Fatigue: Thyroid Issues and Their Impact on Daily Life

Q: Fatigue: Thyroid Issues and Their Impact on Daily Life

Dear Huihui： I'm not sure if there are any issues related to emotional stress. <br>Hypothyroidism can present similar symptoms, but it's rare to encounter the situations mentioned above. <br>I'm wondering if there are other factors, such as stress, that could be affecting you. <b

Recently, I have been feeling fatigued frequently?

I have thyroid atrophy and have regular follow-up appointments.
Last month, my check-up went well, but for the past week and a half, I have been feeling increasingly fatigued.
I usually go to bed around 9 PM and wake up at 5:30 AM to shower and prepare for work.
However, in the past two weeks, my bedtime has been getting earlier, and I feel tired earlier in the morning as well.
Initially, I felt tired around 8 or 9 PM, then by 4 or 5 PM the next day, and now I feel fatigued shortly after waking up.
Recently, I feel tired shortly after getting out of bed.
Since I have to work, I rely on eating to stay awake, but I'm not sure if I'm feeling sleepy because I'm not eating enough or if I'm eating because I'm tired.
For example, a few days ago, I woke up around 5 AM, felt tired again, and went back to sleep.
I woke up around 9 AM but still felt exhausted and couldn't fall back asleep until around noon.
After showering, I felt tired and had difficulty breathing.
I left for work at 12:30 PM after eating a large bowl of beef noodles, which gave me a bit of energy, and I also bought three pieces of bread.
By 1 PM, I felt fatigued again, and after eating another piece of bread around 1 PM, I still felt tired.
Before starting work around 2:30 PM, I ate another piece of bread, which gave me a little energy.
However, by 3 PM, I felt tired again and managed to hold on until after 4 PM when I had another large bowl of beef noodles, which provided some energy.
After work at 7 PM, I came home, ate some bread, and fell asleep.
Lately, I can't tell if I'm tired because I'm hungry or if I'm hungry because I'm tired.
Additionally, the hot weather and stuffy environment make it hard to breathe.
I've experienced this before; once, when it was too hot and stuffy, I felt like I couldn't breathe while taking a shower.
I rushed to get dressed and lay down in my room, not waking up until the evening.

A few years ago, my menstrual cycle became irregular.
Initially, my periods were on time, lasting 5 to 7 days (with a normal flow), but after a week of rest, I would have another period that was dark and scant, lasting about 2 to 4 days.
It was previously suggested that this was due to my thyroid condition, which caused incomplete shedding, so I didn't pay much attention to it.
However, last month, after a normal period, I had a few days of rest, and then the dark, scant flow returned for an entire month.
Now, this month, I had a normal period, rested for a few days, and then the dark, scant flow returned again, which is still ongoing.
I have also always had difficulty with sugar, overly sweet, or salty foods, as they make me feel dizzy and nauseous.
What could be happening? Is it because my thyroid is not well-controlled? However, during my appointment on March 21, the report didn't indicate any issues, and I take my medication as prescribed by my doctor every morning before leaving the house.

Huihui, 30~39 year old female. Ask Date: 2016/04/22

Dr. Zhou Jiazhen reply Breast and Thyroid

Dear Huihui: I'm not sure if there are any issues related to emotional stress.
Hypothyroidism can present similar symptoms, but it's rare to encounter the situations mentioned above.
I'm wondering if there are other factors, such as stress, that could be affecting you.
If thyroid tests and blood work are normal, sometimes an internal medicine evaluation may be necessary.

Reply Date: 2016/04/22

More Info

Fatigue can be a complex issue, especially when it is intertwined with thyroid problems. In your case, it seems that you have a history of thyroid issues, specifically thyroid atrophy, and you are currently experiencing increased fatigue and other symptoms that could be related to your thyroid condition or other underlying factors.

Thyroid hormones play a crucial role in regulating metabolism, energy levels, and overall bodily functions. When thyroid function is impaired, it can lead to a range of symptoms, including fatigue, weight changes, mood disturbances, and alterations in appetite. In your situation, the fatigue you are experiencing could be attributed to several factors:
1. Thyroid Hormone Levels: Even if your recent lab results did not indicate a significant issue, thyroid hormone levels can fluctuate. It’s essential to have regular check-ups and blood tests to monitor your TSH, Free T4, and Free T3 levels. If these levels are not within the normal range, it could explain your fatigue and other symptoms.

2. Sleep Quality: You mentioned that you are going to bed early and waking up feeling tired. This could indicate that your sleep quality is poor, possibly due to sleep apnea or other sleep disorders. It’s important to assess whether you are getting restorative sleep. Keeping a sleep diary or using a sleep tracker might help identify patterns or disturbances in your sleep.

3. Diet and Nutrition: Your eating habits seem to be closely linked to your fatigue. It’s possible that you are not consuming enough calories or the right balance of nutrients to sustain your energy levels throughout the day. A diet lacking in essential vitamins and minerals, particularly iron, vitamin D, and B vitamins, can contribute to feelings of fatigue. Consider consulting a nutritionist to evaluate your diet and make necessary adjustments.

4. Hydration: You mentioned feeling breathless in hot and stuffy environments. Dehydration can lead to fatigue and decreased energy levels. Ensure you are drinking enough water throughout the day, especially in warmer weather.

5. Mental Health: Given your history of thyroid issues and potential mood disturbances, it’s crucial to consider the psychological aspect of fatigue. Anxiety and depression can significantly affect energy levels and motivation. If you are feeling overwhelmed or stressed, it may be beneficial to speak with a mental health professional.

6. Hormonal Imbalances: Your irregular menstrual cycles and the presence of dark, coffee-colored discharge could indicate hormonal imbalances that may need further investigation. Thyroid dysfunction can affect menstrual cycles, but other hormonal issues, such as those related to the adrenal glands or reproductive hormones, could also be at play.

7. Environmental Factors: You mentioned feeling fatigued in hot and stuffy environments. This could be a sign that your body is struggling to cope with heat, which can exacerbate feelings of fatigue. Ensuring proper ventilation and cooling in your living and working spaces can help.

In summary, while your thyroid condition may be contributing to your fatigue, it is essential to consider a holistic approach that includes monitoring thyroid hormone levels, improving sleep quality, optimizing nutrition, staying hydrated, addressing mental health, and evaluating hormonal balance. Regular follow-ups with your healthcare provider are crucial to managing your thyroid condition effectively and addressing any new or worsening symptoms. If your fatigue persists despite these measures, further evaluation may be necessary to rule out other underlying conditions.

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