Coping With Symptoms of Thyroid Disease

Managing weight issues, fatigue, hair loss, temperature sensitivity, and more

Common symptoms associated with thyroid disease can be frustrating and impact your life in many ways. Problems such as fatigue, weight gain or loss, temperature intolerance, hair loss, and more can affect you not only physically but emotionally, interfering with your relationships and reducing your ability to enjoy daily life.

A diagnosis of thyroid disease introduces you to a lifelong need for its management. And given the relentlessness of some of its symptoms, it can be easy to accept what you're experiencing as being "just the way it is." But there are strategies you can employ to feel better than OK. And knowing that symptoms associated with a thyroid condition are often confused with those related to another health concern can help you pursue other possible solutions to help you live your best life.

Where to Begin

Managing the common (and often extremely annoying) symptoms of thyroid disease begins with finding a good thyroid doctor who will partner with you to determine your options. Then, by being proactive and persistent—but recognizing the importance of patience—you’ll be set to identify and deal with the inevitable symptoms that come your way.

No two individuals with thyroid disease experience it the same way, even if they have the same diagnosis. The most effective coping strategies may look different for you than someone else.

Believing that your symptoms are surmountable and making a conscious decision to commit to an educated plan for getting well are crucial in your overall health. Treatments for hypothyroidism or hyperthyroidism aren't magic pills or techniques. Rather, the secret to living well with thyroid disease is embracing an approach that blends both science and the art of wellness.

General Wellness Strategies for Thyroid Patients

While there are specific strategies that can help you with some of the symptoms that can come with thyroid disease, which are discussed below, some measures are worth taking because of the widespread impact they can have on how you feel.

  • Eat a healthy diet that minimizes (but doesn't entirely eliminate) goitrogens—compounds that have an anti-thyroid effect.
  • Practice good sleep hygiene: Getting not only enough sleep, but quality sleep, can reduce many of the symptoms associated with thyroid disorders.
  • Manage stress: Taking time to practice stress management is well worth it. Not only can coping with thyroid disease add stress to your life, but stress hormones such as cortisol can alter the levels of thyroid hormones in your body. (Though results are mixed, there is some evidence that suggests that stress may even play a causative role in the development of autoimmune thyroid disease, as well as pregnancy-related thyroid disease.)
  • Quit smoking: Chemicals in cigarette smoke are dangerous for anyone but are particularly detrimental to those with thyroid disease. For example, among people with Graves' disease, smoking both increases the risk of thyroid eye disease and makes treatment for the disease less effective.
  • Live a resilient life: Living is challenging enough at times without thyroid disease, but resilience can help just about anyone. Learn how to laugh even in the midst of troubles. Try carrying a positive attitude. Lean into your positive relationships and eliminate negative ones. Practice reframing, a skill that entails looking at the same situation (situations that can't be changed) in a different light.

Weight Issues

Weight issues, either weight gain with hypothyroidism or weight loss with hyperthyroidism, are often the most distressing symptom for people coping with thyroid disease. Many people find that diet and exercise strategies that were effective in this regard before their diagnosis are now ineffective.

The first step to take whether you are coping with weight gain or weight loss is to make sure that you are on optimal thyroid treatment. Even if your TSH is "within normal limits" or in the range specified as "normal" by your clinic, optimal treatment may mean adjusting your dose so that you fall in the lower range of TSH values.

The second step is to consider any other condition you may have or change in habits that may be causing weight changes. Potential underlying causes of weight gain can range from polycystic ovaries to medication use. Unintentional weight loss should also be investigated for other causes.

Even if what you're experiencing is thyroid-related, the relationship between thyroid hormones and weight is complex.

Strategies for Losing Weight

Weight gain related to hypothyroidism is common. Even with optimal thyroid replacement, many people struggle with extra pounds that they hadn't before their diagnosis.

To help you reach your healthy weight goal:

  • Equip yourself with knowledge: Learning about insulin resistance, as well as the actions of the hormones leptin and ghrelin, can help you design a plan.
  • Stay well hydrated.
  • Exercise: If you want to lose weight, you may have to put in more than the 150 minutes of moderate exercise or 75 minutes of vigorous exercise weekly.
  • Get enough sleep: Being sleep deprived makes it more difficult to lose weight.
  • Choose foods wisely: Aside from monitoring your calories, a number of other measures, such as increasing fiber and decreasing carbohydrates, have helped some people living with thyroid disease lose weight.
  • Consider how you eat: Some people see benefit from adjusting their eating patterns through intermittent fasting. In addition, there is sometimes a connection between thyroid disease and gluten sensitivity/celiac disease, and some people have found that adopting a gluten-free diet has made the difference in their thyroid symptoms.

Strategies for Gaining Weight

If you are losing weight with thyroid disease, it's important to begin looking into your thyroid function. Do you have hyperthyroidism that needs more aggressive treatment? Are you on too high a dose of replacement therapy for hypothyroidism? If your treatment is correct, talk to your doctor about options, such as increasing calorie-dense foods in your diet.

