Category Archives: hyperthyroidism

Most Commonly Overlooked Causes of Insomnia

Chronic insomnia is a fairly common problem, but it is often addressed by prescribing a sleep medication instead of finding Lady with Insomniaand addressing the cause of the insomnia. In my opinion, it is imperative to identify and address the cause of sleep disturbances instead of merely patching the symptom. I support the use of sleep medications on a short-term basis during times of insomnia and if other remedies have not been effective, but most of those medications have serious side effects and should only be used when absolutely necessary.

We’re all familiar with transient insomnia caused by excess caffeine consumption, stress, grief, pain, etc. Chronic insomnia is characterized by insomnia that lasts for at least a month but which may stretch on for years. Per the National Institutes of Health, most cases of chronic insomnia are side effects of other health problems which may or may not have been diagnosed and addressed.

There are a wide variety of issues that can cause prolonged bouts of insomnia. The list that follows describes some of the most commonly missed causes of insomnia. When possible, I discuss how to identify these causes and how to address them.

The following causes of insomnia are rarely considered when someone has insomnia:

  • Blood Sugar Fluctuations:  The body has an amazing desire to maintain stable blood glucose levels. Its desire to maintain normal blood sugars is strong enough that it will not allow someone to fall asleep who has a low or high blood sugar. It is also very normal for people with a low or high blood sugar to wake up and not be able to fall back asleep until their sugar is at a normal level. Eating a snack before bed that contains low glycemic carbohydrates combined with protein can sometimes help avoid overnight blood sugar drops. Those who struggle with high glucose levels should work with your doctor to find the perfect insulin dose and eating style to avoid high or low overnight sugars.  
  • Hormonal Imbalances:  This issue is most commonly experienced by women. Progesterone is a reproductive hormone that is known to induce sleep. The highest levels of progesterone occur in the days immediately preceding menstruation. This is why sleeping more is a normal part of PMS for many women. Women who have a progesterone deficiency or estrogen excess often experience insomnia. Depending on the severity of the deficiency or excess, their insomnia may only occur during specific days of their cycle or may occur every night. The best way to identify this type of imbalance is with a saliva hormone test. My favorite can be purchased online: Hormone Level Saliva Test Kit. After identifying any existing imbalances, steps can be taken to bring hormone levels back into balance. Please work with a trained practitioner to address any imbalance identified.
  • Neurotransmitter Imbalances:  Neurotransmitters are chemical messengers the brain uses to send signals throughout the body. Imbalances in neurotransmitters can have a broad range of effects, but often include sleep disturbances. Neurotransmitter imbalances can be identified via Neurotransmitter Testing. It is important to work with a trained professional to bring neurotransmitter levels back into balance.
  • Adrenal Fatigue:  The adrenal glands are the body’s “fight or flight” organs. They spring into action anytime the body is exposed to stress. Stressors can result from external environmental sources or from internal, physical challenges. If the adrenals are exposed to stress over a long period of time, they sometimes become fatigued and stop producing normal levels of adrenal hormones. The adrenals secrete over 400 different hormones, so any deficiency will be felt in a wide variety of ways. The most common symptom of Adrenal Fatigue is extreme fatigue, but insomnia can also be an unfortunate symptom. Although saliva hormone testing can be used to test for deficiencies in some adrenal hormones, there is no definitive test to identify Adrenal Fatigue. The most common method of identifying Adrenal Fatigue is identification of symptoms and ruling out other potential physical issues. Adrenal Fatigue is best addressed via changes in eating style, rest, and herbal supplementation.
  • Thyroid Imbalance:  Many people know that excessive thyroid activity (hyperthyroidism) interferes with sleep, but many people do not realize that insufficient thyroid activity (hypothyroidism) may also cause insomnia. Unfortunately, hypothyroidism is rarely suspected in cases of insomnia and correct testing is rarely ordered. Please read How to be Your Own Thyroid Advocate for more information on how to identify a thyroid imbalance.
  • Prescription and OTC Medications:  Many medications cause insomnia. Medications for coronary issues, blood pressure, pain, high cholesterol, antidepressants, allergies, stimulants, steroids, decongestants and products for weight loss may interfere with sleep. if insomnia develops, discuss the medications you are taking with your physician.

Have you suffered from chronic insomnia? What was the cause?

In my next post, I’ll discuss natural ways to address insomnia. Thanks so much for reading!

Facts About Iron-Deficiency Anemia

Red Blood CellsIron-Deficiency Anemia is a very common health issue. Many women have been told at some point in their life they have Iron-Deficiency Anemia and that it is “chronic.” Unfortunately, the term “chronic” typically means the diagnosing doctor has chosen to not identify the cause of the condition. The doctor assumes the woman’s anemia is “normal” for her and therefore can only be controlled, not treated. I beg to differ.

