Thyroid Function and Fatigue

Many people suffering from symptoms associated with fatigue wonder if they have a thyroid problem. Indeed thyroid disease is extremely common and an underactive thyroid can cause fatigue, sluggishness, brain fog, temperature regulation problems among other symptoms that can also be put down to CFS. Primary care doctors often tell patients that their thyroid tests are normal but sub-clinical thyroid disease and a condition called thyroiditis can lead to destabilisation of health without showing up on initial blood tests.

Similarly people treated with thyroid medication  such as levothyroxine to treat an underactive thyroid are often told by their primary care doctors that their thyroid blood tests are “in range” when in fact they are not optimised.

If you are treated with thyroid medication but feel that you still have symptoms of an underactive thyroid or if your thyroid tests are borderline you should ask your doctor about seeing a thyroid specialist to ensure your thyroid function is not just “in range” but optimised for you.

Here are some questions and answers from a recent article by me published in JLife 2014

How can I lose weight successfully despite thyroid disease?

Weight gain can occur when the thyroid is underactive. This is called hypothyroidism. If you are treated for thyroid disease and the treatment is effective, you should feel well and be able to lose weight with dietary restriction in the normal way. If you don’t, then your treatment may not be correctly optimised.

People are often told that their thyroid blood test is “in the normal range” but this can be misleading as the normal range is based on population averages and what is right for one person is not right for another. If weight management or well-being is a problem for someone with thyroid disease they need to be seen by a thyroid specialist like me who can make sure the thyroid treatment dose is optimised.


What factors that contribute to the risk of developing thyroid disease can I influence?

The most important factor that can be modified to reduce the chance of thyroid disease is iodine status. Iodine is very important for thyroid function. Deficiency can cause thyroid gland swelling (goitre) and can lead to an underactive thyroid. However too much iodine can cause the thyroid to becoming dangerously overactive. To safely avoid iodine deficiency, supplements containing very low dose iodine, such as standard A to Zinc supplements, are safe. Another way of getting enough iodine is using iodised salt instead of normal salt (remembering that too much salt is harmful!)  High dose iodine supplements can be dangerous and should be avoided.

How can I reduce the effects of fatigue?

There is no silver bullet, it takes effort, thought and persistence to overcome fatigue.

A good start to relieving fatigue is to avoid processed food. This type of food causes swings in our blood glucose due to the high refined sugar content. Reactive fatigue occurs as the blood sugar plummets later. Processed food is often deceivingly marketed to look healthy, so it is easy to overshoot on calories and gain weight.

Take vitamin D and an A to Zinc supplement (because our modern diets don’t contain enough of these essential micronutrients).

Gentle regular exercise is very good for well-being, relieving fatigue and improving sleep quality.

Establishing a sleep routine and avoiding daytime sleep to improve sleep quality is a must!

Stress is a fatigue catalyst. Life stress is the elephant in the room and needs some thought and attention.

Dr Annice Mukherjee, Hormone Consultant & Fatigue Expert