Why Am I So Tired?: Is your thyroid making you ill?. Литагент HarperCollins USD
deficiencies. Food digestion and absorption depends on many interactions, nutrients and enzymes.
Peggy’s morning temperatures showed an average of 96.8°F (36°C). Her vitamin B12 and thyroid hormones were all within the normal ranges, but towards the lower end of each range. Her minerals showed deficiencies in magnesium, zinc, chromium and manganese.
TREATMENT
Peggy was prescribed a course of weekly vitamin B12 injections, a suitable multi-mineral, and a thyroid glandular supplement.
After the third week she began to feel less fatigued and after three months of treatment she was more mentally alert and had returned to her 18 holes of golf each week. It may be necessary for Peggy to continue with the thyroid and mineral support on a low maintenance dosage for the rest of her life, coupled with monthly B12 injections.
Maintenance treatment is often justified and worthwhile to maintain necessary health and morale in the elderly. I firmly believe that the elderly benefit from regular gentle exercise. The value of rest can be overstated, as inactivity can cause joint stiffness, muscle weakening and excess weight. Exercise also improves bone health and reduces the risk of osteoporosis.
FATIGUE — OTHER NAMES
It may be helpful to discuss the various medical titles that have been used in the UK and the USA to define chronic exhaustion.
Myalgic Encephalomyelitis (ME)
This grand sounding name is synonymous with post viral fatigue (PVF) and also interchangeable with chronic fatigue syndrome (CFS) and fibromyalgia syndrome (FMS). Past definitions for ME have included epidemic neurasthenia, Epstein-Barr syndrome, Royal Free disease and Icelandic disease. The symptoms of ME have also been defined by the media as ‘Yuppy ‘Flu’ or chronic influenza. The chief symptom of ME is chronic fatigue, of a type that requires bedrest but offers little clinical evidence with testing. A history of recurring infections, headaches and muscle pains are characteristic. Observable signs can include throat inflammation and lymph node enlargement in the neck and armpits.
In the US, ME is usually defined as CFS or chronic fatigue and immune dysfunction syndrome (CFIDS). The criteria for diagnosis are similar to ME and many doctors believe that the simple definition CFS will become the internationally recognized title for chronic fatigue.
Post-Viral Fatigue (PVF)
By definition this title describes the chronic fatigue that follows a virus infection. There is usually a history of a viral illness (e.g. Epstein-Barr virus, glandular fever or influenza). The signs are similar to ME and involve lymph node swelling and tenderness. PVF usually shows a history of fever. However, many doctors and researchers have recorded low body temperatures with their ME and PVF patients.
Fibromyalgia
Once known as fibrositis, fibromyalgia like ME and PVS, is often seen as being under the CFS umbrella. The only slight difference being that fibromyalgia patients have mainly muscle-joint symptoms with fatigue, while ME or PVF patients exhibit more symptoms of immune system weakness coupled with their fatigue.
Hyperventilation Syndrome (HV)
Breathing difficulties linked with anxiety and spinal health are found as a common component of fibromyalgia. However, HV is generally seen as a symptom not a cause. It is appropriate to quote Leon Chaitow who has written: ‘After some 15 years of treating fatigue problems and over 30 years of treating musculoskeletal pain problems, I can categorically state that I have seldom, if ever, failed to find at least “some” degree of breathing dysfunction in people with chronic fatigue syndrome (ME) or fibromyalgia.’1
Gulf War Syndrome
Soldiers and other personnel who were involved in the Gulf War have subsequently suffered from chronic fatigue amongst other symptoms. The cause is thought to be a combination of immunization side effects, the toxic atmospheric pollution, poor hygiene, various toxic sprays, and stress. Although these victims of the war are relatively few (30,000 plus), what happened in the Gulf may encourage a greater willingness by the medical establishments to consider environmental and chemical factors when diagnosing chronic fatigue.
The Problems of Diagnosis
Many people suffering from chronic fatigue do not fit into a neat medical pigeon hole. This situation has unfortunately lead some medical doctors to define chronic fatigue as psychosomatic (mind-body). This diagnosis is often followed with a prescription for drugs to treat anxiety and/or depression.
There may be no evidence of disease or damage with fatigue, but there is often evidence of malfunction. Functional medicine recognizes that the simple under-efficiency of a gland, organ or system, can give rise to symptoms. Nowhere is this more clearly shown than in mild or low grade hypothyroidism. This concept of imbalance or mild hypofunction rarely applies to a single function. The domino effect often applies to ill health.
The concept of several poorly functioning but non-diseased glands has been termed multiple enzyme deficiency syndrome (MED), polyendocrine syndrome (PS) or polyendocrinopathy.
An underactive thyroid can lead to adrenal exhaustion, muscle pain, fatigue, obesity, depression and a host of other symptoms. With many health problems there exist recognizable degrees of severity. This can be seen very clearly in diabetic patients. The diagnosis of diabetes can range from a mild glucose intolerance in old age needing care with carbohydrate foods, to a severe diabetic requiring three or four insulin injections daily to stay alive. This concept of ‘shades of grey’ can be applied to almost any illness. Unfortunately a certain standardization of definitions is required in order to determine drug dosages and treatment protocol, so many conditions are diagnosed in terms of ‘black or white’. Hypothyroidism is seen as either severe enough to warrant a lifelong prescription for thyroxine or normal and no treatment is offered.
Functional assessment requires a more sensitive awareness of test results based on a full knowledge of the patients symptoms. Unfortunately many British GPs are simply given a patient’s test results, stating ‘normal’. Yet it is the GP who is in contact with the patient, not the laboratory staff. The diagnosis of mild or early-stage imbalances can easily be missed with this method. The need for more sensitive tests to assess disorders of function, and mild deficiencies or excesses, has lead in the last 10 years to the development of a range of specific laboratory tests. These have included tests to measure or identify leaky gut, malabsorption, candidiasis, gut transit speed, stomach emptying speed, pancreatic enzyme status, 24-hour adrenal function tests and many more.
Therefore the key to understanding the reasons for your fatigue consists of careful test selection and subsequent test interpretation. When this is carried out efficiently and assessed alongside the symptoms you may feel, some understanding of your problem can be achieved and an accurate diagnosis arrived at. Although changes to diet and supplement use are usually harmless, the good response to any treatment depends on specificity