Dr. David Clark, DC - Durham, NC -- explains how to determine if your symptoms are caused by thyroid dysfunction, stress...or both.
How do we figure out the difference between stress and low thyroid?
I see a lot of moms and sometimes I get the question,
"How do I know that I'm not just stressed out and it's not low thyroid causing my symtpoms?"
What if you had these symptoms:
- unexplained weight gain
- brittle nails
- cold hands and feet
- joint pain
These symptoms could be symptoms of a stress response (a very bad one) or these symptoms could mean that you are hypothyroid. The correct answer to the question will help determine the correct way to help you. The wrong answer prolongs your suffering.
So let's explain that for a second. If you're low thyroid what does that even mean?
It's kind of a word game.
Feeling low thyroid means for some reason your body is not responding to the thyroid hormones that you make (or take).
Being low thyroid means you don't make enough thyroid hormones (and also, just to be confusing, it also can indicate that you're making the hormones just fine, but not responding to them).
There are about 24 different ways that your thyroid hormone physiology can go wrong.
The most common kind of hypothyroidism is called Hashimoto's. Hashimoto's is actually an autoimmune disease in which your immune system attacks and destroys your thyroid gland. Your thyroid gland is how you make thyroid hormones, and over time your thyroid hormone levels go down and down and down...and you start suffering the low thyroid symptoms.
What do thyroid hormones do in your body?
Every cell in your body has a little receptor for thyroid hormones. They're critical to normal body function. Most people associate thyroid hormones with body temperature or whether you gain weight or not... and certainly thyroid hormones have a direct relationship to your metabolic rate.
Think of it like this....when you get in your car and you turn the key on and you don't have your foot on the gas pedal...the car is idling.
This is like your Basal Metabolic Rate (BMR). Thyroid hormones basically determine your basal metabolic--or idle--and so they have a lot to do with your ability to gain weight or lose weight.
How do you determine if it's stress symptoms versus low thyroid?
Well, there's really no way to do it based on symptoms. You have to get appropriately tested.
For a stress response, you'd want to look at an Adrenal Stress Index using salivary testing to look at cortisol levels, DHEA and 17-OH Progesterone.
At the same time, should get a thyroid workup.
Now, let me tell you if you go to your family doctor, they're not going want to run a complete thyroid panel that you need to have in order to find out if you've got a thyroid problem.
What they're going to want to run is a TSH itself. TSH stands for thyroid stimulating hormone. Without going into all the science, a TSH level is only going to get you in the ballpark for one or two of those 24 possible reasons.
Your doctor may want to run a T4 along with a TSH, which gets you a little further into the ballpark. But for a full thyroid workup there's several different markers you have to get:
- T3 uptake
- Reverse T3
- Free T4
- Free T3
- And most importantly TPO antibodies and thyroglobulin antibodies because those two antibody tests will tell you if you've got Hashimoto's.
You've got to understand that Hashimoto's is an autoimmune condition. Your immune system is attacking your thyroid gland. You no longer "tolerate" yourself. This broken rule puts your whole body on the menu, not just your thyroid gland.
So having Hashimoto's can cause all those symptoms we just talked about: fatigue, unexplained weight gain, depression, all those things. But, having one autoimmune tissue attack often leads to autoimmune attack on other tissues.
Hashimoto's is a quality of life-threatening condition.
How do you know if you're just stressed out because you're an active mom, or if you have hypothyroidism?
The only way to find out is to get the right tests.
You need to find someone who understands how to interpret adrenal salivary testing and thyroid testing froma FUNCTIONAL perspective. I'm telling you, many well-meaning doctors will want to put you on cortisol or other hormones right away. That can be a mistake.
You don't necessarily need hormones right away just because of your symptoms. You have to find someone that understands how this "whole thing works" ...who won't just automatically recommend hormones or some supplements...who won't say "Take these hormones/supplements because your symptoms indicate your adrenal glands are weak."
It's definitely more complicated than that simplistic model.
Now, to determine if it's thyroid you've got to do the right workup (see the above list). And you'll need someone who understands all those different 24 patterns.
Hashimoto's is by far the most common (and the most concerning). But, a stress response can cause low thyroid symptoms.
It gets very complex. You've got to find someone that understands a functional way of looking at your compliant rather than just saying, "Hey, you have fatigue and weight gain and constipation? Take this."
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© 2012 David Clark. All Rights Reserved.
Dr. David Clark, DC
Functional Neurologist (FACFN)
Diplomate College of Clinical Nutrition
Board Certified Chiropractic Neurologist
Vestibular Rehab Specialist (ACNB)
Disclaimer: The contents of this site are for educational purposes only. Nothing here should be construed as medical advice. Nothing here is a substitute for actual medical care. Consult a qualified healthcare professional.