Hair Loss

Hair loss and thinning are common with thyroid conditions, but as with other symptoms, it's important to rule out other potential causes before chalking them up to your thyroid concern. In fact, some conditions that cause hair loss are more common in people with thyroid disease.

For example, those who have autoimmune thyroid diseases such as Hashimoto's disease (the most common form of hypothyroidism) or Graves' disease are more likely to develop a second autoimmune condition like alopecia areata. Other causes of hair loss include hormone changes post-pregnancy, nutritional deficiencies, and more.

Thyroid-Related Hair Loss Strategies

Hair loss due to thyroid disease is, fortunately, usually temporary and treatable. Most commonly, the hair loss is diffuse (all over without bald patches), and the texture of hair may change, becoming either coarse and thick, or thin and fine.

Hair loss may occur in regions other than the head as well, especially the outer areas of the eyebrows. Most often, effective treatment of your thyroid disorder will lead to resolution of hair loss.

To promote more rapid hair re-growth, some physicians may recommend medications such as topical Rogaine (minoxidil) or the medication Propecia (finasteride). Since these medications may have side effects (and Propecia should not be used by women who are pregnant or may become pregnant), many people find conservative measures, such as having your hair styled in a way that makes hair thinning less evident, sufficient while hair grows back.

Fatigue

Fatigue is another bothersome symptom that has many other potential causes besides thyroid disease. From iron-deficiency anemia, to sleep apnea, to medications, it's important to first rule out these other common causes of fatigue.

Thyroid-Related Fatigue Strategies

Coping with thyroid-related fatigue can be challenging in more ways than one. Not only are many people left coping with a type of fatigue that differs from ordinary tiredness, but family and friends often fail to recognize its degree, impact, and that it can be a fact of life for people with hypothyroidism or hyperthyroidism.

Optimizing your thyroid treatment alone may significantly reduce your fatigue. With hypothyroidism, this might mean having a goal TSH closer to 1.0 mU/l than 5.0 mU/l. With hyperthyroidism, more aggressive treatment may be needed.

Good sleep hygiene is essential so that you not only get an adequate amount of sleep, but quality sleep. For some people, dietary changes (such as reducing carbohydrates) are helpful.

Perhaps counterintuitively, increasing physical activity can reduce fatigue, but it's important not to overdo it—especially if your thyroid levels aren't yet stable.

Sometimes coping with fatigue due to a thyroid condition can have silver linings. For example, most people could benefit from learning to pace themselves and delegate activities they don't have to do themselves. Coping with thyroid disease just might help you face and achieve those goals.

Temperature Intolerance

In general, cold intolerance is a symptom of hypothyroidism and heat intolerance a sign of hyperthyroidism, but there is tremendous overlap. In addition, temperature intolerance may have nothing at all to do with your thyroid, and it's important to look for other potential causes of cold intolerance or heat intolerance.

Possible causes of cold intolerance include anemia, being overly thin, infections (even a cold virus), circulation problems, fibromyalgia, pituitary or hypothalamic problems, and more. Heat intolerance could be related to changes such as menopause, but if you are having night sweats as well, they could be a sign of something more serious.

If your temperature is elevated when you feel hot, talk to your doctor. A fever of unknown origin requires a careful workup.

Thyroid-Related Cold Intolerance Strategies

Symptoms of cold intolerance often improve with optimal management of your thyroid disorder, but this can take time, especially if your thyroid dysfunction is occurring during the colder months of the year.

You may need to turn up the heat in your home, wear a hat, socks (or a few pairs if needed), long underwear, and purchase a warm comforter for the nighttime.

Getting enough sleep can make a big difference in your symptoms, as can making sure you dress for the weather.

Before you consider any drastic changes, such as a move to a warmer area, make sure you have a chance to experience life with normal thyroid function.

Thyroid-Related Heat Intolerance Strategies

Heat intolerance can be every bit as annoying as cold intolerance and is sometimes more difficult to rectify. If you hesitate to crank the air conditioning, promise yourself you'll turn it down when your thyroid test levels improve. Skip the socks, wear shorts and a sleeveless shirt. Get wet and drink cool drinks. Even spraying yourself lightly with a water mister, or placing a wet, cold washcloth around your neck may help. Portable fans can also be priceless.

A Word From Verywell

A lot (if not all) of your symptoms may very well be due to your thyroid condition, and figuring out how best to cope with them can take some worthwhile trial and error. If you're struggling, you can feel better than you do today.

Remember, however, that attributing any symptom you are experiencing to your thyroid disease may cause you to miss important clues about other conditions. You may also feel that your thyroid treatment is unsuccessful because your symptoms are still unresolved.

Being aware of the various symptoms associated with hypothyroidism and hyperthyroidism, and how they overlap with other health issues, can help guide conversations about thyroid management with your doctor and encourage you to explore strategies like those mentioned here and others.

While your thyroid management and coping plan may need some fine-tuning, there's also a chance that you may need to take additional steps completely unrelated to your thyroid to reduce your symptoms.

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