full-out exhaustion or painless thyroid enlargement. If left untreated long enough (rare in the U.S.), hypothyroidism can eventually lead to myxedema coma where a person exhibits marked fluid retention, slowed mental status and even heart failure.
If you’re one of the legions of folks who are fatigued and perhaps struggling with weight gain, the odds are it won’t turn out to be hypothyroidism. But then again, it’s easy to check and if it really is hypothyroidism then you have something you can readily treat and improve. The most commonly recommended blood test is called thyroid stimulating hormone (TSH). If your thyroid is going low, the TSH will go the other way and be abnormally high. If that turns out to be the case, thyroid hormone levels and thyroid antibody levels can also be checked to define the type of hypothyroidism.
About the only type of hypothyroidism to still have a normal TSH is something called euthyroid sick syndrome or nonthyroid illness. In other words, if a person has some other severe illness their thyroid may partially shut down until they begin to recover. There is some controversy as to how to treat these cases but the main approach is to treat the underlying severe illness which then allows the thyroid to recover on its own.
For being such a small gland, perched like a plump butterfly at the base of the front of the neck, the thyroid exerts an amazing amount of control on the rest of the body. So if you’re getting symptoms suggesting that your chubby butterfly is getting sluggish, get a blood test. It’s easy and it may allow you to only have to wrestle with “normal exhaustion.”More