Is it really the thyroid?
The symptoms of hypothyroidism are nonspecific and common. They include memory loss or forgetfulness, depression, mood swings and irritability, muscle weakness, hair loss, anxiety, heart palpitations, sleep disturbances, and irregular periods. Sound like symptoms of perimenopause or menopause? Yes, and the thyroid is frequently involved in the severity of these symptoms, and hypothyroidism may be overlooked when accompanied by menopause. Treating menopause may help but does not completely resolve the symptoms. The symptoms of hypothyroidism are the same as the symptoms of “aging” – fatigue, dry skin, thin nails, forgetfulness, insomnia, weight gain, depression, hair-loss, feeling cold all the time. To further confuse the picture, thyroid lab results frequently do not reflect the whole picture and there is controversy about which lab tests best reflect thyroid function. Physicians are trained to measure TSH (thyroid stimulating hormone) as the best marker, but the TSH can be “normal” when the T3 is very low and the patient may have hypothyroid symptoms with “normal numbers”. The numbers have to be correlated with symptoms and other reasons for low thyroid function.
There are 4 main reasons for low thyroid function:
- low production of hormone which can occur after Hashimoto’s thyroiditis
- poor conversion from T4 (storage hormone) to T3 (active hormone) may be related to nutrient (iodine, iron, manganese, selenium) deficiency
- supplementation with T4 (levothyroxine or synthroid) only, which may fail to convert to the active T3 and can result in normal “numbers” but poor results for the patient
- receptor site insensitivity in spite of adequate thyroid levels
What to do?
Optimal thyroid function is essential for optimal metabolism throughout your body. The production of thyroid hormone declines for a number of reasons including other hormones, toxins, and aging. A typical scenario might be a 40-year-old perimenopausal woman who sees her doctor for heavy bleeding and is put on oral contraceptives to control the bleeding and normalize her periods. In a few months, she begins to experience fatigue, mood swings, irritability and depression so she is placed on anti-depressants. The reverse is also typical and the anti-depressants may come first as the symptoms are attributed to perimenopause when it is really clinical or subclinical hypothyroidism. If you have symptoms of hypothyroidism and have seen doctors and been told your “numbers are normal”, but you still feel hypothyroid, I encourage you to find a physician knowledgeable in bio identical and thyroid hormone supplementation. Your symptoms are real and your thyroid may be a contributing factor.