Thyroid links to depression, lethargy

Tired female executive with hand on head during a meeting

Depression, lethargy, thyroid disease and the art of asking the right questions


I’ve heard the story over and over from hundreds of women, and I’ve experienced it myself: “I feel so bad: exhausted, irritable, crying for no reason, anxiety, memory issues, muscle fatigue, aching limbs …”

A girlfriend said recently: “You Google the symptoms and they are the same for each disease. You think you have something horrible like Alzheimer’s, you think you have some degenerative or auto-immune condition. Your hair is breaking, you are always cold or too hot, you can’t sleep. These are the symptoms of everything. So I always panic.”

But because they are manifestations of so many things, if you are a female over the age of 45 and present to the doctor with these symptoms there are usually just two culprits doctors will privilege first: menopause and mental health (depression, anxiety, stress). Menopause has all these lovely symptoms and more. And what’s more, as you try to find the right hormone replacement therapy with hits and misses, the cure is often worse than the disease.

Depression is something that also has similar features. Myself a sufferer, when the black dog bites I get confused, cold, achy and lethargic, as it affects motor skills. Most women will be suffering one or the other — or both — in a lifetime, which is why these ailments are a first port of call.

From experience, while general blood tests are usually taken to rule out anything sinister, often further more sensitive tests for other causes aren’t done until the meds kick in with no results or are tweaked again to no avail. No wonder a lot of women cry for seemingly no reason.

But subtle changes to how symptoms are diagnosed and viewed are making things a lot easier. I call it the healing-by-back­story technique and it is helping me enormously.

Healing by B&B (back & back) is the trend I’ve started to notice among the medical and scientific community, including leading neuroscientists, to explore more fully the role of subtle precursor disorders in ill health, then to go back further again to the precursors of the precursors. For instance, psychiatrist Norman Doidge, author of the bible of neuroplasticity, The Brain That Changes Itself, is a huge believer in the gut-brain connection and its role in mental health — and when he was visiting recently I noted over dinner that he carried a host of enzymes and nutrients in tablet form for gut health.

My B&B journey into fatigue yielded surprising results. Thyroid disease, in my experience, is about third on the list of possibilities that medicos put on the table for these symptoms.

Doctors will almost always do a standard general TSH test when doing diagnostic bloods. TSH, the pituitary hormone, stimulates the thyroid gland to make and release the thyroid hormones (T4 and T3). When thyroid hormone levels decrease, the TSH rises; in other words, it’s working hard to stay normal in an underactive thyroid (and vice versa).

My tests have usually come back normal so have been ignored but, in light of my symptoms, my GP wanted more sensitive tests — which is often considered over-testing and discouraged by the medical system. She also was aware that certain countries have different baselines. I would have been considered hypothyroid (sluggish) in the US. The lab range used for routine testing has been a controversial topic in medicine in recent years, hotly contested between American endocrinologists.

New York doctor Raphael Kellman, founder of the Kellman Centre for Functional and Integrative Medicine, wrote recently in the Huffington Post that he sees hundreds of patients with thyroid disease symptoms but with normal test results for this very reason. It’s estimated that about 200 million people in the world (mainly women) have some form of thyroid disease. The number of 10 per cent is often quoted.

On further tests my antibodies were normal and everything else was in range (albeit borderline). Another doctor might have dismissed me there and then. But the way my tests were trending made my GP dig even deeper.

She sent me off to have a thyroid ultrasound and there it was in pictures: signs of diffuse thyroid disease, the beginnings of hypothyroidism — and, given the importance of thyroid hormone, enough to worsen my HRT and depression.

Thyroid disorders are quite manageable and some are reversible with meds, vitamins, exercise, all manner of healing tools allopathic and natural — but first I decided to go B&B again to find a possible deeper cause. It’s just common sense. There’s no use taking any vitamins or helpful foods or medicines if your body won’t absorb or process them. As I recently wrote, the gut is the main precursor to a variety of ailments, according to German microbiologist Giulia Enders’s bestseller, Gut: The Inside Story of Our Body’s Most Underrated Organ.

A test determined I did have overgrowth of certain bacteria and needed a program to assist the healing. Easily done.

But not just over-the-counter probiotics, which can exacerbate some growths such as candida; rather, specifically targeted treatment prescribed by a specialist.

In my efforts to heal by B&B, my GP also suggested she test me for the MTHFR gene mutation, which I will do soon. It’s a common mutation but seriously damaging because those with it have a defective enzyme that can severely affect how well the body converts and assimilates folic acid (B9) — critical to every bodily function including tissue growth, DNA, heart, mental health, immune function and inflammation; hence thyroid regulation. Once again, unless requested, most standard tests don’t show what vitamins are active; rather, what’s in the system. Diagnosis is by simple local blood test and it can be easy to treat.

Supplements are given by way of folinic acid rather than standard folic acid (in lay terms a bioavailable form) and a methylated form of B12 — journalist Elisa Black wrote in her The Anxiety Book that having the right Bs has done wonders to her energy and health, and her anxiety is gone.

I went to see natural health practitioner Lucy Herron, co-founder of the nationwide Lucy Rose Clinic chain, which specialises in thyroid health. She gave me a slew of tests and a good solid education of what I’m dealing with and how I can assist my body.

Encouraged by her guidance I went to a conference with thyroid expert David Brownstein, award-winning US-based integrative medicine doctor who believes in prescribing high-dose iodine supplements after doing tests to determine the level of deficiency. His book Iodine: Why You Need It, Why You Can’t Live Without It has created controversy in the medical profession about possible side effects of too much iodine and iodide.

But Brownstein argues iodine is essential and the soil is an inadequate provider. And although it’s now out of fashion, in the early 1900s the Encyclopaedia Britannica described iodine as being “of definite value” for treatment of multiple conditions including asthma, aneurysm, bronchitis, syphilis, gout — albeit at a gobsmacking 100 times what we now consider safe.

A 24-hour urine load test proved I was significantly iodine deficient, another gammy precursor that needs fixing in the battle to achieving good health.

At the moment the verdict is out: it’s too soon to tell the results of my B&B explorations. But I feel healthy in my heart because I feel self-empowered over my body. No, girls, it’s not easy to get the answers — but at least we can start by asking some really great questions, which is where true healing begins.

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