Symptoms of SAD? It may be an underactive thyroid

The thread here called "Diagnosing seasonal affective disorder" touches on this subject and recommends that as part of a routine physical check, thyroid function is tested. There are unfortunately several problems with this. Firstly, the blood tests that are commonly done (usually TSH alone) are not always reliable indicators of the presence of hypothyroidism; many symptoms can be present, but these are usually ignored in favour of the printed numbers on a page. Also, most people are unaware of the symptoms of hypothyroidism and their similarity to those of what is often called seasonal affective disorder. I confess that I didn't even know until recently what the function of the thyroid is. It controls the body's metabolism. Classic symptoms that this is going awry and that the metabolism has become sluggish (i.e. the thyroid is underactive) are fatigue, insomnia, depression, feeling cold all the time, and FEELING NOTICEABLY BETTER ON SUNNY DAYS, as warm and bright days do not require the thyroid to work as hard. If any of this sounds familiar, please read on. I will give what info I can here and add to this topic as I learn more myself.

First, a more comprehensive list of symptoms, though it is by no means complete. The more common ones, which are classically diagnostic of hypothyroidism, I will put in capitals, though of course different people will experience different symptoms according to their state of thyroid functioning, general health, and predisposition toward exhibiting certain symptoms (this can often be genetic).

Physical symptoms:

General:
Excessive tiredness
Weight gain
Weight loss
Cold extremities
LOW BASAL (MORNING) TEMPERATURE
Cold sweats
Night sweats
Slow movements
Slow speech
Pins and needles
Breathlessness
Dizziness
Palpitations
SENSITIVITY TO THE SUN/FEELING BETTER ON SUNNY DAYS AND WORSE ON DARK DAYS
Lack of co-ordination, especially of hands and feet
Trembling
Insomnia
LOSS OF LIBIDO
Repeated urinary tract infections
Upper respiratory tract infections
Candida (thrush)
Heavy eyelids
Hoarse voice
Goitre
Muscle cramps
Joint stiffness
Loss of stamina
Heat intolerance
Cold intolerance
Exercise intolerance
Salt cravings
Sweet cravings
HYPOGLYCEMIA
Fainting episodes
3pm crash
Jumpiness
Unrefreshing sleep
Asthma
Lupus
Rheumatoid arthritis
Radiactive iodine treatment
Surgery on thyroid
Pregnant women: having a baby of around 9lbs or larger (the baby's thyroid makes more hormones if the mother's is weak, which includes extra growth hormones)

Puffiness or swelling of eyes, face, hands, feet, ankles

Mouth and throat:
Difficulty swallowing
Sensation of lump in throat
Sore throats
Choking fits
Dry mouth
Halitosis (bad breath)

HAIR LOSS: body, head, outer third of eyebrow, eyelashes, brittle hair

Nails: brittle, flaking, peeling

Skin: dry, flaky, coarse patches, sallow in colour, rings under eyes, pigmentation in skin creases, rashes and boils

Numbness and tingling in legs, feet, arms, hands, back, face

Pain:
Migraines
Pressure headaches
Back and loin pain
Wrist pain
Muscle and joint pain
Carpal tunnel syndrome
Tendinitis
Heel spur

Digestive problems:
Loss of appetite
Food allergy/sensitivity
ALCOHOL INTOLERANCE
Chronic constipation
Haemorrhoids
IBS
Flatulence
Diabetes

Blood pressure & pulse:
High blood pressure
Low blood pressure
Slow/weak pulse (under 60bpm)
Fast pulse (over 90bpm at rest)

Menstrual disorders:
Cessation of periods
Light periods
Heavy periods
Infertility
PMS
Endometriosis

Visual disturbances:
Poor focusing
Double vision
Dry eyes
gritty eyes
Blurred vision

Mental symptoms:
Panic attacks
Memory loss
Confusion
Mental sluggishness/brain fog
Poor concentration
Noises and/or voices in head
Hallucinations
Phobias
Post natal depression
Nightmares

Emotional:
Easily upset
Wanting to be solitary
Mood swings
DEPRESSION
Nervousness/anxiety
Personality changes
Feelings of resentment
Lack of confidence

Environmental:
Exposure to fluoridated water
Exposure to PCBs
High consumption of soya products
High consumption of goitrogenic foods: broccoli, cauliflower, brussels sprouts, cabbage
Exposure to mercury: dental amalgams, vaccines, fish and seafood

Medications:
Use of medications containing fluorine (e.g. prozac)
Lithium
Other antidepressants
Epilepsy drugs (e.g. phenytoin and carbamazepine)
Amiodarone (used to treat abnormal heart rhythms)
Drugs used in chemotherapy or to fight infections (interleukins, sulfamethoxazole and other sulfa drugs, and interferon alpha and ribavirin)

One of the most common indicators of hypothyroidism is a low basal temperature. You can take yours for 6-10 days and average out the numbers; if they are consistently lower than normal, hypothyroidism can be suspected. Make sure you take your temperature first thing in the morning, before you get out of bed for any reason. Menstruating women need to start this on the second day of their period; others can do this on any day.

