Articles by Dr. Erdman are for informational purposes, and are not to be taken as specific medical advice.
Continuing our series of articles relating to the thyroid,
we will identify symptoms associated with low thyroid and factors associated
with higher risk of hypothyroidism.
Identifying hypothyroidism is not a cut and dried technique.
Many of the symptoms are vague and overlap with other disorders. Doctors often
miss a thyroid problem by relying on traditional testing. Many times people
with hypothyroid can diagnose themselves by listening to your own body. Who
knows you better than you? People often times have an idea something is wrong,
but they can’t put their finger on what it is. They end up at the doctor, who
runs the traditional tests, which all come back normal.
People with a sluggish thyroid often experience lethargy.
This isn’t just tiredness or lack of energy. Thyroid related fatigue begins to
appear when you cannot sustain energy long enough when compared to previous
levels. Some obvious signs of fatigue are feeling like you can’t exercise like
you typically can; the feeling that you have a heavy or tired head, especially
in the afternoon as your head is a very sensitive indicator of thyroid hormone
status; and falling asleep as soon as you sit down to relax.
Another factor is easy weight gain or difficult weight loss
despite an aggressive exercise program and careful eating.
If you have rough, scaly dry skin that does not respond to
moisturizing lotions and creams, consider low thyroid hormones.
Women who have unexplained hair loss can have low levels of
thyroid hormones. Once treated, the hair will grow back as normal.
Feeling cold all the time is a sign of low thyroid function.
These people are slow to warm up even in hot conditions and are slow to sweat
with exercise.
Another sign of low thyroid function is a low basal body
temperature of less than 97.6* on a regular basis.
Here is a list of many other related symptoms: muscle and
joint pain, depression, carpal tunnel syndrome, hearing loss, hoarseness,
puffiness, sleep apnea, reduced heart rate, weakness in extremities,
constipation and forgetfulness.
These sound like a whole lot of other conditions, which is
why diagnosis is often delayed or not found at all.
There are other conditions that give you a greater risk of hypothyroidism.
These include having a goiter, diabetes, multiple sclerosis, autoimmune
diseases, elevated cholesterol, Crohns disease, prematurely gray hair, and left
handedness.
Too much T4 is hyperthyroidism. The symptoms include
feelings of restlessness or nervousness or overly emotional; sleeping poorly,
difficulty concentrating, frequent bowel movements, weight loss, irregular
menstrual periods, rapid, forceful or irregular heart beat and protruding eyes.
These symptoms start mildly and worsen as the levels of T4 accumulate higher.
Lab testing is not the most useful tool in diagnosing
thyroid problems. Most lab reference ranges are wrong, especially the TSH test.
Furthermore, most cases are subclinical, meaning they do not show up at all on
standard lab testing. The patient’s signs and symptoms cannot be overlooked
especially when clinical lab testing shows ‘normal.’ It is important to fully
assess all signs and symptoms for every patient.
In the next article we will look at the normal lab testing
done for thyroid function and then in the final article, how to best start to treat
this disease.