Exhausted all the time? Why is that?

“I just can’t shake the feeling of fatigue.”  This statement is one that I hear on a weekly basis.  Or, “I’m exhausted, bloated and can’t lose weight – even though I’m hardly eating anything!”

There could be so many reasons for low energy or fatigue, and it’s rarely as simple as finding one magic bullet to make everything better.  However, hormones are often a good place to start.  If you can get them working for you better, it can result in far reaching improvements in how you feel.  And one of the major hormone dysfunctions behind ongoing low energy and fatigue is an under-functioning thyroid.  Now, if you have already been told by your doctor that your thyroid is fine, please do continue to read this article, as in my experience the standard GP testing for thyroid hormone health doesn’t show the whole picture.

Your thyroid glands, which are located at the base of your neck, are responsible for producing hormones that control your metabolism. And what exactly does metabolism mean? Well, it’s the term used to describe “all chemical reactions involved in maintaining the living state of the cells and the organism” (that’s you!) It’s a big deal!

Women are more likely to suffer from thyroid disorders than men, and having an underactive thyroid is the most common. Symptoms may include weight gain and difficulties losing weight, fatigue, brain fog, digestive disorders, female hormone issues, feeling cold, depression, heavy periods, dry skin and reduced libido.

An underactive thyroid is referred to as hypothyroid. And if this is the case for you, the question to ask should always be why?

One reason behind an under-functioning thyroid may be stress. Over the long-term, a stressful life – or stressful event in your past – could negatively effect your thyroid hormone mechanisms. One reason for this is because the stress hormone cortisol blocks the action of thyroid hormones to a certain extent.

You might have a genetic pre-disposition to hypothyroidism – look back at your family history. And it’s also very common to develop an underactive thyroid (or to become hyper-thyroid, which is the opposite state) after pregnancy. This is usually autoimmune in nature and linked to the fact that immune system mechanisms shift when you are pregnant. With luck, post-pregnancy thyroid issues resolve by themselves, but that’s not always the case.

In an autoimmune thyroid condition your immune system becomes confused, producing antibodies (immune cells) that target your thyroid gland – causing damage – in a case of mistaken identity. An autoimmune hypothyroid condition is called Hashimotos thyroiditis.

Your doctor should be able to test for – and pick up – an acute thyroid problem. However, sub-clinical (meaning subtle) thyroid conditions often go undiagnosed, as do autoimmune thyroid states – the symptoms of which can be irregular for years. Surely it’s important to pick up an autoimmune condition sooner rather than later?

Wouldn’t it be better to find out if there is a subtle under-functioning of the thyroid, given the huge impact it has on overall cell and whole body health?

The reason many thyroid conditions are missed is because doctors only look for one hormone when they test you.  It’s called thyroid stimulating hormone (TSH) and its job is to trigger your thyroid gland to send out its hormone messengers (referred to as T4 and T3) that then kick-start metabolic processes where they’re needed (which is pretty much everywhere).

The problem with only looking at TSH is that you don’t see the whole picture and it is quite unreliable as an overall identifier of thyroid health.  I have had many clients who have been told their TSH is in range; that they do not have an underactive thyroid; yet they are showing many classic signs and symptoms of thyroid dysfunction. And crucially, when we go on to test thoroughly, we’ve discovered that the TSH reading wasn’t dependable at all.

There are a number of hormones involved in thyroid health, and ideally a comprehensive thyroid assessment should be performed to clearly rule out thyroid as an underlying cause for your symptoms. This should include thyroid stimulating hormone (TSH), thyroxine (T4), Triiodothyronine (T3) and reverse T3. In addition, thyroid auto-antibodies should really be measured, especially if you have been diagnosed as having an under-active thyroid but your thyroxine medication is creeping up and/or you are still feeling sluggish and unwell.

I am amazed by the number of thyroid clients who come to my practice who have not been tested for elevated antibodies. It’s such a common underlying cause, and I am always keen to rule it out if I suspect it’s an issue. If you have an underactive thyroid and medication is not making you feel better, it’s time to explore further, because you don’t have to live like that.

The raw materials that are needed for optimal thyroid function include iodine and selenium. However, supplementing with these minerals can make a bad situation worse if the real root cause for your thyroid disorder has not been clearly established. I would always asses iodine status before supplementing, and if there are question marks over autoimmunity I’d be cautious.

If there is an underlying autoimmune condition then looking at digestive health is crucial.  This is because issues with gut health and gut barrier function are linked to autoimmunity. But the health of your gut also impacts on how well your thyroxine medication works for you too.  Assessment of your gut microbiome (the trillions  of bacteria living in your gut) and screening for underlying infection (bacterial, yeast, parasite or virus) may hold vital keys to why your immune system is working against your thyroid.

If low energy – or any of the other symptoms discussed here – affect you then consider the thyroid as a potential reason behind your symptoms.  And from there, digging even deeper to uncover the root cause for the thyroid dysfunction may mean you are able to support your thyroid health more effectively – or make your thyroid medication work better for you.

If you’re interested in learning more, you can read this short case study on how I supported one client with thyroid issues.  And I’d be delighted to work with you if you’d like support in getting your health and wellbeing back on track.

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