What You May Not Know About the Hormone Most Often to Blame for Fatigue in Women Over 50

Feel Fatigue?

Fatigue. What’s the cause, “Women Who Do Too Much”?

No way. Feeling energetic is your birthright.

Did you know that hypothyroidism is one of the most common causes of fatigue in women? It often goes UNDIAGNOSED in the majority of cases, with some studies suggesting that it is missed up to 60% of the time.

Do You Often Feel Sluggish? Or Maybe Exhausted.

If you’ve been struggling with feeling sluggish all the time, you might be thinking…..

It’s probably just due to “getting older.”

Or maybe it could be due to “menopause.”

So many of the women I work with complain of fatigue. My experience has been that the cause is most often from more than one source. Getting the proper diagnosis, or rather, uncovering the underlying root cause, is crucial for you to get your energy back. But sometimes, discovering what’s really going on can be a lengthy and frustrating process. It certainly was for my patient, Mindy.

Mindy’s debilitating fatigue began around the time that her mother was diagnosed with Alzheimer’s. That was over 5 years ago.

Even after 9 or 10 hours of sleep, Mindy still had a hard time getting out of bed. She found herself pulling into Starbucks for a large cup of coffee with sugar every afternoon, to keep from drifting off as she drove to the nursing home to visit Mom. She used to take the 4 flights of stairs in her office building many times a day. But her leg muscles felt so weak she’d end up resorting to using the elevator. Even her brain seemed tired most of the time.

For the next three years Mindy just pushed through to do the best she could for Mom. All while still working part-time and staying involved with all three of her children who were in college. Tough times, but no regrets.

Have You Been Doing Everything You Know to Do but Still Feel Tired All the Time?

As she navigated her way through the grieving process, Mindy found providing her own self care challenging. Most weeks, taking care of herself fell low on her to-do list. But sometimes, she’d have a stretch of several days when she was able to eat healthy, get plenty of sleep, go for a long walk, and take a yoga class. All that effort to do the “right things” didn’t seem to make her feel any better. She was still tired all the time.

So, was she doing something wrong?

Why weren’t these good behaviors making a difference? She was frustrated.

It wasn’t menopause.

And it wasn’t due to “just getting older.”

For Mindy, it turned out that she wasn’t addressing the attack that her body was mounting against her own tissues. And it took over a year for her to discover what was happening in her body.

You may have heard of Hashimoto’s Thyroiditis. This was Mindy’s problem. Here’s what transpired.

A full two years after her mom died, Mindy’s fatigue was no better. But not for lack of trying to get help.

By the time Mindy came to see me, she had already seen 3 doctors.

Mindy first saw her general practitioner. After a brief visit in the office, blood work was ordered. According to her doctor, the tests showed “nothing wrong.” So her general practitioner, a truly caring woman, told her to join a grief share group, and that with time, she’d surely feel better.

Nine months after her mom died, Mindy’s doctor suggested that, at age 51, chances were good that her fatigue was due to menopause. So she went to see her gynecologist, who suggested hormone replacement therapy with estrogen, progesterone, and testosterone. Though she wasn’t sure she really wanted to get started on hormone therapy, Mindy was relieved to know what was wrong. So she got started on the hormones, but after several months nothing had changed. She quit taking them.

Mindy returned to her general practitioner. Her doctor said it must be depression. She was offered a prescription for Prozac, an antidepressant, but that advice did not resonate with her.

Most recently, Mindy consulted with an internist; more lab tests were performed. Since all her tests came back “normal,” the internist attempted to refer her to a psychiatrist. But Mindy decided the “buck stops here,” literally. She felt she was processing her grief well enough. Her body was sending a clear message, and she did not believe that her fatigue was “just in her head.”

Of course, Mindy was correct. And we soon discovered that the problem wasn’t in her head. The problem was in her throat.

It’s true that women have a high risk of developing hypothyroidism.

But Did You Know That Women Over 50 Have an Even Greater Risk?

Hypothyroidism is seen more frequently in women than in men – 10 times more often, according to many sources. In fact, 1 in 8 women may have hypothyroidism. Also, women over 50 have the greatest risk for thyroid disorders, according to the University of Maryland Medical Center. [1]

Hypothyroidism Fatigue

Why is Hypothyroidism So Often Missed in Women Over 50?

