Why Am I So Tired?: Is your thyroid making you ill? - Литагент HarperCollins USD

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dosages and the appropriate food and drink are always preferable to guesswork. Once you have drawn together a symptom picture as shown in Part Two, and armed with the results of your practitioner’s tests, you can begin to recover from your tiredness and enjoy renewed vitality and well-being.

       CHAPTER THREE ‘Why Can’t I Lose Weight?’

       The Thyroid Gland and Your Weight

      JANE’S STORY

      Jane had battled with her weight since her early teens, when she consulted me she had peaked at 174lb. With her height at 5ft her ideal weight was 120-130lb.

      THE CONSULTATION

      At her initial consultation Jane was aged 27 years, and in spite of a careful diet she had increased her weight by 5-6lb a month over the previous six months. Prior to this Jane had always been a lively, happy young woman with a settled job in the family business and a caring fiance. She was concerned that the recent weight increase was making her ill, for she now suffered from fatigue, depression and low backache. Her doctor and her family were convinced that her increasing weight (now 50lb over her optimum weight) was causing the backache and fatigue, and these symptoms were making her depressed.

      I know from my many years in practice that being overweight does not inevitably cause fatigue and depression, having encountered many underweight exhausted patients, and many overweight patients who were happy and full of energy.

      Jane had also linked the fatigue to her weight, because the fatigue and depression had developed when her weight suddenly increased eight months previously, and her doctor’s comments had endorsed her suspicions.

      Everyone including Jane believed that all her symptoms would improve if she could only lose 50lb of her surplus weight.

      Unfortunately, the low fat diet that she usually followed to control her weight did not seem to work any more. This failure further added to her depression, and she became obsessed with the idea that she had let her fiance down by looking and behaving quite unlike her old self.

      THE SYMPTOMS

      Upon questioning Jane, other symptoms emerged. In spite of her extra ‘padding’ she could not seem to get warm. She found it difficult to get up in the morning, when she felt particularly tired and depressed with frequent headaches. Her friends and family had remarked how impatient and irritable she had become, and her memory and concentration were noticeably worsening. All these symptoms were new to Jane, having developed with the weight increase over the previous six to eight months.

      THE TESTS

      I requested a morning temperature check and a thyroid profile blood test. Jane’s temperatures showed an average of 97.2°F (36.2°C) and her thyroid hormones were in the lower end of the normal range. Jane showed all the signs and symptoms of mild hypothyroidism.

      THE TREATMENT

      A nutritional programme was prescribed which included thyroid glandular supplements, and advice on regular exercise.

      Within three months she was feeling more vital and less depressed. She had managed to lose 12lb on her usual diet.

      By six months her blood thyroxine had improved by 25 per cent and her weight was down to 1501b. Jane was particularly encouraged that the diet was now working and she was hoping to regain a satisfactory weight before her wedding. Her mental lethargy and depression had slipped away and she was able to face the world upon waking with her old energy and enthusiasm.

       Why are People Overweight?

      Changes in weight which seem uncontrollable and inexplicable can be one of the most upsetting symptoms of an undiagnosed underactive thyroid. Many of us place a great deal of importance on our physical appearance; and even if your weight is not of great concern, you probably find it distressing to not be able to explain weight fluctuations.

      There is a common stereotype that all those suffering from underactive thyroid are overweight — this is simply not true. If you are under the age of 40 you may in fact be underweight. Sometimes the metabolism is so sluggish that your use of dietary protein and other foods is inefficient and consequently you lose weight.

      However, there is a tendency for the majority of middle-aged and elderly patients of both sexes with low grade hypothyroidism to put on unwanted weight. The thyroid does not directly cause obesity, but rather leads to symptoms such as tiredness, lack of energy and sugar cravings which in turn can lead you to become overweight.

      Here are some further reasons why weight increase and thyroid are connected:

      1 The metabolic sluggishness that results from hypothyroidism can cause digestive inefficiency and constipation.

      2 The typical muscle and joint pain and stiffness tends to discourage the regular exercise that many patients rely on to control their weight.

      3 The characteristic fatigue does not encourage activity. It is so easy ‘not to bother’ and all types of exercise and activity are usually reduced to a minimum.

      4 If food is not converted to energy it is often converted into fat reserves. The poor gut absorption and candidiasis so common in hypothyroid, contributes to this conversion process.

      5 Intestinal wind can increase the body size, and although the weight may not change — the appearance certainly can.

      6 The efficient digestion of food requires the correct stomach acidity, pancreatic enzyme balance, gut absorption and bowel and bladder efficiency. These important areas of our metabolism can all be adversely affected by a depressed thyroid. The inevitable slowing of our metabolic rate leads to fluid retention, weight increase and a general reduction in our metabolic efficiency.

      7 Depression is a common symptom of mild hypothyroidism, and depressed people usually have low self-confidence and suffer from anxiety. Unfortunately when these symptoms are experienced many of us turn to food for comfort, particular chocolate and sugar-rich foods. Alcohol is also taken for relief from anxiety. So a vicious circle can be established, involving the pattern opposite.

      8 A decrease in brown fat. Brown fat consists of very specialized fat-burning tissue that is located around the neck, shoulders and upper spine, and around the vital organs including the kidney and heart. When the thyroid is underactive, the heat producing properties of this tissue tend to be reduced.

       The Thyroid-Brain Link

      We know that an underactive thyroid can contribute to weight increase, depression and anxiety. The depression and mood changes are in part caused by the resulting low levels of the neurotransmitters in the brain. These include serotonin, GABA and noradrenaline. However, you may not realize that these neurotransmitters are also involved in appetite and taste regulation. For example, a decreased level of serotonin in the brain can cause a craving for sugar and carbohydrates. This craving can lead to a pattern of eating that is so frequently — and mistakenly — attributed to low blood sugar.

      

      Figure 2: Hypothyroidism, weight gain and depression

       How Many Calories Should I Consume?

      Overweight patients frequently ask me for a calorie-controlled diet or a ‘special foods’ diet. Many are convinced that weight-loss would occur if they could only find and follow their ‘ideal diet’. They believe

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