Iron-Deficiency Anemia always has a cause or causes. It is never a “normal” state of being. Never. Let me clarify that I am speaking about Iron-Deficiency Anemia, the type of anemia that occurs when the body’s iron stores are below normal. Please note I am solely referring to Iron-Deficiency Anemia, not Sickle Cell Anemia, Thalassemia, Pernicious Anemia, Aplastic Anemia or any other form of anemia. Although the symptoms of the various types of anemia may be similar, they each have very distinct causes and cannot be addressed using the same approach. Please note that all references in this article are for adults, not children.

Common Symptoms

Iron-Deficiency Anemia results in a deficiency of red blood cells and diminishes the body’s ability to carry oxygen to the cells and carbon dioxide away from cells. The most common symptoms of Iron-Deficiency Anemia include:

  • Fatigue
  • Easy bruising
  • Headaches
  • Cold hands and feet
  • Elevated heart rate/heart palpitations/chest pain (Seek immediate medical attention for any form of chest pain)
  • Breathlessness
  • Dizziness
  • Swollen tongue/sore tongue/cracks in corners of mouth
  • Muscle pain
  • Pale skin
  • Depression and/or a lack of motivation
  • Brittle nails
  • Frequent infection/illness
  • Irritability/inability to concentrate
  • Bluish coloration to whites of eyes
  • Cravings for unusual items (chalk, clay, paper, etc.) or a strong desire to chew ice

Each of those symptoms could also be a sign of other health conditions, some more serious than others. Please consult a trained practitioner if you experience any of the symptoms listed above.

Possible Tests for Iron-Deficiency Anemia

Iron-Deficiency Anemia is typically identified via blood tests. When checking for Iron-Deficiency Anemia, the following tests should be run at a minimum. Please note that each lab has its own definition of what “normal” ranges are. The ranges provided below are general guidelines:

  • Complete Blood Count (CBC):  An overview of blood composition.
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  • Hemoglobin:  A protein in red blood cells that carries oxygen throughout the body. Normal range for men is between 13.5-17.5; for women 12.0-15.5. Please note that results which are within “normal” but are at the low end may still cause symptoms of Iron-Deficiency Anemia.
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  • Iron:  A measure of the iron in the blood stream. Normal ranges between 60-170 mcg/dL.
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  • Ferritin:  A protein that stores iron. Is a measure of the body’s iron stores. Although some labs state that levels as low as 10 are “normal,” most people do not begin to feel anything close to normal until their Ferritin levels are at least 40. Please note that levels as low as zero are not a definite indicator of cancer or other serious disease. Extremely low levels need to be researched in more detail to determine the cause, but are not necessarily an indicator of a terminal condition. I once had Ferritin levels of zero which my doctor erroneously assumed meant I had cancer. After having a bone marrow biopsy, the consulting hematologist looked at me and asked why on earth the doctor ordered a bone marrow biopsy instead of investigating the cause and type of anemia first. Good question!
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  • Vitamin B12:  Vitamin B12 is essential for iron to be absorbed. A deficiency can lead to Iron-Deficiency Anemia. Normal ranges vary between 200-900 pg/mL.
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  • Total iron-binding capacity (TIBC):  A measure of the number of proteins available for transporting iron. Normal ranges are typically between 240-450 mcg/dL.
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  • Transferrin Saturation:  A measure of how saturated with iron the proteins responsible for transporting iron are. Normal ranges are between 20-50%.

Potential Causes of Iron-Deficiency Anemia

Your doctor may order other tests if s/he wishes to identify the specific cause of the Iron-Deficiency Anemia. Potential causes of low iron levels and Iron-Deficiency Anemia may include:

Iron Deficiency Anemia Red Blood Cells

Red blood cells in a person with Iron-Deficiency Anemia

  • Lack of iron in the diet
  • Inability to absorb iron in the digestive tract
  • Unidentified bleeding (in oral cavity, lungs, stomach, digestive tract, etc.)
  • Other forms of anemia not yet tested for or identified
  • Pregnancy and lactation
  • Extremely heavy menstruation
  • Frequent blood donation
  • Excessive exercise (Iron-Deficiency Anemia is common in long-distance runners)
  • Celiac, Inflammatory Bowel Disease, Crohn’s or other digestive disorders
  • H Pylori infection (stomach ulcer)
  • Use of a proton pump inhibitor such as Prilosec, Nexxium, etc.
  • Kidney disease
  • Gastric bypass surgery/colostomy
  • Thyroid imbalances or other hormonal imbalance
  • Enlarged spleen or splenic dysfunction
  • Lead poisoning

Further Testing to Identify the Cause of Chronic Iron-Deficiency Anemia

Consistent Iron-Deficiency Anemia can be caused by any of the factors discussed previously, but may also be an indicator of more severe health issues. I advise considering the following to identify the root cause of Iron-Deficiency Anemia:

