How To Manage Hashimoto’s Disease Fatigue

Most people with Hashimoto's disease experience chronic fatigue and exhaustion. This is because Hashimoto's disease leads to a decrease in the production of thyroid hormones that control the body's metabolism.

But what exactly is Hashimoto’s disease?

What is Hashimoto's disease?

Hashimoto's disease is an autoimmune disorder that affects the thyroid gland. An autoimmune disorder involves the body's immune system producing antibodies to fight healthy cells in the body that it considers harmful.

In the case of Hashimoto's disease, the antibodies attack healthy thyroid cells, causing the thyroid gland to produce less thyroid hormone. When your body produces less thyroid hormone, you can develop hypothyroidism.

Hashimoto's disease is also called Hashimoto's thyroiditis, chronic autoimmune thyroiditis, or chronic lymphocytic thyroiditis.

What causes Hashimoto's disease?

There is no known cause for Hashimoto's disease. Still, some factors like genetics, environmental factors¹, and exposure to excessive radiation² are associated with the development of this condition.

What are the risk factors for developing Hashimoto's disease?

The risk factors for developing Hashimoto's disease include:

Sex

Women are more likely³ to develop Hashimoto's disease than men. The reason for this increased risk is not well understood, but it is associated with sexual reproductive hormones.

Age

Hashimoto's thyroiditis can occur at any age but is most common in middle-aged people, especially in middle-aged women⁴.

Pre-existing autoimmune conditions

Someone with other autoimmune diseases such as type 1 diabetes, lupus, and rheumatoid arthritis⁵ may be more likely to develop Hashimoto's disease.

What are the symptoms of Hashimoto's thyroiditis?

If you develop Hashimoto's disease, you are most likely to experience:

• Constipation

• Gaining of weight

• Chronic fatigue

• Depression⁶

• Dry skin

• Joint, muscle pain, and stiffness

• Puffiness or paleness of the face

• Heavy or irregular menstrual periods

• Challenges getting pregnant

• Problems with memory and concentration

• A slowed heart rate

• Sensitivity to cold

• Enlargement of the tongue

What are the risk factors for Hashimoto's thyroiditis?

When Hashimoto's disease is not treated in time, you could develop complications like:

• Heart problems⁷

• Goiter

• Sexual and reproductive dysfunction

• Poor pregnancy outcome (issues with fertility) 

• Myxedema⁸

• Depression

How is Hashimoto's thyroiditis treated?

Thyroid hormone replacement therapy is the most effective treatment for Hashimoto's thyroiditis. This involves the replacement of the T-4 hormone (tetraiodothyronine or thyroxine) produced by the thyroid gland by taking a medication called levothyroxine.

You might experience mild side effects like headaches, appetite changes, and diarrhea when taking levothyroxine. If you experience shortness of breath, wheezing, and nausea, you should seek medical attention immediately.

What is fatigue, and how is it different from tiredness?

Fatigue is the feeling of being drained, overtired, and lacking energy. If you experience fatigue, you will want to sleep and avoid physical activity. Medical conditions often cause fatigue.

Fatigue is often confused with tiredness, but fatigue persists even after rest, unlike tiredness which can usually be improved with sleep.

Fatigue can affect your day-to-day life by reducing concentration and attention, limiting your memory, and impairing judgment. It might also drain your energy, making it difficult for you to perform physical tasks.

It is not unusual to experience fatigue for a couple of days, especially if you work for long hours and do not get enough sleep. However, if your fatigue happens to persist for more than two weeks, you should see a doctor.

You could be experiencing fatigue due to an underlying illness or infection. If your fatigue is accompanied by shortness of breath, wheezing, stomach pains, or swelling hands and feet, you should see your doctor immediately.

Is fatigue a symptom of Hashimoto's thyroiditis?

Chronic fatigue is common in patients with Hashimoto's disease and hypothyroidism. This is because the two disorders affect the thyroid gland, reducing thyroid hormone production.

The thyroid gland produces T-3 (triiodothyronine) and T-4 (tetraiodothyronine or thyroxine). These two hormones control the metabolism in your body, including functions like your heartbeat and body temperature.

When there is less production of these hormones in your body, it means that your body's metabolism will slow down. When your heartbeat slows down, it will cause you to feel physically weak, and you will experience fatigue.

How does Hashimoto's disease impact sleep?

People with an underactive thyroid (an effect of Hashimoto's disease) experience trouble dealing with cold temperatures at night, which means they have poor quality sleep⁹. People with Hashimoto's disease are typically sensitive to the cold due to the slowing of their metabolism. They may also experience joint and muscle pains at night, take longer to fall asleep, and sleep for shorter periods.

If you develop Hashimoto's disease that leads to hypothyroidism, you might also develop hypersomnia. Hypersomnia is the irresistible urge to sleep or continual lapsing into sleep.

Could your fatigue be caused by something else?

You may develop fatigue from other factors like stress, working in a hot environment¹⁰, or the inability to sleep at night due to other sleep issues like insomnia or sleep apnea. Stress-related fatigue, however, goes away after some days if you relieve your stress.

If you experience fatigue that doesn't go away even after sleep, it could indicate an underlying condition.

Both medical and psychological factors need to be considered when investigating the cause of your fatigue. 

How can I boost my energy levels with Hashimoto's disease?

The best way to boost your energy levels when you have Hashimoto's disease is by taking your thyroid hormone replacement medication. This medication will help boost your underactive thyroid, thereby achieving normal metabolism.

It is essential to take the thyroid replacement medication as prescribed and take it the same way every day. Typically, you should take the medication on an empty stomach and wait 30 minutes to one hour before eating anything, but ensure you follow the advice of your doctor.

Additionally, you can try the following to help keep your energy levels up:

• Eat meals rich in fruits, vegetables, and lean proteins

• Limit your consumption of alcohol and caffeinated drinks

• Avoid the use of tobacco

• Engage in physical activities like walks or aerobic exercise

• Get enough high-quality sleep, preferably six to eight hours

• Visit your doctor for regular checkups

When is it time to see a doctor?

Hashimoto's disease does not show symptoms immediately. It develops over time, and symptoms appear slowly.

If you begin experiencing severe symptoms associated with Hashimoto's disease like dry skin, brittle hair, chronic fatigue, sensitivity to cold, constipation, and diarrhea, you might need to see your doctor.

If your Hashimoto's is mild, your doctor might decide to observe it without issuing you medication. However, if it is found to have caused hypothyroidism, they will prescribe levothyroxine to treat your condition.

The lowdown

If you have Hashimoto's disease, you will most likely experience fatigue. Fatigue can get in the way of your productivity by reducing your attention span, reducing your memory, and impairing your judgment.

If your fatigue does not go away after two weeks, you should see your doctor.

Taking your hormone replacement medication, eating a healthy diet with plenty of fruits and vegetables, exercising, and getting enough sleep can help boost your energy levels when you have Hashimoto's disease.

You should also avoid taking alcohol, caffeinated drinks, and tobacco, especially if you are experiencing symptoms of Hashimoto's disease, as they could make them worse.

Lastly, make sure to take your medication as prescribed by your doctor.