Fatigued: Is It Your Thyroid or Something Else?

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Whatever you (or your loved one) may call it—exhaustion, weakness, feeling run down, sluggish, overtired, or just plain pooped out—fatigue is a common symptom of thyroid disease.

Be reassured, though, whether you find yourself needing a nap every afternoon to make it to dinnertime or waking up unrefreshed and brain-fogged despite a full night's sleep, you are not alone.

The good news is that there are ways to combat your fatigue, such as tweaking your thyroid medication dose, refining your sleep habits, or searching for another fatigue-causing culprit with your doctor.

Fatigue and Thyroid Disease

Fatigue is a very common symptom of hypothyroidism (an underactive thyroid gland), occurring as a result of the decrease in thyroid hormone production. The upside is that when the treatment for hypothyroidism is optimized, many people report a resolution or improvement of their fatigue.

Fatigue is also a symptom of hyperthyroidism (an overactive thyroid gland), commonly resulting from insomnia, anxiety, or disrupted sleep patterns. Like hypothyroidism, treatment of Graves' disease and hyperthyroidism usually resolves the fatigue.

Fatigue and Other Causes

If your thyroid disease is treated, and you are still experiencing fatigue, it's important to consider other causes with your doctor.

Depression

People with both hypothyroidism and hyperthyroidism commonly have symptoms of depression. Besides fatigue, other symptoms of depression include:

  • Lack of interest in daily activities
  • Feeling sad or empty
  • Eating too much or too little
  • Slowing down of thoughts or movements or restlessness
  • Problems focusing
  • Sleep troubles like unrefreshed sleep, or difficulty staying asleep or falling asleep
  • Feelings of hopelessness or guilt
  • Thoughts of death 

Be sure to see your doctor if you are experiencing any symptoms of depression. Treatment can be life-changing and often entails a combination of taking an antidepressant with undergoing psychotherapy.

Sleep Apnea

Some research suggests a link between thyroid disease and sleep apnea, when breathing stops for short periods of time during sleep. Sleep apnea can contribute greatly to fatigue, due to reduced oxygen intake.

Besides fatigue and grogginess, other common symptoms of sleep apnea include snoring, waking up gasping for air, morning headache, and waking up at night to urinate.

Anemia

Anemia, indicated by a low red blood cell count, is common in hypothyroidism, and sometimes the fist sign of thyroid disease. Along with fatigue, anemia may cause symptoms of dizziness, heart pounding, and shortness of breath.

 Fibromyalgia

If you have long-term, debilitating fatigue, and the fatigue is accompanied by other symptoms such as widespread muscle aches and pains, you may have be experiencing fibromyalgia. In fact, research suggests that Hashimoto's thyroiditis (an autoimmune thyroid disease) is a cause of fibromyalgia.

 

Poor Sleep Habits

While insomnia and un-refreshing sleep may be associated with your underlying thyroid disease, engaging in poor sleep habits may be contributing to your fatigue, as well.

According to the National Sleep Foundation, adults need seven to night hours per night, and a substantial percentage of us are not getting this amount of sleep on a regular basis.

Here are some tips on optimizing your sleep health. This way you can give your body and mind the rest they need to get you through your day happily and healthily:

  • Try to keep the same sleep schedule weekdays and weekends
  • Keep your bedroom cooler than the rest of your home
  • Avoid electronics before bedtime like watching television, working on your computer, or looking at backlit devices or smart phones 
  • Minimize light in your bedroom by using blinds or blackout curtains
  • Avoid caffeine and alcohol in the afternoon, and before bedtime
  • Avoid naps, if possible
  • Avoid  exercise after dinner time

You may also consider proactive measures to maximize your relaxation before bedtime: 

  • Take a hot shower or bath before bedtime
  • Use a sound conditioner or earplugs to block noise
  • Listen to relaxation or guided imagery audios to help fall asleep
  • Drink an herbal or relaxation tea at bedtime
  • Have a bedtime snack with protein

Other Causes of Fatigue

Besides the medical conditions listed above, there are many other potential causes of fatigue, such as other health problems (for example, chronic kidney or liver disease, infection, alcohol or drug abuse) and medication side effects. Some people also report that altering their diet has improved their fatigue, whether thats eliminating gluten, sugar, or dairy. 

A Word from Verywell

In the end, it's important to have your fatigue thoroughly evaluated by a doctor. Often times, there is more than once cause, like your thyroid disease and another contributing factor or condition. 

Remain resilient as you navigate your fatigue, which may be a daily battle for some.

Sources:

Ahmad J Tagoe CE. Fibromyalgia and chronic widespread pain in autoimmune thyroid disease. Clin Rheumatol. 2014 Jul;33(7):885-91.

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.

Takeuchi S et al. Relationship between sleep apnea and thyroid function. Sleep Breath. 2015 Mar;19(1):85-9.