Got Fatigue? Maybe your thyroid is underactive

How is it that one of the smallest glands in the body can cause so many problems?   The thyroid is key to making hormones that get the energy we need to the body’s cells.  But sometimes, it just doesn’t do its job.

I call it having “lead legs”.  You are so tired, that when you drag yourself across the room it feels as though you have lead blocks attached to your feet.  This, and unexplained weight gain, are two of the most common signs that you have an underactive thyroid also known as Hypothyroidism.  Other symptoms include (but are not limited to)-


  • Can’t lose weight no matter what you try
  • Always feeling cold (even on a hot day)
  • Having a chronic bad hair day (dry, breaking, frizzy/coarse hair; losing hair)
  • Skin is dry, scaly
  • Painful, achy joints
  • Puffy face
  • Forgetfulness and problems focusing
  • Really bad cramps during menstruation
  • No libido


If you are saying, “Hey, that’s me!” then you may want to have a complete physical.  Share with your doctor all of the supplements, vitamins, minerals, etc. that you are taking (to make sure that they are safe and won’t interact with any medications you may need or currently take).  Since the symptoms above can be signs of many conditions, make sure that blood work is done including TSH (Thyroid Stimulating Hormone).


TSH is a chemical that pushes the Thyroid to produce more hormones.  When the TSH is high, it means the thyroid isn’t putting out enough of the hormones you need.  So, what is a normal TSH?  It depends on whom you ask.


Thyroid Stimulating Hormone (TSH) Results
Source                            Result         Diagnosis
Most Labs                     Above 5.0      Hypothyroidism
Endocrinologists*      Above 3.0      Hypothyroidism


After your blood work, review your symptoms and test results (get the actual number) and work together with your healthcare provider to determine a diagnosis.

If you get diagnosed with Hypothyroidism, you will find yourself with a prescription in hand (e.g. Synthroid).  Don’t hesitate to start taking your medication right away.  Your healthcare provider will tell you to take it on an empty stomach, an hour before breakfast.

There is a strong food:drug interaction with quite a few nutrients and thyroid medication.  What does that mean?  It means you are wasting a lot of the Thyroid medication if you take it within 4 hours of eating certain foods/nutrients because they will get in the way of absorbing it. If you can’t absorb your Thyroid medication, it won’t do you any good. So, separate thyroid medication by 4 hours from these particular foods/nutrients:


  • Calcium (calcium pill, milk, cheese, yogurt, dark green leafy veggies, calcium fortified juice and possibly your multivitamin).
  • High fiber foods (whole grain cereal, breads, rice, pasta)
  • Iron (iron pills, meats/poultry/fish, dark green leafy vegetables and possibly multivitamins)
  • Walnuts
  • Soy (tofu, soymilk, soy yogurt)
  • Cottonseed


If you are someone who wakes to a coffee with milk/cream, a bowl of Kashi cereal and milk while reading the morning paper or like to have a yogurt parfait from McDonalds™ on your way to work, taking your Thyroid medication an hour before breakfast won’t work for you.  Option 2 is to stop eating after dinner (no evening snacks), and then take that Thyroid pill at bedtime (as long as 4 hours have gone passed).


If you have the timing down on taking your Thyroid pill, then take your treatment plan one step further.  You most likely will have gained weight on your path to a diagnosis. Now you need to lose it.  To do so, consider practicing portion control.  You can also benefit in general from:


  • High fiber whole grains, fruit and vegetables (4 hours separate from your pills)
  • Heart healthy fats
  • Lean protein such as fish, chicken and turkey
  • Limiting treats (such as cookies, cake, candy, ice cream) to a small serving only 1- 3 times a week
  • Skipping fried foods


If you still can’t drop those pounds, consider seeing a Registered Dietitian for some one-on-one guidance.  Also, as important as eating right, is to get moving!.  Take off those lead blocks and do some physical activity (biking, walking, swimming, dancing, etc.) 3- 6 days a week.


Jennifer Giffune, R.D., L.D.N., is a freelance author and professional speaker.  She currently is providing nutrition counseling services for Hampden County Physician Associates at their offices in Westfield, Southwick, Feeding Hills and West Springfield. 


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