Is it my Thyroid? Or is it Just Stress?

Here’s a statistic for ya: approximately 60 to 70 percent of people with thyroid dysfunction don’t know they have it. Yep, you read that correctly.

How can this happen, you ask? Well, part of the problem has to do with how and when we test the thyroid, part of it has to do with a lack of awareness about the prevalence of thyroid dysfunction, and a BIG part of the problem is the similarity of symptoms related to both thyroid and stress.

Let’s unpack this together.

Determining if your symptoms are coming from thyroid dysfunction or stress-response system dysfunction is tricky, because there’s a lot of overlap of symptoms, particularly in the case of low thyroid function. And symptoms are often nonspecific or frequently dismissed - especially in busy women, who are much more likely to have thyroid dysfunction than men.

For example, one of the most common signs of a thyroid disorder is an unexplained change in weight. And one of the most common signs of a poorly-regulated stress response is...wait for it...unexplained change in weight. Same for sleep disruption, fatigue, and anxiety. It can be difficult to tease apart the roots of these misery-inducing symptoms, which is why so many folks stay stuck in confusion.

Here are a few things to keep in mind when you’re trying to answer the question: is it my thyroid? or is it just stress?

First of all, there’s no such thing as “just stress.” Stress is a very real, very tangible, biochemical response that happens in your body, thanks to the nervous system and HPA axis. Remember that I told you most people with thyroid dysfunction don’t know they have it? I’d bet that 80 to 90 percent of people with HPA-axis dysfunction don’t even know it’s a thing (including a lot of very smart people with very fancy medical degrees).

Here’s why it matters: when we relegate stress to something that’s “just in our heads”, we’re ignoring the huge physical impact that chronic stress has on our bodies. Yes, understanding and addressing the mental and emotional triggers of stress is a super big deal. But there’s so much more we could be doing to keep ourselves healthy and well - both to prevent chronic disease stemming from an unchecked stress-response system and to relieve physical stress-related symptoms. But in order to do that, one has to recognize that stress isn’t “all in your head” and then implement physical stress-optimization interventions, not just mental & emotional ones.

In case you’re wondering, you’ll find oodles of strategies that address stress on a physical, biochemical level in the Stress Smarter Mini-Workshop.

Alright. Another thing to keep in mind when trying to differentiate between thyroid and stress is that most of the thyroid testing we do is inadequate, specifically, testing thyroid stimulating hormone (TSH) alone. It just doesn’t give us the full story!

TSH is measuring how “hungry” the brain is for thyroid hormone. It’s a messenger that tells your thyroid, “Hey, we need more active thyroid hormone up in here!” So when it’s elevated, it’s gives us a hint about how well the thyroid is making hormone, or how well that hormone is functioning in your body. But it does not measure the actual thyroid hormone (T3), its VIP precursor (T4), or the antibodies that indicate whether we may be developing an autoimmune thyroid problem (TPO). That’s pretty important information, don’t you think?

Here’s the other sticky issue with TSH testing. Even though the standard range of “normal” TSH levels is 0.4 to 4.0 mIU/L, many endocrinologists and Functional Medicine doctors agree that people with normal thyroid function actually have a TSH of 0.3 to 1.5. That means you could wait years for your TSH to reach the abnormal range of 4.0 before anyone does anything about it - or even tests to see what else is going on. Years of suboptimal thyroid function, damage, and the nasty symptoms that go with untreated thyroid dysfunction.

Just FYI, my goal range for TSH is .03 - 2.0 mlU/L for most people.

As if things weren’t complicated enough already, stress directly impacts the thyroid and vice versa. The systems are VERY interconnected, so the conversation is less about “thyroid OR stress” and more about “which came first,” the thyroid dysfunction or the HPA axis dysfunction (stress). Because chronic stress = excess cortisol, and excess cortisol dysregulates thyroid function. Which then creates problems for your metabolism, energy, weight, and a lot of other downstream effects - which, in turn, act as additional stressors! It becomes a vicious cycle of thyroid AND stress dysregulation.

So, now what?

Here are a few questions you can ask yourself if you’re wondering about your thyroid health. Like I said, some of these things do overlap with the effects of chronic stress, but if you’re experiencing more than a few of these issues, it’s time to at least get some thyroid testing going...and I don’t mean just TSH (obviously)!

Questions:

• Have you gained weight? Do you have 20 pounds that you just cannot lose?
• Have you noticed any changes in your hair, nails, or skin?
• Have you been unusually tired or sluggish?
• Have you noticed any bowel changes? Especially constipation? Are you always cold?
• Have you been especially moody? ***Small changes in thyroid levels can cause dramatic changes in mood and mental state. Every patient with depression and anxiety should have their thyroid panel checked.

Here’s the bottom line:

If you suspect that your thyroid isn’t functioning optimally, and you’re experiencing issues like the ones above, you deserve answers. Maybe that means pushing for more comprehensive testing, or interpreting your test results through a new, Functional Medicine lens. Maybe you already know you have a thyroid issue, but you need new strategies to treat it. Or maybe it’s not your thyroid, and you need help getting to the root of whatever is creating your weight gain, anxiety, bowel issues, or hair loss.

I can help you with this!

I can help you get the testing you need and deserve.

I can help you discover Functional Medicine strategies (like nutrition, lifestyle, and nutraceutical support) so you don’t have to just wait until your doctor prescribes you meds.

I can help you get to the root of your concerns - especially if you suspect that chronic stress is playing a role.

All you have to do is reach out. Shoot me an email at [email protected] and we’ll figure out the best next steps - together!