Feeling Awful? Check Your Thyroid by Holly Chism

Posted on by Sarah A. Hoyt

Feeling Awful? Check Your Thyroid by Holly Chism

I’ve been fighting my own body for the past decade and a half, now.  Almost exactly, as of the middle of this coming May.  All from one itty-bitty gland not doing what it was supposed to do. 

My son is sixteen, now.  When I had him, I was warned that I’d be exhausted for a long time.  Well, they were right, but it went on a lot longer than it should have: the exhaustion should have passed within about six to eight months, especially since he started sleeping six to eight hour nights before he was three months old. 

Unfortunately, despite my first pregnancy having fixed several issues (too tight ligaments around one knee, a bad gallbladder, and reducing menstrual issues), it also triggered my immune system to attack, and kill, my thyroid gland.  Nobody caught it.  I went two years with my thyroid non-functional.  And then I fell pregnant with my daughter…and it got noted. 

When you attend your first prenatal visit, your practitioner will schedule a bunch of tests, mostly blood work.  One of the things tested is your thyroid levels.  Mine were…bad.  Really bad.  Bad enough she thought it was a typo, and sent me back—twice—to get the tests redone.

The way things work is that your body signals the pituitary gland that it needs energy.  The pituitary sends out thyroid stimulating hormone (TSH) to tell the thyroid gland to uptake some amino acids, iodine, and cholesterol to turn into thyroid hormone (T4), which your body breaks down (T3, RT3) to use. Your thyroid gland does what it’s told, and everything’s golden. 

Mine didn’t.  It tried, but my immune system had more than half-killed my thyroid gland.  Autoimmune disorder.  It happens, and pregnancy can trigger it. 

So, while my thyroid was straining to comply and failing, my pituitary thought it wasn’t listening, and pumped out more TSH.  And more.  And more.  My TSH, when tested, was nearly 11.  It’s supposed to be no higher than 3.5. 

I shouldn’t have been pregnant.  I shouldn’t have been able to get pregnant.  Not with a non-functioning thyroid gland.  Shouldn’t have been able to stay pregnant, either…and could have lost the pregnancy (which I may have done before that one), or it could have led to really nasty repercussions for the baby.

But I was pregnant, I got treated, and I had a gorgeous baby girl who didn’t have any nasty side effects from my body dropping the ball…but I also had a thyroid gland that continued to fail.  And then to swell, and develop nodules. 

Backing up.  The TSH your body produces is inversely related to the amount of thyroid hormone you have.  If your body is not producing thyroid hormones, your TSH skyrockets.  If your body is producing too much thyroid hormones, your TSH plummets.  Ideally, your TSH should be between .5 and 3.5.  4 is subclinical hypothyroidism.  All that means is that your thyroid isn’t working quite right, but it could kick back off.  Your thyroid will slow down if you get really sick—it drains your energy so you sleep off whatever ails you.  Endocrinologists prefer to take a wait-and-see approach until your TSH eases up to 5. 

Here’s the fun thing: they can’t tell if your thyroid is working or not without drawing blood.  The symptoms are too diverse. 

So, what are you likely to face with a low- or non-functioning thyroid? 

1. Exhaustion.  You’re not going to have any energy to do the things you need to do.  You’ll sleep a lot more, and it won’t help. 

2. Weight gain.  No, it’s not just because you’re too tired to move.  It’s not because you’re eating too much.  Your thyroid runs your metabolism.  You’re shuffling everything to storage.  Not burning it.

3.  Hair, skin, and fingernail nonsense.  You start shedding like a nervous cat.  And it goes gray prematurely.  It’s dry—your hair dries out and conditioner doesn’t work. Your body hair thins—yes, everything from your eyebrows to the fine down of hair on your arms and legs.  Your nails soften and break.  When they’re not peeling.  Sometimes, they do both.  And your skin dries out, flakes, and you get itchy.  You can use all the moisturizer in the world, and you’ll still be dried out and itchy. 

4. Temperature regulation.  You’re cold.  You’re cold all the time.  And you can’t get warm.  Your body temperature actually drops.  Remember what I said about your thyroid running your metabolism? Yeah, your body temperature is part of that.

