Is Your Thyroid Making You Exhausted?

Hypothyroidism, Hyperthyroidism and the Link to Fatigue and Exhaustion

Mixed race woman sitting in bed
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Fatigue and severe exhaustion can be key symptoms of undiagnosed or insufficienty treated thyroid conditions. Unfortunately, for some patients, fatigue persists, even after treatment for the thyroid condition. Here is a look at the connection between fatigue and various thyroid problems.

Fatigue in Hashimoto's Disease and Hypothyroidism

For many patients, one noticeable sign that thyroid levels are not properly regulated or that your thyroid hormone replacement medication dosage needs to be adjusted is bone-numbing fatigue.

This exhaustion can develop slowly, or may come on suddenly, and leave you barely able to lift your head off the pillow in the morning. You may feel like you can't get through a day without a nap or you sleep more than usual but still feel completely exhausted. You may not have energy to exercise, or you may fall asleep during the day, or very quickly at night, and find it difficult to get up in the morning. 

If you are experiencing this kind of fatigue -- which is frequently seen along with other hypothyroidism symptoms you'll find on our Hypothyroidism Symptoms Checklist -- the problem may be that your hypothyroidism is not sufficiently treated

Fatigue in Graves' Disease/Hyperthyroidism

Some people with Graves' disease and/or hyperthyroidism find themselves completely exhausted. This can be due to the insomnia and difficulty sleeping that is common with an overactive thyroid -- known as hyperthyroidism.

It can also be due to the stress on your body from having a rapid pulse, higher blood pressure, diarrhea, tremors, anxiety, and other symptoms of hyperthyroidism.

To help understand more about Graves' disease symptoms, see our Graves' Disease/Hyperthyroidism Checklist of symptoms and risk factors. For information on diagnosis and treatment, see Graves' Disease and Hyperthyroidism: An Overview, which goes through most of the important information regarding Graves' disease and hyperthyroidism.

The key issue for patients is if you are on an antithyroid drug and you are getting too much medication, this may shift your thyroid function into hypothyroidism, creating worsening fatigue. Also, if you have had radioactive iodine (RAI) ablation, or surgery to remove your thyroid, and are not on thyroid hormone replacement drugs, you may have shifted into hypothyroidism, and require treatment. If you are already on thyroid hormone replacement, as discussed earlier, you may need an increased dosage in order to properly treat your hypothyroidism and resolve your symptoms.

Are You Getting Enough Sleep?

If your treatment for an underactive or overactive thyroid is optimized, then it's time to look into a simpler and potentially more obvious issue -- are you getting enough sleep?

According to data released by the National Sleep Foundation, two out of every ten Americans sleep less than six hours a night, substantially less than the recommended 8 hours. The average person gets 7 hours of sleep a night, and 40 percent of adults report that they are so sleepy during the day that it interferes with their daily activities.

If you are regularly fatigued, and your thyroid treatment is otherwise optimized, you may be tempted to continue blaming your thyroid.

But here's a simple test: for a week, try getting at least eight hours of sleep each night. If you feel better and more energetic, your problem may be sleep deprivation, rather than a poorly treated thyroid problem.

Note, however, that anecdotally, some thyroid patients do report an increased need for more sleep, even with optimal treatment. 

Thyroid Disease and Sleep Apnea

There is also a relationship between an increased incidence of sleep apnea (brief periods when you stop breathing while sleeping) and hypothyroidism. Frequent apnea can also cause unrelieved exhaustion. Apnea is often also seen in conjunction with snoring.

For more information on apnea and other sleep disorders, and how they can be treated, see What is Sleep Apnea?.

When Fatigue is Chronic

If you suspect that your fatigue is more than just sleep deprivation, you might also want to read Chronic Fatigue Syndrome, Fibromyalgia and Autoimmune Thyroid Disease.

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