Do Thyroid Symptoms Equal Thyroid disease?


Do you have lots of symptoms suggestive of hypothyroidism?

Three different patients with hypothyroid symptoms.

1. Symptoms not confirmed with a blood test

PK is a 46 year old busy self- employed lady who presents with lots of symptoms which she believes are due to an underactive thyroid.  

Fatigue, poor sleep, an active “on the go” mind, hot flushes, premenstrual syndrome, constipation, bloating, and occasional diarrhoea, craving sugar, weight gain and fluid retention. Enough symptoms to tick many boxes in an online hypothyroid quiz. Thyroid hormone results were in the normal, but not ideal range.

An earlier trial of thyroid medication had not helped her feel better.

What was going on?

2. Symptoms confirmed with blood tests and a great response to thyroid treatment.

For many people it is a straight forward diagnosis followed by a great response to treatment. For example, I saw an elderly lady with burn marks on her shins from being so close to her portable heater. Blood tests confirmed an extreme case of hypothyroidism. Mood, weight, temperature regulation and energy were hugely better after a few weeks of treatment with thyroxine.

3. Hypothyroidism confirmed with blood tests but still unwell despite thyroid hormone treatment.

The third group of patients have had the diagnosis proven with thyroid blood tests that are well and truly abnormal, but have experienced limited symptomatic improvement with thyroid medication. In other words, they still have fatigue, brain fog, weight gain and lowered mood.

Why do patients need individualised tests and treatment?

Symptoms of an underactive thyroid can also apply to other health issues.

• Depression, Weight gain, Difficulty losing weight, Fatigue

• Feeling cold, Dry skin, Hair loss (alopecia),

• Poor concentration, Brain fog, Memory problems,

• Insomnia, Sleeping difficulty, Waking up exhausted

• Fluid retention, Constipation, Slow heart rate

• Elevated cholesterol, Thinned eyebrows laterally

• Muscle cramps at night, Decreased sweating

• Multiple miscarriages and infertility, Fibrocystic breasts

Three conditions that can cause, mimic or worsen hypothyroid symptoms.

1. An Unhealthy Gut

Digestive problems often result in lots of symptoms, including fatigue, bloating, wind, gas, poor sleep, heartburn, bad breath, weight gain or loss, poor concentration, mood fluctuations, feeling cold, memory problems, brain fog, fluid retention, constipation….and the list goes on.

Eighty per cent of your immune system and neurotransmitter (brain chemistry) production occurs in your gut. So it is not surprising that poor gut health can result in lots of unwell symptoms, as well as compromise thyroid hormone function.

2. Low Iron

A recent study showed that two-thirds of women with symptoms of hypothyroidism, despite taking thyroid hormone treatment, felt better when their ferritin levels (an iron storage protein) were increased to above 100. Many of my patients have presented with Ferritin levels in the low 20s.  This may be “normal” given the wide reference ranges, but it is certainly not ideal. The advice from a haematology specialist at a recent seminar is that a Ferritin below 40 is generally consistent with iron deficiency.

Iron deficiency symptoms may appear on a hypothyroid list and include extreme fatigue, weakness, pale skin, palpitations or shortness of breath, headaches, dizziness or lightheadedness, cold hands and feet.

3. Stress

Most new patients have at least one stress in their life. Work-life balance, difficult colleagues or bosses, demands of raising a family, traumatic events in the past, responsibilities to elderly parents, relatives or friends are some of the emotional challenges described.

Stress results in many biochemical and hormone changes. For example, high Cortisol blocks the conversion of thyroxine (T4) to the active T3 thyroid hormone. High cortisol also damages the gut lining, resulting in “leaky gut”.

Symptoms of anxiety and stress include panic attacks, hot and cold flushes, racing heart, tightening of the chest, quick breathing, worry, catastrophizing, or obsessive thinking. Anxiety may cause a vicious cycle of difficulties with study, work or social life

What This Means For You

In my experience it is rarely just the thyroid that is causing all your symptoms.

These are just some of the conditions and symptoms that people might blame on an underactive thyroid gland. Is your diagnosis correct?  Has something been missed?

Dr Pete

PS This blog is not designed to provide a diagnosis or definitive individual treatment. I recommend that you see a holistic doctor, such as myself, for a comprehensive assessment and treatment plan.

PPS You are welcome to forward this email newsletter to interested family and friends.

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