The Thyroid Question In Fibromyalgia And Chronic Fatigue Syndrome Me/cfs
by Cort Johnson | Oct 24, 2016 | Holtorf, Homepage, Thyroid, Treatment |
Fatigue, lethargy, mental sluggishness, difficulty tolerating heat and cold, depression, joint pain, headaches, morning stiffnessthe list goes on and on. Its almost a perfect match for chronic fatigue syndrome or fibromyalgia but its not either its hypothyroidism one of the trickiest conditions that people with either disease have to deal with.
If a hypothyroid diagnosis was done purely symptomatically, most if not all people with ME/CFS and FM would be considered hypothyroid. Dr. Teitelbaums description of the thyroid gland as the bodys gas pedal regulating its metabolic rate resonates strongly with ME/CFS and FM. Few studies on this have been done in FM and almost none have been done in ME/CFS.
Most perplexing for the patient is the considerable disagreement among doctors regarding what constitutes low thyroid and how to treat it. The problem is that giving thyroid hormone to someone who doesnt need it is can cause their thyroid gland to shut down, leaving them dependent upon thyroid medication for life. Plus, other factors such as low cellular energy production or autonomic nervous system problems can cause similar symptoms.
Most doctors, however, probably believe hypothyroidism is rare in ME/CFS and thyroid supplementation is unnecessary and possibly harmful.
A few simple concepts:
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How To Manage Hashimotos Disease Fatigue
Most people with Hashimoto’s disease experience chronic fatigue and exhaustion. This is because Hashimoto’s disease leads to a decrease in the production of thyroid hormones that control the body’s metabolism.
But what exactly is Hashimotos disease?
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What Are The Signs And Symptoms Of Chronic Fatigue Syndrome
The symptoms of CFS are not particularly unique. Many of them are, in fact, also symptoms of hypothyroidism, or common infections like the flu, or COVID-19. Generally, the symptoms include:
- Fatigue: severe and unexplained fatigue that does not improve with rest is considered the most common symptom of CFS.
- Post-exertional malaise : a worsening of fatigue after physical activity or mental exertion
- Muscle weakness
- Allergies and sensitivities to foods, scents, chemicals, medications, and supplements
- Numbness, tingling, and burning sensations in the hands, feet, and face
- Orthostatic problems: dizziness, especially dizziness that worsens when you change position, i.e., when you move between lying down, sitting, and standing. The dizziness can also be accompanied by feeling faint or nauseated.
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How Is Hashimoto’s Thyroiditis Treated
Thyroid hormone replacement therapy is the most effective treatment for Hashimoto’s thyroiditis. This involves the replacement of the T-4 hormone produced by the thyroid gland by taking a medication called levothyroxine.
You might experience mild side effects like headaches, appetite changes, and diarrhea when taking levothyroxine. If you experience shortness of breath, wheezing, and nausea, you should seek medical attention immediately.
What Does Your Day With Hashimotos Look Like
Mornings arent my best time, generally. I try to start with some stretching and a few minutes of meditation.
My day depends of several factors, including how much sleep I got , if Im eating healthy, if my CFS is flaring up , and a little luck, I think.
Once I get going, I generally feel a little better. I eat steel cut oatmeal with berries and crushed up Brazil nuts every morning to get a healthy start. Then I usually do some writing.
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Whats The Biggest Struggle And Biggest Victory You Experienced
The biggest struggle was getting diagnosed. Its frustrating and demoralizing when the way you feel is minimized.
Once I found someone who was outstanding in the thyroid field, I felt a huge sense of relief. I went through a lot: biopsy, other tests, radioactive iodine treatment, and finding the right medication dose. But once I knew I had a partner in healthcare, and that I wasnt in it alone, I knew I would be okay.
Is Fatigue A Symptom Of Hashimoto’s Thyroiditis
Chronic fatigue is common in patients with Hashimoto’s disease and hypothyroidism. This is because the two disorders affect the thyroid gland, reducing thyroid hormone production.
The thyroid gland produces T-3 and T-4 . These two hormones control the metabolism in your body, including functions like your heartbeat and body temperature.
