Health & Fitness

Feeling tired and low? It might be time to check your thyroid

Low mood, fatigue, and weight gain could all be signs of an underactive thyroid, also called hypothyroidism.

Have you been drained of energy recently with no obvious cause? Are you feeling anxious, gaining weight, or experiencing brain fog? If the answer is yes to any of these, it might be a good time to get your thyroid checked. 

Studies have estimated that around 200 million people across the world have a thyroid condition. An underactive thyroid, also called hypothyroidism, is the most common type, with research suggesting it affects up to 3% of the European population.

Although hypothyroidism is a common health problem, it’s often left undiagnosed, so many people don’t realize they have it. People who were assigned female at birth are 5–8 times more likely to develop a thyroid condition than people assigned male. An estimated 1 in 8 people assigned female at birth will develop a thyroid condition at some point. 

This is partly because aspects of female biology can cause hormonal changes that lead to a higher risk of developing an autoimmune disorder, which is often the cause of a thyroid condition.

What is the thyroid gland and what does it do?

The thyroid gland is a butterfly-shaped organ that sits at the front of your neck. It releases 2 hormones, triiodothyronine (T3) and thyroxine (T4), which help regulate your metabolic rate, telling all the cells in your body how much energy to use.

If you have hypothyroidism, it means your thyroid gland isn’t releasing enough T3 and T4. This can cause your metabolic rate to slow down, causing extreme tiredness and other symptoms.

What are the symptoms of hypothyroidism?

Often, hypothyroidism doesn’t have obvious symptoms in the early stages as they tend to develop slowly. Signs and symptoms to look out for include:

  • tiredness and fatigue
  • anxiety, irritability, or depression
  • weight gain
  • brain fog or poor concentration
  • irregular or heavy periods
  • dry, coarse hair
  • thinning hair
  • dry, scaly skin
  • constipation
  • sensitivity to cold temperatures
  • a puffy or swollen face
  • muscle weakness, aches, tenderness, and stiffness
  • joint pain, stiffness, or swelling
  • a slowed heart rate
  • low libido

If you have any of these signs and symptoms, a blood test can help you work out if they are caused by hypothyroidism. 

What causes underactive thyroid?

Several things can cause your thyroid to stop producing enough hormones. They include:

  • autoimmune disorders
  • iodine deficiency
  • childbirth
  • some medications
  • thyroid surgery
  • radiation therapy
  • over-response to treatment for hyperthyroidism

Worldwide, the most common cause of hypothyroidism is iodine deficiency and Hashimoto’s – an autoimmune disorder. Pregnancy is also a common cause: Around 5% of parents who give birth will develop postpartum thyroiditis several months afterward.

How do you test for an underactive thyroid?

The only way to find out if you have hypothyroidism for sure is to have a blood test to measure your levels of thyroid-stimulating hormone (TSH). If you have low levels of TSH it could mean your thyroid isn’t working properly and you may have hypothyroidism. 

Normal ranges for TSH can vary from lab to lab, and can also vary depending on your age, gender, and geography.

Measuring the levels of thyroid antibodies in your blood may also help identify the cause of hypothyroidism as it can bring autoimmune disorders such as Hashimoto’s disease to light.

Treating an underactive thyroid 

Although an underactive thyroid cannot be cured, there are ways it can be treated and managed. If you have an underactive thyroid, your doctor will prescribe you a medicine called levothyroxine that you’ll need to take daily. These tablets replace the hormone thyroxine, which your thyroid gland isn’t producing enough of.

You’ll be started on a low dose, which may increase depending on how you respond to the treatment. You will need to have regular blood tests to monitor your hormone levels as your dose is increased until you reach the right dosage. Then you’ll only need to have blood tests once or twice a year to check your hormone levels.

Can diet help treat hypothyroidism?

There’s not enough evidence to suggest that specific foods can help treat hypothyroidism, but some nutrients do play an important role in thyroid health. 

So, as well as taking your medication, it’s helpful to try to eat a healthy, balanced diet to get all the nutrients you need. 

Nutrients that can support thyroid health

  • Selenium: Selenium plays an important role in thyroid metabolism. Some studies suggest that increasing your selenium intake could help if your hypothyroidism is caused by an autoimmune disease like Hashimoto’s or by pregnancy. You can take selenium as a supplement, or increase it in your diet by eating more selenium-rich foods like turkey, Brazil nuts, and fortified cereals.
  • Iron: Iron deficiency can weaken the production of thyroid hormone. To keep your iron levels up, try eating more iron-rich foods like red meat, poultry, fish and shellfish, pulses, nuts, seeds, and fortified breakfast cereals. 
  • Zinc: Some scientific evidence suggests that zinc may help regulate thyroid metabolism and is linked to your TSH levels. Zinc deficiency affects up to 17% of the global population. Foods to eat to boost your zinc levels include beef, poultry, oysters, pumpkin, sesame, and hemp seeds, lentils and fortified breakfast cereals.  
  • Vitamin D: Low vitamin D levels have been linked to hypothyroidism caused by autoimmune diseases. If you have low vitamin D levels you can boost your dietary intake by eating foods like oily fish, liver, egg yolks, and some fortified foods. 

Foods to avoid

Some foods and drinks like soy, walnuts, cruciferous vegetables, millet, and alcohol can affect the absorption of hypothyroid medications so should be avoided if you’re undergoing treatment. 

Some supplements like calcium, iron, aluminum, chromium, and vitamin C can also interact with your medication, so always check with your doctor before taking them.

The bottom line

Hypothyroidism comes about when the thyroid doesn’t release enough of the hormones T3 and T4. It’s a condition with lots of symptoms, so the best way to be sure if you have an underactive thyroid is with a blood test. It’s not possible to cure hypothyroidism, but with medication, a balanced diet, and healthy lifestyle choices, most symptoms can be tackled and relieved.  

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