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 important 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 the 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 are common with an overactive thyroid, the condition known as hyperthyroidism.

Difficulty sleeping 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 reviews 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, which can create worsening fatigue. Also, if you have had radioactive iodine (RAI) ablation, or surgery to remove your thyroid gland, and you are not taking thyroid hormone replacement drugs, you may have become hypothyroid and require thyroid hormone replacement treatment. If you are already on thyroid hormone replacement drugs, 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, 2 out of every 10 Americans sleep less than 6 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 chronic sleep deprivation, rather than a poorly treated thyroid problem.

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

Thyroid Disease and Sleep Apnea

There is also a relationship between an increased incidence of sleep apnea and hypothyroidism.

When you have sleep apnea, you experience brief periods when you stop breathing while sleeping. Frequent apnea can cause sleep disruption, and 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 Your Fatigue is Chronic

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

Sources:

Dayana, Colin. "Hypothyroidism and Depression." Eur Thyroid J. 2013 Sep; 2(3): 168–179.

Husson, Olga et al. "Fatigue Among Short- and Long-Term Thyroid Cancer Survivors: Results from the Population-Based PROFILES Registry" Thyroid. 2013 Oct; 23(10): 1247–1255.

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