When there is less production of these hormones in your body, it means that your body’s metabolism will slow down. When your heartbeat slows down, it will cause you to feel physically weak, and you will experience fatigue.
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The T4 Paradox When Treatments Make Things Worse
DeGroots personal experience is that treating patients with NTIS with T4 often results in significantly elevated rT3 levels .
Nunez-Ruiz et. al. also suggest that standard thyroid therapy in the NTIS-like ME/CFS subset could actually induce a state of NTIS, and point out that T3, recommended by Holtorf for ME/CFS and FM, has been suggested for severe NTIS. They referred to the NHANES cohort, which found that T4 administration resulted in higher T4 levels but 510% lower T3 and FT3 levels, and a 1520% lower T3/T4 ratio. They believe tissue levels of those factors are probably far lower.
Low T3 syndrome in our study resembles the thyroid hormone profile of a subgroup of hypothyroid patients receiving T4 monotherapy. The authors
Holtorf also has found T4 supplementation unproductive and even harmful at times in his ME/CFS and fibromyalgia population. When high levels of rT3 are found, or free T3/reverse T3 ratio is greater than 0.2 , instead of T4 Holtorf will prescribe free T3 instead.
Discovery Of A Crucial Link Between Chronic Fatigue Syndrome And Lower Levels Of Key Thyroid Hormones Raises Hopes For Treating This Common Yet Debilitating Disease
- Date:
- Frontiers
- Summary:
- A new study reveals that chronic fatigue syndrome, a debilitating condition with unknown causes, can be explained by lower thyroid levels — but may be distinct from thyroidal disease. This can be seen as a first step to finding a treatment for a common illness for which diagnosis is hard to come by.
New research demonstrates a link between chronic fatigue syndrome symptoms and lower thyroid hormone levels. Published in Frontiers in Endocrinology, the study indicates that CFS, a condition with unknown causes, can be explained by lower thyroid hormones — but may be distinct from thyroidal disease. This finding can be seen as a first step to finding treatment for a debilitating illness for which there is no recognized treatment.
Chronic fatigue syndrome is a common disease marked by lengthy spells of weakness, fatigue and depression. Its diagnosis is predominantly based on symptoms and on ruling out any underlying medical condition, rather than on laboratory tests and physical examination.
Interestingly, several symptoms resemble those of hypothyroidism — a condition where the thyroid gland does not produce enough thyroid hormone. In hypothyroidism, the body tries to encourage thyroid hormone activity by releasing more thyroid-stimulating hormone — however, this does not happen in patients with chronic fatigue syndrome.
If the study findings are confirmed by additional research, it may pave the way for a treatment for chronic fatigue syndrome.
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Is Hashimotos Disease Dangerous Or Fatal
If left untreated, hypothyroidism can lead to some serious complications and, in rare cases, death. These include:
- Heart problems, such as enlarged heart or heart failure.
- Mental health issues, including depression.
- Myxedema coma, which needs immediate emergency care. Myxedema is a rare, life-threatening condition that can lead to heart failure, seizures, coma and death.
Chronic Fatigue Syndrome And Thyroid Connection
So, what can this tell us about Chronic Fatigue Syndrome? Well, CFS went into my medical records. That was the diagnosis. I was told I had CFS and that I had near perfect thyroid labs. I have come to believe that a good proportion of CFS patients could still have a thyroid hormone imbalance behind their CFS symptoms. These CFS patients may, or may not, be on thyroid hormone treatment. I also think that other complex conditions that are hard to diagnose properly, like B12 insufficiency, can also be behind many CFS cases. The problem is that it is often extremely difficult to find the cause and so the label of CFS is the only thing that the poor patient is left with. I wish more doctors would consider trying T3 therapy or B12 injections if they have cases of CFS patients for whom they have no other clues.
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Hashimotos Can Trigger Recurrent Adrenal Fatigue Syndrome
So, was it being Type A + stress + my Hashimotos triggers all lined up which lead to Hashimotos?
Or, was is having undiagnosed Hashimotos as one of my triggers for Adrenal Fatigue Syndrome?