  • Check antiparietal antibody levels to ensure Pernicious Anemia is not the cause of the anemia
  • Test for other forms of anemia if symptoms and blood work indicate a possibility
  • Test for digestive disorders
  • Test for vitamin and nutritional deficiencies and supplement as needed
  • Test for food allergies (the inflammation caused by food allergies can impair iron absorption)
  • Check for bleeding in the digestive tract and digestive disorders
  • Check for bleeding in the respiratory system
  • Test thyroid levels (with a complete thyroid panel including TSH, Free T3, Free T4, TPO and Reverse T3 at a minimum)
  • Test hormone levels and have a gynecological exam if extremely heavy menstruation is suspected as the cause
  • Test for pregnancy (if appropriate)

Reversing the Deficiency

Many factors may contribute to Iron-Deficiency Anemia, so work with your doctor to determine what approach should be taken to reverse the deficiency. The most common approaches used to reverse the deficiency include:

  • Identify and Address the Cause:  Although it is imperative to get iron levels up using supplements or other approaches, it is also essential to identify why the iron deficiency exists and address the cause. If the cause can be identified and eliminated or greatly alleviated, the body can more easily restore iron levels to normal levels. If testing reveals a more severe form of anemia exists, additional steps will be needed. I will share more about the other forms of anemia in future posts.
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  • Increase Iron Consumption:  Increasing the amount of iron eaten on a daily basis can be helpful, but may not be sufficient in cases of absorption and digestion challenges. Please be aware that the iron contained in plants is called “non-heme” iron. It is not as easily absorbed as the heme iron in animal products. The body must convert non-heme iron into heme iron before it can absorb it. The best way to assist the body in making converting non-heme iron into heme iron is to eat fruits or veggies high in Vitamin C with foods containing non-heme iron. (Eating foods high in Vitamin C will assist with the absorption of iron in animal products, too, but is especially important for vegetable sources of iron.) This is one reason why spinach salads often contain oranges. The food that is highest in iron content is liver. Other foods high in iron include red meat, chicken and turkey, quinoa, organ meats, raisins, dark leafy greens, egg yolks, prunes, molasses, beans and lentils, salmon, nuts and seeds, dark chocolate (at least 80%), broccoli and others. I am not a fan of “iron fortified” milk and cereals because the iron those foods contain is in a form that is very difficult to absorb.
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  • Use Iron Supplementation:  Iron pills or supplements should never be taken if testing has not proven you are deficient in iron. Excess iron in the bloodstream can have negative affects which are as bad or worse as an iron deficiency. Please also be aware the forms of iron most commonly sold in drug stores are difficult to absorb and often cause constipation. Ferrous sulfate is the most commonly sold form of iron, but is very poorly absorbed and often causes constipation. It is not a form I recommend. My preferred forms of supplemental iron include iron citrate, iron gluconate, iron bisglycinate and/or chelated iron. Iron is best absorbed when it is taken on an empty stomach. My favorite iron supplements are Hematinic Formula and Vitamin Code Raw Iron.
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  • Severe cases of Iron-Deficiency Anemia may require blood transfusions or intravenous iron. Those approaches are usually not needed unless other health issues are present.

In conclusion, I’d like to say that Iron-Deficiency Anemia can usually be quickly addressed and reversed. More difficult cases may require further testing and additional therapies, but quality of life can usually be restored fairly quickly.

Red Blood Cell Photograph courtesy of Wellcome Images
Anemia Blood Cell Photograph Courtesy of Alpha Images

 

 

Confessions from Thyroid Hell

I guarantee you have been touched by Thyroid Hell at least once during your lifetime. If you do not personally have thyroid disease, you have definitely come in contact with someone who does. That encounter may have been quite pleasant, or may have been a nightmare. Either way, the quality of the encounter can be directly attributed to how well that person’s thyroid levels were balanced on that particular day. (Thyroid levels can fluctuate on a daily basis, which makes managing thyroid conditions that much more difficult.)

I thought I’d share an insider’s look at Thyroid Hell, mainly because I’ve spent a lot of time there. I invite those of you with thyroid imbalances to share your stories in the comments. Feel free to have fun with it and please don’t worry about offending us. Thyroid disease is no laughing matter, but the situations it creates are sometimes hilarious.

In the upcoming weeks, I will share more detailed information about thyroid disorders. I will also launch a wellness coaching program for thyroid patients that will provide detailed information about lifestyle changes, dietary changes and supplements that can be used to support the thyroid gland. This program will also contain very specific information on how to discuss thyroid issues with your doctor and on the tests you need to request. I do not want one more thyroid patient to needlessly suffer, and I recognize that education is the only way to prevent that.