5. Digestion problems.  Your thyroid malfunctions, your digestion slows.  All of it.  Oh, and you’re more prone to reflux, so enjoy that, too.  You can take acid blockers, but only short term—long term, they cause damage to other parts of your body and digestive system.  And the reflux is caused by slow emptying stomach anyway, because your digestion has slowed down. But when your digestion slows like that?  Guess what?  You’re eating less than normal, still gaining weight, and your body starts sucking the moisture out of what’s moving through you, and you get constipated.  Eating more fiber makes it worse.  Drinking more water doesn’t help.  Laxatives can, but that can cause severe, long-term damage. 

6. Reproductive issues.  Your libido tanks.  If you’re female, your cycle goes longer, gets heavier and more painful, and you lose more iron.  It’s harder to get, and stay pregnant, because all of your hormones are influenced by your thyroid levels.  All of them.  Some of the symptoms can be masked by birth control pills…but those will actually make the underlying issue of a non-functioning thyroid worse.  Because estrogen binds the bit of thyroid hormone your body is making into its permanently inactive form that your body can’t use.

7. Blood pressure/cholesterol.  Your blood pressure can drop…or it can skyrocket, because your body’s under a ton of stress.  Your cholesterol will go up.  Because your body’s not using it to make the hormones you need to live.  Doctors will push statins at you, but those will just make you feel worse, because the root issue—a non-functioning thyroid—is still untreated. 

8. Cognitive symptoms.  You get forgetful.  You can’t focus.  Your thoughts move at the speed of molasses in January, if they move at all.  You can’t get interested in anything, can’t maintain interest in anything.  You get depressed, and nothing helps.  Not sunshine, not antidepressants, not talk therapy. Nothing.  Everything’s gray, and life sucks.  And it’s not clinical depression, because it’s not caused by brain chemicals going out of whack.  It’s your thyroid…which no one will actually test for, even if you have presented with treatment resistant depression. 

9. Pain levels.  You get more prone to headaches.  Not sinus headaches, not blood pressure headaches, not tension headaches, not migraines.  Just…random, mild, run-of-the-mill headaches.  Oh, and joint pain.  Your joints will ache.  And you won’t know why, and not much will help…because there’s nothing that you’ve done to hurt yourself.  Your body is just being an asshole.  Oh, and your muscles will ache, but you won’t have done anything.  (Doctors will actually test you, at this point, for Epstein-Barr, for fibromyalgia, for a bunch of different things…but not thyroid.)

10. Eye issues.  Your vision will go wonky.  You’ll go near-sighted, and may develop astigmatism.  And it will worsen, and continue to get worse.

11. Nerve issues.  Low thyroid numbers can cause tremors and spasms.  Because like your brain needs thyroid hormones to function properly so does your nervous system.  If it’s bad, it can look like Parkinson’s.  But it won’t be. 

If you stand back and look for patterns?  There isn’t one.  Not really.  And general practitioners look for patterns.  Symptom clusters.  That normally tells them where the problem is. 

Unfortunately, your body uses thyroid hormone to regulate literally everything.  There isn’t a single system in your body that it doesn’t touch. 

The absolute hell of it is, TSH is an easy check.  Most doctors don’t know what it signifies, but it’s easy to keep an eye on.  If it fluctuates, there’s a problem.  And if it’s not functioning and not treated?  It can cause severe and worsening problems. 

Including cardiac issues.  You read that right: untreated or under-treated hypothyroidism can lead to heart failure.  And early death. 

It’s an easy test.  Ask for it, if it’s not in your annual panels.  Keep an eye on that TSH number.  Remember: you want it between .5 and 3.5.  Lower than .5, and you’re hyperthyroid (different set of symptoms and risks—mostly inverse), and higher than 5, you’re hypothyroid.  Both can—and should—be treated. 

You deserve to feel better than this. 

