The most common cause of hypothyroidism, the autoimmune thyroid disease known as Hashimoto’s, has been found to cause fatigue and other symptoms of thyroid problems, such as weight gain, dry hair, constipation, and difficulty concentrating, even when thyroid function is “normal.” In other words, even if lab tests show normal thyroid hormone levels, it is still possible to experience classic hypothyroidism symptoms like chronic fatigue.
What is autoimmune thyroid disease (Hashimoto’s)?
Hashimoto’s is one of the most common autoimmune disorders, occurring when the immune system produces an antibody that attacks the thyroid gland. This results in inflammation of the thyroid gland and often leads to decreased thyroid function, otherwise known as hypothyroidism. Hypothyroidism most commonly affects middle-aged women and is associated with decreased quality of life and an array of symptoms of which chronic fatigue is the most common.
Symptoms of thyroid problems (hypothyroidism) include:
- Fatigue, loss of energy, lethargy
- Weight gain
- Cold intolerance
- Dry skin
- Hair loss
- Muscle pain, joint pain, weakness in the extremities
- Emotional lability (nervousness, irritability)
- Forgetfulness, impaired memory, inability to concentrate
- Menstrual disturbances, impaired fertility
Researchers find symptoms occur whether labs show thyroid function is normal or not
Even if antibodies against the thyroid gland don’t cause hypothyroidism (thyroid hormone levels below the normal range,) researchers have for shown that high levels of anti-thyroid antibodies may still cause symptoms. Dr. Johannes Ott and colleagues from the Medical University of Vienna, Austria, published a study in the medical journal Thyroid showing that even when thyroid function is normal, high levels of anti-thyroid antibodies, indicating autoimmune thyroid disease, are associated with increased symptoms like fatigue and decreased overall quality of life.
The Austrian researchers found that women with higher levels of antibodies against their thyroid glands had a significantly higher number of symptoms, even though their levels of thyroid-stimulating hormone (TSH)—a measure of thyroid function—did not differ from TSH levels measured in women with lower antibody levels. The researchers concluded that hypothyroidism is only one factor contributing to Hashimoto’s symptoms.
Many with thyroid symptoms are not receiving adequate diagnosis and treatment
The study raises important issues about thyroid disease—issues that healthcare practitioners specializing in natural and integrative medicine have already been addressing for some time but that the conventional medical community has not: many people are told their thyroid function is normal and are not offered treatment, even though they are suffering from thyroid-related symptoms due to autoimmune thyroid disease. Not only that, but many patients who are being treated for hypothyroidism are still suffering from symptoms, even though their thyroid hormone levels are “normal” with treatment.
Both of these scenarios (not being offered treatment or receiving inadequate treatment) ends up leaving too many people suffering from chronic fatigue and other hypothyroid symptoms. The fact is, anyone with abnormally high anti-thyroid antibody levels and suffering from hypothyroid symptoms may need treatment with thyroid hormone whether they have abnormal thyroid function based on the standard test—TSH—or not. For some individuals, standard hypothyroidism treatments will help. But for others, additional therapies may be necessary to treat the autoimmune disorder itself.
Natural treatment of hypothyroidism and autoimmune thyroid disease (Hashimoto’s)
Autoimmune conditions, including Hashimoto’s, often require more comprehensive treatment incorporating diet and lifestyle changes and supplementation with thyroid-supportive nutrients and herbs. Natural therapies to support the body’s detoxification and anti-inflammatory pathways may also be utilized and help decrease symptoms related to autoimmune thyroid disease. For a detailed discussion of evaluation and treatment of fatigue related to hypothyroidism and autoimmune thyroid disease, see our Comprehensive Guide to Fatigue.