Thyroid

One of the first and most important things to consider in CFS is the functioning of the thyroid. Many people with CFS have a compromised thyroid function. It helps to have a doctor who is alert to this possibility. There are many books (see Reading) and sites on the internet discussing this phenomenon. The Patient Advocate does not learn about thyroid overnight. It takes time, sometimes longer than one would want. Certain doctors are more alert to the complexities of thyroid functioning. It is important that the Patient Advocate concerns himself with this issue, not as a doctor, but as an advocate. The thyroid has to be fixed first. According to Dr Ridha Arem (The Thyroid Solution), a smooth functioning thyroid in necessary to recovery.

Testing for thyroid function includes blood tests for TSH, free t3, free t4, TPO antibodies, ferritin and a few other things. Treatment will depend on the results of these tests - and on symptoms. It is important to get a good doctor.

While many CFS patients have an underactive thyroid, others can have an autoimmune disease called Hashimoto’s thyroiditis. Hashimoto’s mimics CFS in many symptoms: fatigue, brain fog, light sensitivity, and weight gain. The diagnosis of Hashimoto’s is primarily through elevated TPO antibodies, indicating that the body is attacking itself.

My patient has Hashimoto’s thyroiditis. My patient was diagnosed with HAIT by an endocrinologist in NYC in 2003. This endocrinologist decided to do nothing. The consequence of this decision is not known, although the Patient Advocate can speculate that this was “not good”. Subsequently, as symptoms - weight gain, light sensitivity, brain fog, goiter and TPO antibodies - worsened, my patient began taking Armour thyroid. A year and a half later we are still working to get it right.

There is a great amount of information available about diagnoses and treatment for hypothyroidism and Hashimoto’s thyroiditis on the internet. Various message boards and websites such as stopthethyroidmadness.com and realthyroidhelp.com can be very helpful in learning the language about the diagnosis and treatment of thyroid problems.

Problems with thyroid regulation can be complex and ongoing, and most patients will say that it takes some doing, over time, to successfully deal with them. In certain cases, most of the CFS symptoms will recede when the thyroid is normalized, but that is in a minority of cases. In most cases, some benefit is derived from treatment - so it is worth the effort.

A prudent Patient Advocate would attend to thyroid at the very beginning of the illness, and try to determine where and how it might be involved in the particular fatigue situation. Hashimoto’s, or hypothyroidism, is one of the few areas of the CFS picture that is clearly delineated. This dysregulation can be treated. For emphasis, I will repeat this: Hypothyroidism is the one very specific physical observation in this pathology that can be identified and treated. Hashimoto’s thyroiditis (myxedema) has been around for a long time, as has the treatment of thyroid hormone (Armour thyroid). People have been successfully taking desiccated thyroid for over 100 years.