Your doctor may be willing to do a TSH test but make sure you also request tests for T4 (fairly common) and T3 (not so common) as well. A mistake that many doctors and patients make is to take a synthetic T4-only medication for hypothyroidism. The most potent thyroid hormone is actually T3. Your body manufactures this from T4, and the T3 is what gets into your cells and does the job of regulating metabolism. The brain requires particularly large amounts of it. If your body is failing to convert T4 to T3, then no amount of T4-only medication is going to restore optimal health; and depending on the ability of your body to convert, you may actually find that you develop hyperthyroid symptoms on a T4-only medication, as the chemical floats around in your blood and your body cannot make use of it. Indeed, this can happen with a T3 medication as well, if the cells are unable to use it. This is why blood tests for T4 and T3 may appear "normal" when a patient's symptoms are screaming hypothyroidism. Now that blood tests are a standard diagnostic tool, unfortunately all too often this is the only thing doctors pay attention to, while symptoms are ignored. Don't let yours be ignored -- don't give up on demanding the treatment you need!

One reason why the body may not be able to make use of thyroid hormones, even when taken via a natural dessicated supplement such as Armour, can be due to low levels of cortisol. Adrenal fatigue often goes hand-in-hand with hypothyroidism, and it needs to be addressed if present before thyroid treatment can begin. Otherwise, the thyroid treatment may fail, and the adrenals are taxed even further until eventual exhaustion ensues.

Another common reason why thyroid treatment can fail is when ferritin is low; this is the part of the blood that holds iron in reserve. As anaemia and low ferritin are common symptoms of hypothyroidism, this particular chicken-and-egg scenario can be a tricky one. Some lucky people with sympathetic doctors have been able to get iron injections to help them along in this way.

If you think many of the symptoms listed above could be you, then it is probably wise to get some tests done. The best tests for adrenal fatigue are 24-hour saliva tests. Don't let your doc fob you off with a one-off serum cortisol test. Unless you have Addison's disease, which is the final and deadly stage of this progressive condition, then you will be told you are "normal."

Thyroid blood tests can be helpful but are not always accurate, as explained above. TSH levels can be normal and a person can still be hypothyroid. The test I had was a 24-hour urine test which measured the amounts of T3 and T4 my body was disposing of; this revealed what use the cells in my body was making of both hormones, and showed that while my T4 levels are well within normal parameters, I am not converting well to T3 and have low amounts of that particular hormone.

Unfortunately, my GP is conventional in most every sense of the word and will not pay any attention to any test other than the standard blood tests that he orders himself. I have had 2 useless serum cortisol tests. I have had my blood taken 3 times to measure T3; the first time the lab lost my blood, and the next 2 times a result never came back because my surgery doesn't even know if their lab measures T3 -- though that hasn't stopped them from insisting they should take more blood and try again! Thank goodness I don't have to rely on them or I'd probably be dead by now one way or another, after 4 years of chronic depressive illness and fatigue.

I have been seeing a doctor privately who is one of the UK's foremost specialists in metabolic medicine; he is the one who ordered my tests and who has been advising me. After decades of practise, the GMC decided a few years ago that because he relies more on symptoms and tests like the ones I had, and not so much on the blood tests like my GP has had done, he needed to be struck off. So while I and hundreds of other grateful patients see him at his travelling clinics around the UK, he cannot prescribe for us. This is OK for some, whose conditions are not severe and can be treated with diet and over-the-counter supplements. The rest of us . . . well, as they say, where there's a will there's a way, though I still hold out some hope that eventually I will get a T3 blood test that will satisfy my GP that he needs to prescribe a T3 medication. I am treating my adrenals on my own as my GP has no clue about this and his own tests are useless.

There is a world of information about adrenal fatigue and hypothyroidism on the internet. I am learning all the time, myself. Here is a website I've found to be particularly useful:

www.stopthethyroidmadness.com/

And some books:

Your Thyroid and How to Keep it Healthy, by Dr. Barry Durrant-Peatfield

Hypothyroidism: The Unsuspected Illness by Dr. Broda O. Barnes and Lawrence Galton

I'm happy to help with any questions here but please remember I'm not an expert and I'm learning too! I have tried taking an OTC thyroid glandular supplement and also Armour, but can't seem to get on with T4-containing meds. I am currently awaiting the arrival of a T3-only med. As I have many of the hypothyroid symptoms listed above -- including the reaction to sunlight LOL, which is why I am here -- I have hopes that this might really help me. But it's also going to require some artful balancing with my adrenal treatment and my ferritin levels, which are very low. I hope to be able to report sometime in the near future that I'm feeling better . . . looking forward to it!

I just have been diagonised with hypothyrodine and seem my symptons match its horrible how there seem to be a dark cloud hanging over you hope seeing my consultant next month will help