Thyroid Patients and Fatigue

One of the most common complaints I hear from thyroid patients is about fatigue. In one patient quality-of-life survey I conducted, more than nine out of ten thyroid patients surveyed reported fatigue as a problematic symptom. Some thyroid patients say they feel tired from the moment they wake up in the morning until they go back to bed in the evening. Others have points during the day -- often the afternoon or early evening -- when exhaustion overtakes them, and they may even need to close their eyes for a few minutes, or have a brief nap, in order to keep going. Others have low endurance, and a late night, or an exercise session , can leave them feeling rundown and exhausted for several days.

For patients who have a persistent symptom like fatigue, there are many factors that thyroid patients need to consider -- is your thyroid treatment optimized, is there an underlying adrenal fatigue issue, and are there other thyroid-related issues that may be causing fatigue.

Often, however, the most obvious issue of all is the one frequently overlooked by patients and practitioners: are you getting enough sleep?

According to a survey released from the National Sleep Foundation, one in three people in the United States sleeps for 6 hours or less per night, substantially less than the recommended 7 to 9 hours per night that we need to function at our best. In their survey, 40 percent of adults said that they are so sleepy during the day that it interferes with their daily activities.

And keep in mind, the National Sleep Foundation surveyed the broader population -- not just thyroid patients. In my coaching work with thyroid patients, I often hear people say how exhausted they are. Yet when I ask how much sleep they are getting regularly, it's almost always far less than 7 hours per night. Sometimes it's as little as four or five hours a night. It's no wonder they're tired!

I am one of those people who does not do well on less than 7 1/2 to 8 hours of sleep per night. But between work and home life -- and particularly, having a younger child -- getting that much sleep is a luxury I rarely enjoy. In the past, I often wanted to blame my thyroid , and would think that perhaps I needed to talk to the doctor about tweaking my dosage, or about supplements for energy, and so on. Whenever I've had a few nights in a row when I actually get around 8 hours a night, however, I immediately feel much better and am energetic. My fatigue is clearly related mainly to getting the amount of sleep I need to function.

Sleep is important to alleviate fatigue, but it is also crucial to ongoing health. Studies have shown that insufficient sleep can have a number of negative health effects, including:

• increased heart rate and increased blood pressure
• increased inflammation
• impaired glucose tolerance
• increased hunger/appetite, weight gain
• increased risk of hypertension
• reduced immune function

If you're not getting quality sleep, you should start by practicing good sleep hygiene. This involves: not using your bed as a place for work, television watching, or reading; establishing regular bedtime routines; managing stress levels, getting enough exercise; limiting napping; avoiding stimulants like caffeine before bedtime; avoiding food later in the evening; minimizing noise and light in the bedroom; and other common-sense techniques.

Some people find that napping -- including what's known as power napping -- can help make up for lack of nighttime sleep.

If you simply can't get into a healthful sleeping pattern, you may wish to talk to your practitioner about trying nonprescription sleep aids and herbs, including over-the-counter drugs, such as diphenylhydramine (i.e., Benadryl), melatonin, doxylamine (i.e., Unisom), or herbal formulations such as valerian root, passion flower, or kava kava. For chronic sleep problems, your practitioner may recommend antidepressants, anti-anxiety medications, or medications to aid with sleep.

_Sources

_{Bonnet Ph.D. Michael and Donna L. Arand Ph.D. "How Much Sleep Do Adults Need?," White Paper: National Sleep Foundation. http://www.sleepfoundation.org/article/white-papers/how-much-sleep-do-adults-need}

_{How Much Sleep Do We Really Need?, National Sleep Foundation. Http://www.sleepfoundation.org/article/how-sleep-works/how-much-sleep-do-we-really-need}

_{"2005 Adult Sleep Habits and Styles," National Sleep Foundation. http://www.sleepfoundation.org/article/sleep-america-polls/2005-adult-sleep-habits-and-styles}