A Story
I’d like to tell you a story about a patient I recently saw. She was struggling with fatigue, moodiness, weight gain, constipation and irregular periods. She saw her primary care provider, and was told her labs were all normal. She was given a prescription for prozac, and sent on her way. She had a gut feeling that there was something else going on, and came to see me for a second opinion. We ran a complete thyroid panel (more on this later), and found that she had hypothyroidism. She started taking the correct medication, along with some diet and lifestyle changes, and felt like her self again.
I wish this were the first time I saw this type of situation, but sadly it’s not. Statistically hypothyroidism is an under diagnosed condition, and many doctors seem much more likely to hand out an antidepressant prescription than to do a full thyroid workup.
What are the symptoms of hypothyroidism?
Symptoms of hypothyroidism include:
- Fatigue
- Increased sensitivity to cold
- Constipation
- Dry skin
- Unexplained weight gain
- Cravings for sugar and carbohydrates
- Puffy face
- Muscle weakness
- Elevated blood cholesterol level
- Muscle aches, tenderness and stiffness
- Pain, stiffness or swelling in your joints
- Heavier than normal or irregular menstrual periods
- Thinning hair
- Slowed heart rate
- Depression
- Impaired memory (“Brain fog”)
Because these symptoms are so common, many women are dismissed as having depression, normal symptoms of menopause, or normal postpartum symptoms.
Laboratory Testing
The standard screening lab for hypothyroidism, TSH, is often not sufficient to make a diagnosis. In my practice, if I often I run the following labs: TSH, free T4, free T3, thyroid antibodies and reverse T3. I may also run tests for nutrient deficiencies common in patients with hypothyroidism, such as zinc, selenium and iron.
I Have A Diagnosis, Now What?
Another common problem that I see in my practice is patients who feel great when they are first put on thyroid medication, but within a month or two their symptoms return despite normal labs. For many people, hypothyroidism is a symptom of an underlying problem such as leaky gut, a chronic infection or chronic stress. If you have a diagnosis of hypothyroidism, it is important to look at all of these things and more. Stay tuned for my next blog post where I will discuss these issues in more detail.
A Doctor Who Listens
If you are experiencing the symptoms of hypothyroidism mentioned above, or already have a diagnosis of hypothyroidism but are not feeling as good as you’d like, I encourage you to set up an appointment. I will take the time to listen to all of your symptoms, and order the laboratory testing that you need. Together we will create an individualized treatment plan to get you feeling like your self again.
Here’s to you and your health!
Dr. Rebecca
