Five Early Signs Of Hypothyroidism (TTE20)

Hi, I am Dr Eric Balcavage, and welcome back for another edition of Thyroid Thursday.   

Today, we are going to talk about the five earliest symptoms of hypothyroidism.  Now, I want to make sure you understand, we are not talking about when the gland goes bad, because if you’ve watched any number of these videos, I talk about tissue or cellular hypothyroidism as being the beginning of a thyroid process. 

  

If you develop symptoms of hypothyroidism, those symptoms aren’t the result of the gland going bad initially. Those symptoms are the result of not enough thyroid hormone getting to the peripheral tissues, and that occurs or can occur for days, weeks, months or years before the gland actually goes bad.  The biggest problem we see in how people are evaluated and treated for hypothyroidism is that medical doctors and endocrinologists are looking for disease or dysfunction of the gland when they run a TSH and T4.  They are not looking for, or even considering many times, the fact that hypothyroidism symptoms start as a result of decreased thyroid hormone to the tissues, not when the gland goes bad.  So, tissue or cellular hypothyroidism is where we develop symptoms first.  So, let’s talk about the earliest symptoms of tissue or cellular hypothyroidism that starts long before your TSH and T4 are going to go out of range. 

The first, most common symptom of hypothyroidism at a cellular level is fatigue.  So, this is not the fatigue where, “Hey, I just didn’t sleep last night, so therefore I am tired, or I exercised really hard and I’m tired”.  This is the fatigue or tiredness that you just can’t shake.  It is at your very core and it is just a drag to try and do almost anything through the day.  You work your way through it and you try and drive yourself through it with caffeine or other stimulants to try and help you through the day.  You are just not the same person because you just don’t have the energy, but especially as a mom or a working professional, you drag yourself through the day, but this is the unrelenting tiredness and fatigue that nothing seems to shake.

   

Now, why would low thyroid hormone cause that?  Well, thyroid hormone is responsible for the metabolism of the cells and how the cells make energy.  So, without optimal metabolism, without the ability to make energy, you just don’t have sufficient energy to do all the processes that need to be done.  So, fatigue is one of the earliest signs of hypothyroidism at your peripheral cells and at your peripheral tissues, and it is going to occur long before TSH and T4 are considered out of range or abnormal. 

The next is weight gain.  This is weight gain that really you don’t have a great answer for why it is occurring. Your diet hasn’t changed too much; your exercise routine hasn’t changed too much.  Nothing has really changed too much and yet you seem to be putting on weight.  You may be a little bit puffy.  You may feel like you are retaining fluids.  This is a very early sign or indicator that you are having hypothyroidism in your peripheral tissues.  Again, this can occur long before the TSH and the T4 go out of range, long before the gland becomes diseased and dysfunctional.  The gland can make plenty of T4, but if it can’t get it into the peripheral cells, to be converted into T3 and bind to the receptors, you are going to have these symptoms.  So, weight gain is going to be that second most common symptom of tissue or cellular hypothyroidism. 

The third is decreased circulation.  So, if you have the sense of being cold when you shouldn’t be, I think today it is probably 97-98 degrees at my house, but you may be in that same environment and you may be in those environments where you’re just cold all the time, your hands are cold and your feet are cold.  Decreased circulation is a common, very common symptom of tissue or cellular hypothyroidism.  So, this is one of those issues where you just can’t get good blood flow to the extremities, to the tissues, and not only are you going to potentially have cold extremities, but you may also see it as dry skin and thinning hair.  You are not necessarily going to have patches of hair falling out, but when you brush your hair or you get a shower, you may find that there is more hair laying on the floor or laying in the shower than there should be, and it is a result of cellular hypothyroidism and decreased circulation. 

The fourth is brain fog.  One of the biggest consumers of energy is the brain.  You’ve got neurons that just generate or need to generate lots of energy for function.  There is a lot going on up there and if you have reduced circulation due to poor thyroid hormone physiology in your cells, or you just can’t make enough energy or the metabolism is slow or you can’t make neurotransmitters, the brain just isn’t going to work the way it should.  So, you are going to have this brain fog and this brain fatigue and your memory is going to decline, and your ability to focus and pay attention may be compromised.  You may even develop headaches as a result of it.  So, this is the fourth most common symptom. 

The last is depression.  I almost hate to say depression, but I’d say this is a sense of melancholy or sadness. It’s not that depression is the reason you have the issues, and a lot of people are afraid to admit that maybe they’re sad or depressed, but what happens is you need thyroid hormone in your cells to help make and generate neurotransmitters, and the two biggies are serotonin and dopamine.  Those are the feel good neurotransmitters.   

If you have poor thyroid hormone physiology in your peripheral tissues and cells, you are going to struggle to make appropriate levels of thyroid hormone, and one of the most important things that actually causes tissue or cellular hypothyroid in the first place is inflammation.  Inflammation will increase the rate at which you clear serotonin out of the body.  So, some research says that when you have inflammatory mechanism at play, it can actually increase the rate at which you clear serotonin 2000 fold.  So, that means that you don’t have enough serotonin hanging around to help you feel happy.  So, you can be sad and you can feel the sense of depression or just blah as a result of the inflammatory mechanism that are driving your tissue hypothyroidism and also causing you to deplete serotonin and making you sad or blue. 

Not only can it encourage those symptoms, but it can also impact sleep, because serotonin is used to make melatonin, which is one of the neurotransmitters that help with sleep cycles.  So, these are the five early signs of tissue or cellular hypothyroidism which occurs days, weeks, months or years before the thyroid gland starts to become diseased or damaged, long before the TSH and T4 values will go out of range.  So, if you have these symptoms, you might as well start looking for a functional medical practitioner like myself to start addressing these things, because you need more than a TSH and T4 to evaluate these.   

I need to look at your history, I need to look at all of your symptoms, I need to look at what medications you’re on and I need to take a look at your labs.  By putting all of those things together, we can determine if what you are struggling with is this tissue or cellular hypothyroidism, and more importantly we can start to get an idea of why you have it in the first place, and then how do we go about fixing it or correcting it. 

So, if you have some interest, if you have these symptoms and you’ve been told you don’t have a thyroid problem because your TSH and T4 values are normal, if you have an interest in gaining some help with this, there are two options; you can call my office directly at 610-558-8920 and ask to schedule a thyroid appointment, or the second option is if you are a little on the fence, but you want to talk about it, there should be a link below the video where you can click to schedule a 15 minute consultation with me over one of my lunch periods and we can talk about your condition, and if it seems like a good match or good fit, then I will point you in the direction back to my staff to schedule an appointment and we’ll see what we can do to start helping you.  

I hope this Thyroid Thursday edition has helped.  I look forward to more of these in the coming weeks.