*Yes, Holly has been badgering me to see an Endo. Now if only I get the test results back and the doctor knows what to do about it… Holly is an author, and this is the link to her Amazon page. -SAH*

51 thoughts on “Feeling Awful? Check Your Thyroid by Holly Chism”

  1. Sadly, at least in my area, there aren’t enough endos, and they insist that you have all your thyroid lab levels be bad to let you in the door. They don’t care what your symptoms are. I can check off almost every single one of those symptoms (not that the TBI in October has helped any) but since my lab levels look good, I’m fine.

    I miss the bad old days when they treated the patient not the labs.

    Liked by 3 people

    1. It’s a sad state of affairs in American Medicine, but you are lucky to have any endos around if you are in a smaller community. However the symptoms of most endocrinology disorders are not very specific for endocrinology issues. Labs and physical exam results are key to diagnosis and referral. I see the same issue with access in Neurology as in Endocrinology however. When I practiced sub specialty medicine many decades ago (neither of the above), I never turned away someone who self referred. Usually all they needed was some reassurance. Sometimes they did need me and they got attention quicker due to their diligence. Sometimes they needed a different specialist, and I got them to them post haste. These days the problem is the insurance companies that act as gatekeepers. And the tort attorneys that can make life very miserable for the physician even if they have done nothing wrong. Not to mention the medical schools, training programs and State/Federal agencies that either push DEI nonsense or (inclusive or here) the importance of following orders no matter how nonsensical their “guidelines” are.

      Liked by 1 person

        1. But you see, they’re not practicing medicine, only determining what medicine can be practiced, therefore they are regulators and not doctors, therefore they are gov’t functionaries, therefore they work outside the bounds of any law.

          Liked by 1 person

          1. They are simply saying what they’ll pay for, and what they’ll sanction your participating provider for if they transgress. Economically, of course.

            Liked by 1 person

          2. If you don’t have ‘insurance’ and pay cash, you soon find that things actually cost FAR less and you can actually get what you need done on the medical level… Done it for years and it costs FAR less…

            Unfortunately, this doesn’t work on the surgical level…

            —

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      2. 0bamacare drove thousands of doctors and nurses out of medicine, and added hordes of bureaucrats. The COVIDiocy forced out even more. Everything about our health care establishment gets in the way of doctors and nurses practicing actual medicine for actual patients. Clueless bean counters and bureaucrats dictate to medical professionals how to do their jobs.

        When government is the problem, more government is not the solution.

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      3. What should be the bedrock of medicine is a well-trained, independent primary care doctor that knows his patients, and cares enough to make sure things go well. Think Marcus Welby. This is exactly what the medical system is busy trying to destroy. It shouldn’t be the random specialist’s job to figure out where they should be, or shepherd them through the system (No offense, Vizzini, but that used to be OUR job!)

        Liked by 1 person

        1. I did sub specialty care for about 15 years and various forms of primary care for another 30 years or so before calling it quits. GFY.

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              1. That’s not what ‘GFY’ means to most people these days. ‘Go F Yourself’ ring any bells? If that’s not what you meant to say, it’s still how it was received.

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            2. Now I have an idea why my boss was in a panic to make sure I got the Medicaid billing in on time. He said we have to get paid as soon as possible…

              Liked by 1 person

      1. I could go on about how to properly and tolerably supplement iron for several paragraphs but I’ll spare you for now. You know how to find me, Sarah, I think.

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      2. Make sure to take them with Vitamin C because that is necessary for absorption. I stopped being so tired when I ate citrus every day with my iron-rich cereal.

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  2. After decades of my TSH being between 2.5 and 3.0, it started to climb. This was almost twenty years ago, in my early 50s. I hit a TSH of 5.5. The docs were talking about T4. But I had read something…. We don’t eat organ meat much anymore. When people are poor, if you slaughter an animal, you eat it all. But we don’t anymore. And organ meat has micronutrients the thyroid needs. So I started taking desiccated thyroid capsules. They actually grind up the thyroid glands of animals, desiccate them into a dry powder, and put them in capsules. I told the doctors to wait and started taking those capsules. Three months later, my TSH tested in the low threes. Not saying this will work for everyone, but it’s worth a try before going on T4.

