Issue #251  November 3, 2014

Welcome to KnowYourThyroid.

So, are you tired? Experts say as many as 60% of adults have some form of thyroid disease.

Amy Rushlow explains why so many are being left untreated.




Sick of Being Tired? Maybe It’s Your Thyroid  


by Amy Rushlow


Sick of Being Tired? Sneaky Signs Your Thyroid Is Slacking Off

Dragging throughout the day after logging enough shut eye is one of the most common symptoms of an under-active thyroid.  (Frederick Bass/fstop/Corbis)

For all the attention paid to the popularity of sleep medications, it’s surprising to find out that the No. 1 prescription drug in America is one that’s meant to help people out of bed.

With 23 million brand-name prescriptions filled between April 2013 and March 2014, according to IMS Health, the top pill popped in America is the synthetic thyroid hormone levothyroxine. The drug is used to treat hypothyroidism, which occurs when the body doesn’t produce as much thyroid hormone as it needs. Nearly 5 percent of U.S. adults have the condition, according to the most recent estimates available. And its most common form, Hashimoto thyroiditis, is now considered the most common immune disease in America. The number of prescriptions for levothyroxine has increased by more than 40 percent over the past five years.

Doctors say the number of prescriptions might vastly underestimate the disease’s true prevalence. According to the American Thyroid Association, up to 60 percent of people with some form of thyroid disease don’t know that they have it.

“It is now clear that the tests that we thought could easily determine if a person suffers from hypothyroidism are missing the majority of people who could benefit from treatment,” said Kent Holtorf, MD, medical director of the Holtorf Medical Group and president of the National Academy of Hypothyroidism.

In its first update on screening for thyroid dysfunction since 2004, the U.S. Preventive Services Task Force released a new draft recommendation Monday. The expert panel concluded that “the current evidence is insufficient” to recommend for or against screening adults without symptoms.

However, “That’s not necessarily great advice for each individual person to follow,” said endocrinologist Richard Shames, MD, author of Thyroid Mind Power. “Low thyroid is one of the most common illnesses in the country, and the symptoms are many and varied.”

Common symptoms complicate diagnosis

The symptoms of hypothyroidism read roughly like a description of the modern human condition: fatigue, weight gain, digestive issues, irritability, and depression, to name a few. High thyroid hormone (hyperthyroidism) is less common and can trigger weight loss and sleep difficulties.

“Some people have only one symptom, some people have several, and no person has the same presentation,” Shames told Yahoo Health. “This is all due to the fact that thyroid is the metabolic gas pedal. But it’s a gas pedal that runs everything, not just the speed of the motor. It runs the volume of the radio, the crispness of the air conditioner, how fast the windows go up and down. That’s what a thyroid does—it’s your metabolic control. And no one thinks about it as long as it’s doing fine. It can affect anything, and that’s why it seems to affect everything.”

Could you have a thyroid problem?
Internist and hormone expert Erika Schwartz, MD, has worked with more than 15,000 patients in prevention and hormone balance during her career. The following are the telltale signs of hypothyroidism, as Schwartz’s clients have described them to her.

You feel pervasive fatigue that goes far beyond always feeling like you could use a little more coffee. “Feeling so tired getting out of bed to go to the bathroom is an insurmountable chore. Taking a shower is beyond comprehension. Every cell in my body is exhausted.”

Hair loss
Hair falls out at an unusual rate and its texture may change. “My hair consistency just changed. My hair may look still full but I know it’s thinner and it comes out in gobs on the pillow.”

Weight gain
The key here is that the weight gain can’t be explained by another cause, like a poor diet. An inability to lose weight despite diligent exercise and nutrition can also be a symptom.

Digestive issues
Constipation and indigestion are the two main digestive problems. “I have never been able to go to the bathroom more frequently than once a week. I thought it was normal for me. It’s just that I always felt bloated.”

Cold intolerance
Feeling chilly even while indoors and extreme sensitivity to cold weather. “One sign that in my 20 years of practice that has never not been due to hypothyroidism (and resolved with treatment) is having to wear socks to bed,” Holtorf said. 

The tests you should (and shouldn’t) have
The standard test for thyroid disorders is a blood test only for thyroid stimulating hormone (TSH) only. But leading experts caution that there are several problems with the test. “The newest research is showing that hypothyroidism is a much more common problem than previously thought because the standard test used for diagnosis, typically based on the TSH level, is extremely insensitive and missing 50 to 80 percent of those who suffer from hypothyroidism and would benefit from treatment,” Holtorf said.

Anyone who has symptoms of a thyroid disorder should have a full thyroid panel that includes TSH, free T4, free T3, reverse T3, and SHBG, Holtorf recommended. Keep in mind that “normal” ranges aren’t accurate for everyone and that your symptoms should also inform a doctor’s diagnosis, Schwartz added.

You can also do a DIY screening at home with a regular oral thermometer. For one week, take your temperature when you wake up, before you even get out of bed. “If your temperature never reaches 98.6 and you also have symptoms of hypothyroidism, chances are you have the condition and would benefit from treatment,” Schwartz said. “That is a very inexpensive and highly reliable method of helping you find out if you are hypothyroid.”, including all associated social media, is for informational purposes only and should not be considered a substitute for consulting your medical professional regarding medical advice pertaining to your health. is not responsiblle for any loss, injury, or damage that
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