Midlife Fatigue, or is Your Thyroid Slowing Down?

Don’t ignore the symptoms of hypothyroidism.

You’re nearing, into, or just past your fabulous 50s. Lately, you’ve felt more tired than ever before. Weight gain happens despite eating less or about the same. And “aches and pains” are creeping in far more often. Is it normal midlife aging, menopause (for women), a sleep disorder, or could it be a condition called hypothyroidism?

What does your thyroid do?

Hypothyroidism is the medical term for saying you have an underactive thyroid. The thyroid has two sides, or lobes. It sits in the front area of your neck, just below the Adam’s apple. Each lobe is about five centimeters long, three centimeters wide and two centimeters thick.

Your thyroid gland releases the hormones triiodothyronine (T3) and thyroxine (T4). These hormones play an important role in managing our cell metabolism, the process in which cells produce energy. As a result, they help in body temperature regulation, ensuring a healthy heart rate, muscle strength, food digestion, brain function, cholesterol levels and more.

Why does hypothyroidism happen?

“The most typical cause of hypothyroidism in the United States is an autoimmune disorder called Hashimoto’s thyroiditis, also known as chronic lymphocytic thyroiditis,” says Rajesh Garg, M.D., an expert in endocrinology, metabolism and diabetes at the University of Miami Health System. “This is when a person’s antibodies get directed against his or her thyroid gland.”

According to Dr. Garg, antibodies normally intended to help protect us against the external harmful materials like infections, are formed against the thyroid and lead to its chronic inflammation. This, in turn, decreases the thyroid’s ability to produce the hormones we need.

“Additional causes of hypothyroidism include past treatment for hyperthyroidism (an overactive thyroid), thyroid surgery, and some medications,” he adds. “Hypothyroidism, or another thyroid disorder, can occur during or after a pregnancy. It is important to be monitored by your doctor for these reasons.”

What are the risks of untreated hypothyroidism?

The trouble with an underactive thyroid is that the lack of hormones it creates have a big influence on other parts of our health.

“Left untreated, hypothyroidism can increase your risk of developing high cholesterol, heart disease and depression,” says Dr. Garg. “However, contrary to common belief, hypothyroidism is not a major cause of weight gain.”

The challenge? According to the American Thyroid Association, it is estimated that 60 percent of the 20 million Americans with a form of thyroid disease are unaware that they have it. This is because the early symptoms can have a slow, gradual onset. You may not even connect them to a possible thyroid condition.

What are the signs and symptoms of thyroid disease?

These are some of the most common risk factors and symptoms. If you notice them in combination, contact your doctor for an appointment.

• Fatigue
• Being over age 50, especially a woman over age 60
• Past thyroid surgery
• Constipation
• Dry skin
• Family history of an autoimmune disease
• Treatment with radioactive iodine
• Muscle or joint weakness, aches, tenderness, stiffness, pain
• For women, heavier than average or irregular menstrual periods
• Enlarged thyroid gland (also called goiter)
• Women are five to eight times more likely to have thyroid problems
• Memory challenges

Diagnosis and Treatment

Thyroid function tests are readily available to help your doctor diagnose a possible thyroid disorder. A blood test measures for the amount of thyroid-stimulating hormone (TSH) in your body.

“Once diagnosed and treated, the symptoms typically improve rather quickly,” shares Dr. Garg. “After that, we see thyroid patients once or twice a year to ensure continued health.”

Therapies for hypothyroidism usually include treatment with synthetic thyroid hormones. Your doctor would prescribe such a medication, which can be taken orally, by mouth each day.

If you experience some of the symptoms listed above, or seek advice about thyroid health issues, call the University of Miami Health System at 305-243-4000 or 1-800-432-0191.

John Senall is a contributing writer for the UMiami Health News Blog. He is a former hospital and comprehensive cancer center communications director.

Tags: chronic lymphocytic thyroiditis, Dr. Rajesh Garg, Hashimoto's thyroiditis, hypothyroidism, thyroid disorder