Guest Author - Jim Lowrance

In the year 2006, my blood lab results, to monitor my thyroid hormone therapy, including TSH, T-4 and Free T-3 (thyroid function tests), were not jiving or correlating with each other. My TSH, at just below 0.2 (normal range 0.3 to 5.0), did not match up with the thyroid hormone levels which were also low. Usually a low TSH will mean high readings of the thyroid hormones or "hyperthyroidism". Patients taking Armour Thyroid (brand of T-4/T-3 thyroid med I take) do commonly have a somewhat low T-4 level but usually not flagged below normal and a below normal TSH usually means over-treatment with thyroid medication but this was not true in my case.

My Doctor, an Endocrinologist, actually raised my 120mg dose, to 150mg, so increased it 30mg, despite my low TSH. He said TSH in some patients, does not always accurately reflect some of the other thyroid lab levels. In my case, this was due to my other endocrine glands, including my "pituitary" (regulates the thyroid), also operating at sub-clinically low levels, due to my also having CFS. Many medical sources state that CFS results in a "blunted HPA Axis" (hypothalamus-pituitary-adrenal axis).

He also said from all of my test results, including low adrenal hormones, a highly elevated Epstein-Barr Virus count, continually swollen lymph nodes in my throat etc..., that I have co-existing Chronic Fatigue Syndrome (CFS). I had already been told this by a chiropratic doctor, three years earlier. He also added that thyroid patients sometimes have multi-endocrine problems, when everything runs low in addition to the thyroid gland but is especially true if the patient also has CFS.

I asked him if CFS was found more commonly in thyroid disease patients and he said it was but is often not recognized by doctors. This all amazed me because I had seen this Endocrinologist, 4 times previous and I had never asked him if he recognized CFS as a real syndrome/illness. He said he certainly does and he recognized it in me, without my having ever brought the subject of CFS up to him. Several years following this diagnosis of Hashimoto's and CFS, I have improved in many ways, especially when my thyroid is treated well, which reduces and helps control all symptoms significantly.

I also asked my doctor if thyroid patients commonly have symptom flare-ups and he said any patient with autoimmune thyroid disease will have ups and downs with symptoms, due to antibody and inflammation levels fluctuating, which in turn causes thyroid hormones to also fluctuate slightly. I believe this is also an aspect in the symptom levels of patients with co-morbid CFS and Fibromyalgia.

My doctor ordered follow up blood tests for me after two months on the increased thyroid med dose, asking for TSH, Free T-4 and Free T-3. My TSH was and is consistently below normal with blood retests but must be in my case due to my having co-morbid CFS. This keeps my thyroid hormone levels at mid-range and above, which most treated thyroid patients need to feel well.

I haven't often shared about my struggles with the co-occurring CFS but have done relatively well with it much of the time and always remain positive about it. I do feel that thyroid patients with ongoing adrenal fatigue could possibly be experiencing a blunted HPA axis and co-morbid CFS. If they suspect they have ongoing adrenal fatigue or CFS symptoms, they should ask for their adrenal hormone levels to be tested, preferably by multiple saliva samples over a 24 hour period, to better determine their cortisol rhythm.

My doctor did say that treating thyroid disease or any other underlying autoimmune condition is a major factor in helping control the symptoms of CFS and I know this has been true in my case. I also take adrenal support when needed that consists of a combination of vitamins, safe herbals and adrenal glandular supplement, which also helps control my symptoms of CFS and the adrenal fatigue that is a major feature of it.

It is an incorrect view for medical sources to state that having thyroid disease, eliminates the possibility of having CFS because this is not true in some cases and in fact autoimmune diseases including thyroid ones, may be a trigger for causing co-existing CFS or Fibromyalgia.