Feeling fatigued? Lacking sleep? It could be your thyroid

Published on Thursday, April 1, 2021

By: Annie Oeth, aoeth@umc.edu

Has your “get-up-and-go” gone?

An overactive or an underactive thyroid could be to blame.

Fatigue can be a symptom of multiple medical conditions, but a malfunctioning thyroid could be one of them, according to experts at the University of Mississippi Medical Center.

A butterfly-shaped gland at the front of the throat, the thyroid produces hormones that help the body stay warm; keep the heart, brain and other organs functioning well; and metabolize energy.

The most common thyroid conditions involve either the overproduction of these hormones - hyperthyroidism - or underproduction - hypothyroidism.

Since metabolism affects so many functions of the body – from how many calories you burn to the speed of your heartbeat – having a thyroid that produces either too much or not enough hormone can contribute to other conditions. For example, the Sleep Foundation notes that hyperthyroidism and hypothyroidism both are risk factors for some types of sleep disorders.

The good news: These disorders can be easily diagnosed through a blood test and most can be managed well with medication.

"Any physician can easily order thyroid blood tests and this could immediately be helpful,” said Dr. Lillian Lien, professor and chief of the Division of Endocrinology, Metabolism and Diabetes at UMMC. “There are good medications that assist with managing both hypothyroidism and hyperthyroidism. There are other treatments as well, but in many cases, the first and easiest step will be to start medications.

“Just starting the medical treatments can really help someone feel better quickly.”

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Hyperthyroidism

Those with an overactive thyroid may have symptoms, including anxiety, a loss of appetite, itchy skin, fever, sore throat, diarrhea and eye changes.

“Some of the most common signs of an overactive thyroid include weight loss, sweating, diarrhea, anxiety and fast or irregular heartbeat,” Lien said.

Hyperthyroidism can be the result of several conditions, including Graves’ disease, inflammation of the thyroid, growth of nodules or an enlarged thyroid, also known as a goiter. In rare cases, it can be caused by a cancerous growth.

Untreated hyperthyroidism can cause serious health problems involving the heart, bones, muscles or fertility. During pregnancy, hyperthyroidism can contribute to health risks for mothers and their babies.

— — —

Hypothyroidism

Hypothyroidism is an underactive thyroid, or one that doesn’t produce enough hormones for your body’s needs.

“Those with an underactive thyroid may experience weight gain, tiredness/exhaustion, constipation and hair loss,” Lien said.

Other symptoms can include joint and muscle pain, dry skin and an enlarged thyroid. Hypothyroidism can also cause fertility problems in women.

Hypothyroidism can be caused by Hashimoto’s disease, a condition in which the thyroid is attacked by the body’s immune system. Inflammation of the thyroid can also cause an underperforming thyroid gland. Congenital hypothyroidism can also result in a lack of thyroid-produced hormones, as can radiation treatments and some medications.

Get tested

Those experiencing these symptoms should talk with their primary care physician, who may prescribe a blood test to determine whether a problem with the thyroid gland is to blame.

The most common blood test measures levels of thyroid stimulating hormone in a blood sample. According to the American Thyroid Association, changes in TSH levels can happen before the actual levels of thyroid hormones become too high or too low.

A high TSH level means that the thyroid is not making enough thyroid hormone, while a low TSH level indicates hyperthyroidism. In most cases, a normal TSH level means that the thyroid is doing its job well.

Women who experience these symptoms and are thinking of starting a family should have their TSH level evaluated before conception, said Dr. Rachael Morris, UMMC associate professor of maternal fetal medicine.

“During pregnancy, your Ob-Gyn and maternal fetal medicine specialist will monitor thyroid levels, fetal growth and watch for complications,” Morris said. “A very successful pregnancy can be achieved with routine care and compliance with medications, if they are necessary.”

Complications with pregnancy or other medical conditions show why this small gland is so important, Lien said.

“Both hyperthyroidism and hypothyroidism can affect the heart, which is particularly concerning,” she said. “But so many other areas can be involved – including the eyes, the skin, the gastrointestinal tract, as well as thinking and memory.

“This is why diagnosing and managing thyroid disorders is so important.”

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