Why Am I So Tired? : Hypothyroidism

Case study ( 1875 views as of March 19, 2024 )

Sarah is a 32 year-old software engineer who presents with a one year history of fatigue, difficulty losing weight, dry skin, cold intolerance and difficulty concentrating. She has been busy working long hours and initially attributed her symptoms to long work hours and stress. Her mother has a history of hypothyroidism.

At her routine follow-up with her family physician, Sarah mentioned her symptoms, and her physician noted slight enlargement of her thyroid gland. The results of her blood tests were as follows:

Thyroid stimulating hormone (TSH): 15.6 mIU/L (N 0.32-400 mIU/L) Free thyroxine (Free T4): 7 pmol/L (N 9-19 pmol/L)

The combination of signs and symptoms along with bloodwork showing an elevated TSH and low Free T4 confirmed the diagnosis of hypothyroidism, almost certainly due to Hashimoto’s thyroiditis, the most common cause of hypothyroidism and typically more common in women than men and often associated with a family history of thyroid disease.

Sarah is started on thyroid hormone replacement therapy with a high quality brand preparation of levothyroxine (Synthroid®). Her pharmacist instructs her to take the medication on an empty stomach every morning. Within about 6 weeks, all of Sarah’s symptoms have resolved and she has returned to feeling perfectly normal. Repeat bloodwork done 8 weeks after initiating treatment revealed a normal TSH.

Sarah will benefit from regular follow-up with her family physician, with TSH testing at least once yearly or if symptoms return. Her pharmacist can help with ongoing reminders about how to properly take her medication.

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Conversation based on: Why Am I So Tired? : Hypothyroidism

Why Am I So Tired? : Hypothyroidism

  • hypothyroidism can present with a wide range of symptoms, many of which can significantly impact an individual's quality of life. The most common symptoms, as you mentioned, include fatigue, sensitivity to cold, weight gain, hair loss, dry skin, and constipation. Additionally, changes in menstrual cycles for women and difficulties with erectile function for men can occur. One of the challenging aspects of hypothyroidism is its potential to mimic depression. The psychological and psychiatric changes associated with hypothyroidism can include a lack of motivation, depressive mood, and overall feeling of low energy. Distinguishing between mild depression and hypothyroidism can be difficult for both patients and physicians, as the symptoms can overlap. Therefore, thorough evaluation and testing are essential for an accurate diagnosis and appropriate treatment.
  • Absolutely, the overlap between symptoms of mild thyroid deficiency and depression can make it challenging to distinguish between the two conditions. Both hypothyroidism and depression can cause symptoms such as fatigue, low motivation, and depressive mood. As a result, it's crucial for healthcare providers to conduct thorough evaluations, including medical history, physical examinations, and possibly laboratory tests, to accurately diagnose the underlying cause of these symptoms. Collaboration between patients and healthcare professionals is essential in navigating this diagnostic challenge and ensuring appropriate management and treatment.
    • hypothyroidism can present with a wide range of symptoms, many of which can significantly impact an individual's quality of life. The most common symptoms, as you mentioned, include fatigue, sensitivity to cold, weight gain, hair loss, dry skin, and constipation. Additionally, changes in menstrual cycles for women and difficulties with erectile function for men can occur. One of the challenging aspects of hypothyroidism is its potential to mimic depression. The psychological and psychiatric changes associated with hypothyroidism can include a lack of motivation, depressive mood, and overall feeling of low energy. Distinguishing between mild depression and hypothyroidism can be difficult for both patients and physicians, as the symptoms can overlap. Therefore, thorough evaluation and testing are essential for an accurate diagnosis and appropriate treatment.
    • hypothyroidism can present with a wide range of symptoms, many of which can significantly impact an individual's quality of life. The most common symptoms, as you mentioned, include fatigue, sensitivity to cold, weight gain, hair loss, dry skin, and constipation. Additionally, changes in menstrual cycles for women and difficulties with erectile function for men can occur. One of the challenging aspects of hypothyroidism is its potential to mimic depression. The psychological and psychiatric changes associated with hypothyroidism can include a lack of motivation, depressive mood, and overall feeling of low energy. Distinguishing between mild depression and hypothyroidism can be difficult for both patients and physicians, as the symptoms can overlap. Therefore, thorough evaluation and testing are essential for an accurate diagnosis and appropriate treatment.
    • hypothyroidism can present with a wide range of symptoms, many of which can significantly impact an individual's quality of life. The most common symptoms, as you mentioned, include fatigue, sensitivity to cold, weight gain, hair loss, dry skin, and constipation. Additionally, changes in menstrual cycles for women and difficulties with erectile function for men can occur. One of the challenging aspects of hypothyroidism is its potential to mimic depression. The psychological and psychiatric changes associated with hypothyroidism can include a lack of motivation, depressive mood, and overall feeling of low energy. Distinguishing between mild depression and hypothyroidism can be difficult for both patients and physicians, as the symptoms can overlap. Therefore, thorough evaluation and testing are essential for an accurate diagnosis and appropriate treatment.
    • Kiwifruit indeed offers a plethora of health benefits beyond just its high vitamin C content. Here's a breakdown of its nutritional and health value: High Vitamin C Content: Kiwifruit contains more vitamin C per serving than most citrus fruits, making it an excellent source of this antioxidant vitamin, which supports immune function and overall health. Low FODMAP: Kiwifruit is considered low FODMAP, making it suitable for individuals with irritable bowel syndrome (IBS) who may experience symptoms aggravated by certain types of carbohydrates. Rich in Fiber: Kiwifruit contains a blend of soluble and insoluble fiber, which enhances its water-holding capacity. This fiber content contributes to improved bowel movement consistency and quality, while also promoting a healthy gut microbiome and reducing inflammation and abdominal discomfort. Effective in Reducing Constipation: Studies suggest that kiwifruit may be as effective as popular fiber supplements like psyllium in reducing constipation, with potentially fewer side effects. Contains Actinidin: Kiwifruit contains a unique digestive enzyme called actinidin, which may aid in the digestion of proteins and contribute to overall digestive health. Rich in Potassium: Kiwifruit is a meaningful source of potassium, an essential mineral that plays a key role in regulating blood pressure and maintaining heart health. Many people in North America don't consume enough potassium, making kiwifruit a valuable addition to the diet. Incorporating kiwifruit into a balanced diet can provide numerous health benefits, ranging from supporting immune function and digestive health to promoting heart health and reducing inflammation.
  • It's essential for individuals to recognize these signs and seek medical advice if they suspect they may have an underactive thyroid. Consulting with healthcare professionals, such as primary care practitioners, family physicians, physiotherapists, registered dietitians, and athletic therapists, can provide valuable support in diagnosing and managing this condition effectively.
  • They are a major and dense source of food energy for many animals and play important structural and metabolic functions, in most living beings, including energy storage, waterproofing, and thermal insulation.
  • Your thyroid is responsible for providing energy to nearly every organ in your body. It controls functions such as how your heart beats and how your digestive system works. Without the right amount of thyroid hormones, your body’s natural functions begin to slow down.
  • If you feel like you’re always run down even if you eat well and exercise, or if you are always tired even if you get enough sleep, it could be a symptom of hypothyroidism. Fatigue is one of the symptoms of hypothyroidism, which can often mimic those of other diseases.
  • Determine my BMI and understand what the healthy weight range is for my body.
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