If you look at the list of symptoms in Chapter 3 that comprise hypothyroidism, as well as the symptoms of exhaustion in thyrotoxicosis (see Chapter 4), many of them can exacerbate normal fatigue that is part of daily life. Hypothyroid symptoms can also be confused with chronic fatigue. This chapter discusses normal versus unusual or chronic fatigue, and suggests ways to manage both fatigue that is thyroid-related and fatigue that is unrelated to but can aggravate your thyroid condition.
It's important to note another cause of fatigue common in people with thyroid disease; there's a real risk that exhaustion may be caused by problems with your adrenal glands. The adrenal glands, located above each of your kidneys, make cortisol, the steroid hormone essential for life. They also make adrenaline and related hormones. Just as the thyroid gland is often afflicted by autoimmune disease, causing Hashimoto's thyroiditis or Graves' disease, the adrenal gland is sometimes similarly afflicted by the immune system, causing the adrenal gland to make too little cortisol. This can cause a profound fatigue, known as Addison's disease. Likewise, if hypothyroidism is caused by pituitary or hypothalamic disease, since these organs also control the adrenal gland, trouble here can also cause loss of adrenal gland function. Specific tests must be done to test for this if it's suspected. This is discussed later in this chapter.
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