I will never know. But, they are cousins of the same dysfunctional family.
I am certain AFS was part of the picture of my poor health at the time of my Hashimotos diagnosis in my early 20s, even though it was not discussed with me at the time.
I have since had a pattern of concurrent thyroid and adrenal ups and downs in the 20 or so years that have followed.
My most challenging period of AFS was last year
The most severe case was last year, when an unknown adult congenital heart condition disrupted my healthy balance.
The toll my heart condition took on my body had a direct negative impact on both my thyroid and adrenals.
It was a BIG new stressor, to say the least.
My thyroid levels changed for the worse for the first time in years.
My thyroid replacement medication dosage changed for the first time in years.
Many of my Hashimotos symptoms returned.
And, with all this, Adrenal Fatigue hit hard and fast.
I was actually caught off guard with the symptoms of stage 3 AFS, because they were pretty severe.
The reality is: I am probably always heading towards AFS because of my Hashimotos. It doesnt take much to go all the way.
What Did You Learn Since Do You Have Some Tips Or Findings To Share With Other Hashimotos People
Ive learned more than I ever thought possible. Im a believer in knowledgeand its a confusing and overwhelming time when you are diagnosed and feeling sick.
Im lucky to have an endocrinologist who is a thyroid expert and passionate about helping patients. She and I both realized that there was a need for comprehensive information to reach Hashimotos patientsto give then help, hope, and support. Thats why we wrote the book What You Must Know About Hashimotos Disease.
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Is There A Special Diet For People With Hashimotos Disease
There is no special diet for Hashimotos disease, but some foods, medicines or supplements may affect your ability to absorb levothyroxine, your thyroid medication. These include iron and calcium supplements, the ulcer medicine sucralfate, cholestyramine and aluminum hydroxide . Taking these four hours before or after the levothyroxine may solve this problem.
Talk to your doctor about any dietary questions you have.
Eating well and a healthy lifestyle exercising, sleeping well and controlling stress can help your immune system. No matter what, youll need to keep taking your medications if you are diagnosed with hypothyroidism.
Thyroid Dysfunction And Hashimotos
Hypothyroidism may develop for a number of different reasons, from an autoimmune attack on the thyroid gland to taking certain medications. Hypothyroidism may also be the first sign of an underlying pituitary gland problem. Hypothyroidism is the umbrella terncludes Hashimotos disease. Hypothyroidism is, in fact, a conditionnot a disease.
Hashimotos thyroiditis is an autoimmune disease. In Hashimotos, antibodies react against proteins in your thyroid gland, causing the gradual damage of the gland itself. This impairs the thyroid produce the hormones the body needs.
Symptoms of an underactive thyroid usually include:
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What Is The Cause Of Hashimotos Thyroiditis
Hashimoto’s thyroiditis is an autoimmune disorder. Normally, your autoimmune system protects your body by attacking bacteria and viruses. But with this disease, your immune system attacks your thyroid gland by mistake. Your thyroid then can’t make enough thyroid hormone, so your body can’t work as well.
Similarities To Other Conditions
Several symptoms of CFS resemble those of hypothyroidism, which is a condition where the thyroid gland does not produce enough thyroid hormone.
In hypothyroidism, the body attempts to encourage thyroid hormone activity by releasing more thyroid-stimulating hormone. This, however, does not happen in patients with CFS.
It was this contrast in thyroid-stimulating activity which led study authors to hypothesise that chronic fatigue syndrome is caused by low activity of thyroid hormones in the absence of thyroidal disease.
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Controversy Around Adrenal Fatigue
Adrenal fatigue is somewhat of a controversial topic. According to the Endocrine Society, adrenal fatigue is a myth promoted by health books and alternative medicine websites. There are no scientific facts to support the theory that long-term mental, emotional, or physical stress drains the adrenal glands and causes many common symptoms, the society says on the Hormone Health Network website.
Adrenal fatigue isnt an accepted diagnosis, Dr. Singer says. Its not something doctors are taught about in medical school.
However, if you take synthetic hormones for hypothyroidism and still experience fatigue and other symptoms, its important to determine the cause, Singer says. Extreme fatigue can be a symptom of many health other conditions, such as depression, that are identifiable and treatable, he says.