The Thyroid Gland is a tiny gland that wraps around the esophagus. It sits just below the “Adam’s Apple.” In spite of its size, the thyroid gland is incredibly powerful. It secretes hormones that directly affect every body system. Every single one. An imbalance in thyroid hormone levels can affect brain chemistry, emotions, digestion, reproductive health, fluid balance in the tissues, kidney function, heart function, liver function, hair and nail growth, sexual function, emotional balance, energy levels, sleep patterns, weight, dexterity, muscle strength and stamina, cholesterol levels, anxiety, vision, internal temperature regulation, and more. As you can see, thyroid dysfunction affects body, mind and spirit in profound ways. Unfortunately, many MDs prescribe antidepressant meds to treat the symptoms instead of doing detailed blood work to find the cause of the problems.

The one item that is also affected but which was not included in the list is: RELATIONSHIPS. It is very difficult for thyroid patients to explain to family members and friends that they truly aren’t themselves. I frequently hear people with thyroid disorders express: “I hate myself and don’t know who this monster is living in my body, so I don’t know how any of my coworkers, family members or friends could stand me.” I’ve been that monster. Even though I was able to usually control my outbursts, the constant turmoil spinning through my brain and thought patterns was pure hell. Many people who are very positive, calm and chipper become Mr. Hyde when their thyroid levels become imbalanced. Those of us who have dealt with thyroid issues for many years instantly know it’s time to get blood work and check levels when the monster starts to rear her ugly head.

Unfortunately, people who have never before received a thyroid diagnosis often genuinely think they’re going crazy. It is extremely common for patients who are hospitalized due to suicide attempts to be diagnosed with a thyroid disorder. It is not uncommon for lab tests to reveal that people who successfully committed suicide had thyroid imbalances. I am very thankful that a growing number of MDs are choosing to specialize in both endocrinology and psychiatry. I personally believe the two cannot be completely separated.

In my own experience, I can say that I could easily deal with the physical afflictions of thyroid imbalance if the emotional effects were not so profound. I’ve heard other thyroid patients echo similar sentiments. Once you realize your thyroid levels are out of balance, you begin the process of changing medication dosages until the correct dosage is found. This can sometimes create a rollercoaster effect where the patient goes from being hypothyroid (having thyroid levels that are too low) to being hyperthyroid (having thyroid levels that are too high.) Unfortunately, there is a lot of overlap between the symptoms for hypo- and hyperthyroidism, which makes the entire process that much more fun.

For those of you who have friends, coworkers or family members with thyroid challenges, here’s a list of the emotional and behavioral changes you might observe when their thyroid levels become imbalanced:

  • Having extreme anxiety where none existed before
  • Reacting irrationally to minor issues
  • Responding to almost everything with anger
  • Displaying extreme levels of irritability (as in being annoyed by your breathing)
  • Overtweeting or excessive use of social media (I’m not making that up)
  • Suddenly having a total lack of self confidence and a complete disbelief their efforts will succeed
  • Becoming completely apathetic about projects or topics for which they have a passion
  • Dressing very differently because their clothes do not fit, their body image plummets, or they just don’t care
  • Suddenly becoming out-and-out mean, caustically sarcastic, hypercritical, etc.
  • Becoming very negative
  • Suddenly becoming a hermit who has no desire to leave the house or interact with others
  • A total slob may suddenly become obsessively tidy, or a neat freak may suddenly become a slob

That list could continue with many more points, but the bottom line is that thyroid imbalance changes people’s personalities, not just their physiology. The good news is that there are a wide variety of natural approaches that can support thyroid health. These approaches, used in combination with natural thyroid replacement hormones, can eliminate the hell and restore normalcy.

So what can you do to help a thyroid patient who’s in flux? Love them, obviously. In the midst of that, ask questions to ensure they are working with a professional to stabilize their hormone levels. I cannot stress this enough: Most thyroid patients are already experiencing a bit of self hate. Try not to be negative and judgmental about the changes in their life habits. They may need your assistance in maintaining the status quo, and they may need you to very gently hold them accountable, but they do not need your judgment. Threatening them with ending the relationship will not motivate them at all. Their hormonal imbalance is already affecting their self image, so losing a relationship may not matter to them (or they may expect it) when their levels are out of balance. I know that sounds extreme, but I hear it and see it on a daily basis.

The best advice I can offer is to ask the thyroid patient in your life how you can help them. Be specific. Ask if you can help with chores, if they need you to take them out to have fun, and let them know you love them and are there for them if they need to talk or need a soft shoulder to pound on. Your support will do more for them than anything else.

Ok … your turn. Have you experienced this? What else can we add to the list? I welcome in put from thyroid patients and from people who love them and who are on the receiving end of the angst.