While there are a few reasons for this, my vast experience points to these two reasons as the primary ones.

First. The symptoms of hypothyroidism and menopause are similar. It’s quite common that around the age of 45 to 50, many women begin reporting to their doctors that they are suffering with depression, fatigue, brain fog, struggles with weight gain, and low libido. If you’re at all like these women, you’re hoping for answers, solutions, and R.E.L.I.E.F. Nearly every day in my practice I hear from women, saying that their doctors commonly attribute these issues to “menopause” or “normal aging.” Google these signs and symptoms and you’ll probably find the same conclusions drawn.

Do You Know the Signs of Low Thyroid Function?

  • Fatigue, feeling exhausted all the time, requiring more than 8 hours of sleep, having to take a nap every day
  • Unexplained weight gain, difficulty losing weight, or maintaining your ideal weight
  • Depressed mood, unmotivated, lost your “Mojo”
  • Impaired memory, Brain Fog (my article)
  • Loss of Libido
  • Feeling cold all the time, especially hands and feet

Note that most of these signs and symptoms are also commonly associated with menopause.

Second. Lab Testing. And this problem is actually two-fold:

  1. Comprehensive lab is necessary to make an accurate diagnosis.
  2. The labs aren’t interpreted through the lens of Optimal Function.

Part 2 of this series will cover the 6 components I recommend, and I’ll be explaining the concept of functional ranges.

Have You Been Told That Your Lab Tests Are Normal…. But You’re Still TIRED?

I see so many women who seek my help with fatigue. When I inquire about lab testing for their thyroid, it’s so common to hear that they’ve been tested and told that everything was fine. Yet they don’t FEEL fine. So they bring me a copy of their most recent test and, almost 100% of the time, I discover that BOTH problems mentioned above are at play. Only one or two thyroid markers were tested (not all 6 that are required, at least initially, to make an accurate diagnosis). What was tested was not interpreted through the lens of Optimal Ranges.

So, if your thyroid gland isn’t functioning optimally, this may be exactly why you feel so tired. And you shouldn’t ignore your body’s signals. Fatigue that doesn’t respond to rest, stress management techniques, proper exercise, or a healthy diet needs to be investigated further. Thyroid hormone is required by EVERY cell in your body for optimal metabolic function.

Signs and Symptoms of Low Thyroid

  • Elevated blood cholesterol level
  • Increased sensitivity to cold, especially hands and feet
  • Constipation, less than 1 bowel movement per day.
  • Dry skin
  • Thinning hair or hair falling out
  • Puffy face
  • Thin Eyebrows, especially the outer ⅓ edge
  • Muscle weakness, muscle aches, and pain
  • Joint pain, joint swelling
  • Exercise intolerance, less stamina, don’t recover well
  • Headaches, especially in the morning

Your takeaway from Part 1 is this: If you are suffering from fatigue and are waiting to “get through” menopause, or you’re doing all the “right” things and you don’t feel any better, I want you to know that hypothyroidism could be the cause.

What if You’re Already Taking Thyroid Medication… but You Still Don’t Feel Good?

This is something I frequently come across with the women I work with. You’ll need to hang in there with me. I will provide the answer to this dilemma in Part 4.

In Part 2, I’ll explain exactly which tests need to be run and how they need to be interpreted. If you’re like the vast majority of the women I work with, you may have been told that your thyroid tests were normal. Rarely, if EVER, have these women received COMPLETE thyroid testing. If you have nodules, you probably should have an ultrasound.

In Part 3, I’ll cover the most common cause of hypothyroidism, Hashimoto’s Thyroiditis, which is actually an autoimmune condition. This is the type I have. I’ll explain why, even if you have already been diagnosed, and even if you are currently taking medication, you absolutely must find out if you have Hashimoto’s.

In Part 4, I’ll share all of the various options for treatment of hypothyroidism. Uncovering your unique “root causes” will lead to the best options for you personally. Sometimes medication is necessary, along with stress management, proper diet, the right exercise plan, supplements and adequate, high quality sleep. Sometimes the downward trend can be reversed.



[1] http://umm.edu/health/medical/reports/articles/hypothyroidis


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Video – Eat 2 of These Nuts Everyday to Support Your Thyroid

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