Dr. Aviva Romm Explains the Thy Gap (3:26)
Just recently a patient came into my practice feeling fatigued, moody, was having heavy periods, no libido, and was bothered by constipation. She also wasn’t sleeping well – waking up too early in the morning and unable to fall back to sleep, and she’d gained 7 pounds in just a couple of months even though she hadn’t changed her eating habits.
All are signs of hypothyroidism.
We talked. She really didn’t feel that stress was causing her symptoms – nothing in her life was really that troublesome. She had no outlier symptoms that suggested another diagnosis. She was pretty sure something was wrong with her thyroid so she’d asked her primary doctor to check her thyroid labs before scheduling to come see me for an more integrative medicine consult. He’d checked her thyroid stimulating hormone (TSH) test only, and told her that since it was still in the normal range, even though it was at the upper end of normal, she did not have a thyroid problem. He sent her on her way suggesting that maybe an antidepressant would be good to consider.
But her labs weren’t normal. One step over a very thin line and she’d have had a slam dunk diagnosis of the most common thyroid problem: hypothyroidism. And in fact, this is what I diagnosed. She started appropriate treatment and her energy and symptoms quickly began to improve! This is a typical story.
Getting to The Bottom of Thyroid Testing
While not all hypothyroid-like symptoms turn out to be a problem with the thyroid or thyroid hormones, we do know that statistically, hypothyroidism is an under-diagnosed condition. In fact, only about half of Americans with a thyroid problem know they have one, and it is estimated that this can be as many as 4-10% of Americans
Hypothyroidism is the most common thyroid problem, and Hashimoto’s disease, an autoimmune form of hypothyroidism, is the most common form of all. Women are much more likely than men to have thyroid problems. Hypothyroidism can appear at anytime but is especially common after childbirth and is prevalent in woman in their 40s and 50s.
Yet so many doctors seem reluctant to do an adequate work-up of thyroid function. Some even refuse! This seems strange given how common thyroid problems are, and yet they are quite willing to freely prescribe antidepressants. My patient’s doctor was doing just what we were all told to do in medical school – check the TSH and if that’s within what we were told is the normal range, there’s no problem. But there’s much more complexity to thyroid testing than that! Sadly, so many women are left believing that their symptoms of depression, fatigue, joint aches, weakness, weight gain and more are all in their head! Perhaps this has even happened to you. In reality, your symptoms could be due to hypothyroidism.