Theres no test for adrenal fatigue, according to the Endocrine Society. However, if your traditional doctor believes your synthetic thyroid hormone should be making you feel better and its not, you can schedule an appointment with a doctor that practices alternative or integrative medicine if youre interested in learning more about adrenal fatigue.
If Borenstein suspects adrenal fatigue, his first recommendation is to practice relaxation techniques like meditation and deep breathing. He also recommends cutting back on high-fructose corn syrup, gluten, and stimulants and to get good sleep.
Testing For The Root Cause Of Hypothyroidism
There are a number of tests one should consider before coming to any conclusion as to the manifestation of hypothyroidism.
Thyroid stimulating hormone test
Tests the levels of your thyroid stimulating hormone as released by the pituitary gland
Free T4 test
Tests the free T4 production levels of the thyroid gland function. A TSH test might present as normal but does not rule out thyroid dysfunction. Rather, it indicates pituitary gland function.
Antithyroid Microsomal Antibodies Test
A test for the presence of anti-thyroid microsomal antibodies. When a blood test comes back positive for these antibodies, it indicates possible damage to the thyroid gland function.
Free T3 test
Measures the T3 levels floating freely as well as those attached to your proteins. A lower concentration of this hormone with normal T4 levels is indicative of a problem regarding the conversion of T4 to T3.
Reverse T3 test
Besides T4 and T3, the thyroid also produces a hormone called reverse T3 . During times of stress, and in a bid to conserve energy , higher concentrations of T4 are converted to RT3 instead of T3. Heightened RT3 levels are thus indicative of hypothyroid symptoms due to stress.
Thyroglobulin antibodies test
This test measures the presence of thyroglobulin antibodies. Thyroglobulin is present in thyroid cells. The presence of these antibodies indicates possible damage to the thyroid gland function
Other possible tests
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How To Deal With Hypothyroidism
Whether your hypothyroidism is caused by Hashimotos thyroiditis or adrenal fatigue, there is a lot you can do to improve your state. If it caused by autoimmunity, then you can do a lot to manage it. If it is caused by AFS, you may be able to clear it up completely. Both require a holistic health plan.
First of all, you should address any underlying adrenal fatigue. This includes eating an adrenal fatigue diet and also making sure you are getting enough iodine and other essential nutrients in your diet. It also includes managing stress through meditation, therapy, support, and any other methods you find relaxing. Gentle forms of exercise, such as adrenal breathing and adrenal yoga are great ways to relax and also slowly increase your strength.
The fatigue that you are experiencing does require you to make time for a lot of rest and get good sleep. Theres no point fighting it and trying to function at full capacity when it will only make your system weaken further. You may also consider supplements that can help the adrenal glands and the thyroid gland get stronger, but in this area, it is important to have expert guidance in order to avoid inadvertently worsen your condition.
Do You Have Hashimotos Hypothyroidism And Chronic Fatigue Syndrome
Do you have Hashimotos hypothyroidism and chronic fatigue syndrome? Although Hashimotos can cause fatigue, some people have both.
Chronic Fatigue Syndrome , a condition of severe, chronic tiredness, is a well-known term in the medical world and affects between one and four million people in the United States. However, since it was coined in 1988, considerable controversy has arisen over the term CFS. Many patients, advocacy groups, and experts believe the name trivializes the condition and leads to a lack of respect for patients within the medical community some doctors view the illness skeptically and as a psychosomatic condition, and patients find they receive improper – or no – treatment for the illness.
Globally, a number of accepted names for this illness of uncertain cause are used, including Myalgic Encephalopathy , Post-Viral Fatigue Syndrome, and Chronic Fatigue Immune Dysfunction Syndrome. In the United States, organizations and doctors recently started calling the illness ME/CFS, for Myalgic Encephalopathy/Chronic Fatigue Syndrome. This combined name reflects the standpoint that the illness is indeed physical as opposed to psychological.
The increased attention on ME/CFS may also help differentiate symptoms related to Hashimotos hypothyroidism and ME/CFS.
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