    Liked by 1 person

    2. The desiccated thyroid, and Armour Thyroid, both contain T4 AND T3, but the amount varies batch to batch, so dosing can be tricky or at least lead to undesirable variations in thyroid levels. Also note that all thyroid preparations including synthetic T4 and T3, are temperature sensitive. A day in a closed car or truck in the summer OR winter can partially or totally inactivate the hormone. While buying your thyroid from a reputable local pharmacy should minimize the risks as pharmaceuticals are supposed to be shipped in a protected manner, if your usual preparation doesn’t seem to be working, it might be because it got zapped. The other issue is absorption. Gotta take it on an empty stomach without other meds or vitamins.

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      1. The Solaray Thyroid caps are desiccated bovine thyroid and are thyroxin (T4) free. I do keep them refrigerated once they arrive, as they are a beef product. Like most supplements, it’s basically a food, not a pharmaceutical.

        Liked by 1 person

        1. They make no mention of T3 content, if any, which tends to be higher in proportion to human T3/T4 in bovine extract. While it does not appear to be a problem in your case, elevating the T3 level proportionally higher than T4 level can lead to problems when using desiccated animal thyroid supplements. Since it is marketed as a food rather than drug, there is no requirement to provide results of product testing for thyroxine and tri-iodothyronine content, nor do I see any in their literature. Point me to it if I’ve missed it, as this thyroxine-free desiccated product seems intriguing. I wonder if the free-drying process destroys some or all of the hormone content while leaving the minerals intact.

          Liked by 2 people

  3. Great post Holly.

    You resident retired physician with three Boards and 50 years experience has a very few things to add.

    1. Sarah, you need an endo, or at least an old fashioned internist who was trained before 1980, given your other medical issues, the likelihood you could have additional confounding factors in your endocrine system like sluggish adrenal glands, as well as how thyroid and adrenal function mess with them, you need someone who does this stuff with their eyes closed (or at least squinting). How your thyroid meds are handled are not a simple matter in your case, and poor handling of this could lead to bad things for you.
    2. Preventive health exams are how you catch this kind of stuff BEFORE you become symptomatic. Women are MUCH more likely to become hypothyroid, and a TSH, if not a thyroid profile, should be part of that annual checkup. Other common problems, like iron deficiency, are usually screened by a CBC or H/H. A urinalysis keeps an eye on a number of issues but mainly kidney function and asymptomatic urine infections. Chemistries and lipids are often included. The TSH used to be on the list of every annual lab profile, but it seems to have dropped off of many of the recommended actions by various entities in the past few years. Bad idea.
    3. Any abnormal lab should be rechecked before any major action is taken unless the result is highly expected. Three or four rechecks is wasting time and money in most instances.

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    1. I would recommend anyone who is overweight be tested for thyroid operation. As Rich says, the American diet isn’t what it used to be, and that may be influencing the skyrocketing of obesity in this country.

      Liked by 1 person

      1. I’m on the side of multiple factors influencing obesity (particularly since *lab rats* have gained weight too.) Among them are lifestyle and diet, yes, but also stuff in the water (since the highest correlation to percentage of population with obesity is to lowest position on a watershed, with people at the end of the Mississippi having the worst in the US), mental health meds (known side effect, but those also get in the water), and—as it happens—diet culture of our parents and grandparents, since the body doesn’t understand when “famine” is deliberately imposed, and passes on the stresses to descendants.

        Liked by 1 person

    2. $SPOUSE$ was fortunate enough to have that kind of internist (well, not trained before 1980 – but he had been taken on as the junior doctor in the practice of the internist that I’D had since I was a teenager in the 70’s – and so had any bad habits corrected).

      Didn’t hurt that his insurance coordinator was absolutely cracker jack at her job. I knew she was, as I worked with her when, among my many different industries, we were both laboring for the Dark Side.

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    3. I might actually wish to have you consult with younger DIL who pings most of the symptoms, but whose TSH is normal and to a GP her further thyroid tests also look normal. Since the kids want to have kids, this is a worry. She also has interesting auto-immune issues. This Neanderthal re-breeding project might have some issues. :)
      I keep flashing to Kate Paulk’s talking of our kind in her books “Minds as weird as their bodies.”…. Sigh.

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  6. Dorothy Sayers wrote a short story where the villain, a brilliant but malignant doctor, had married his ward, who had low thyroid, and deliberately carried her off to a remote region and slowly, slowly cut her dosage of thyroid hormones so he could watch her deteriorate. (He thought she’d been attracted to a former friend and wanted to,punish both of them).

    Which is how Lord Peter temporarily became a white magician….

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  7. If you are having trouble getting into a specialist or if you aren’t being taken seriously as far as symptoms go, seek out a Functional Medicine practitioner.

    They can order all the necessary tests and are extremely diligent in tracking down nagging issues.

    I have MS which has very similar symptoms to those above and my Functional medicine practitioner has helped me immensely. I have been able to keep it under control for years without the expensive and damaging drugs the neurologist always tries to get me to take.

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  8. Basic blood tests to always have before starting any treatment for weight or depression: thyroid, iron, vitamin D. They can all have issues, they’re easily spotted, and (comparatively) easy to treat.

    I’m going to have to start with another new GP (why they switched me to one that was retiring in a year is beyond me), but all I had to do to get thyroid on annual blood screen was to point out hyperthyroid with both my father and my sister. (The latter actually caught it really early because of a fitness tracker, of all things. So she didn’t have to have her gland killed off.) The iron has to get tested because of an iron deficiency (supplements finally got me up into the 20s—I was at 6 when it was diagnosed. “Normal” is 22-140, so no wonder I was tired all the time!)

    We never did figure out what triggered the waist gain, and fixing the iron didn’t fix that. Oh well.

    Liked by 1 person

  9. I got my thyroid checked last fall and it turned out that was the problem with my depression and lack of energy. I had been blaming my brain since I always blame my brain so that was an interesting twist. I didn’t go to a specialist but the dosage my doctor has me on is working well right now.

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  10. Do not forget to check your iodine supply. Seafood, multivitamins, and iodine supplements may all help.

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  12. I have most of those symptoms, but also have a bunch of other autoimmune issues. My primary care always says that my Thyroid tests normal (right in the middle), for whatever VA considers normal. Things have gotten way worse this past year, despite everything being “normal” and not changing diet and doing more exercise (I’ve been on a medically supervised ketogenic diet for 4+ years). Weight keeps going up, BG up. Tried lots of different supplements…VA is even harder to work with. But it might be other hormonal, too. I have a LOT of Neanderthal markers, but I am a Natural redhead…but it could be Sidhe blood, too…

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    2. I was like that for YEARS. Every practitioner looked at me and did thyroid tests, then told me I was normal. I was in fact only making RT3. No T3.
      Have them test for that.

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      1. Never heard of that….Also, I recently heard that if Estrogen is too low then it can effect Thyroid and vice versa. So, just scheduled an appointment to talk to doc to see if they’ll set up a community care appointment, where I can get outside testing.

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  13. Entirely unrelated except for the similarity in names: a family member had low blood calcium for a long time, which didn’t seem to respond to calcium pills. Then she got a new doctor (a young woman from Bangla Desh) who said “could be parathyroid”. We did some reading and that seemed right.

    Parathyroid glands sit next to the thyroid (hence the name), four each the size of a grain of rice, normally. Their job is to regulate the blood calcium level. Occasionally one goes hyperactive, driving calcium low. That can do various unwanted things — obvious ones like osteoporosis, but a bunch of nervous system related issues because calcium ions are intricately tied into brain and nerve function. So tremors and headaches are an example. The treatment is to remove the offending parathyroid gland, no problem because you have three more.

    We found a clinic in Tampa that does nothing else. So they do it very well indeed. A small incision (an inch or less), a brief procedure, and things closed up with cosmetic surgery style suture and band-aid. A few days later you can’t see a thing, and the problem disappears overnight. Nice. Apparently, non-specialist surgeons often do large ugly incisions because they don’t have the technology to know exactly where the misbehaving parathyroid is located.

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  14. Sarah, if I wish to submit a guest post for consideration that is a complement to Holly’s on this subject, do I send it to you or to her? Thanks!

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