Optimizing thyroid function, especially if you have Hashimoto’s or other autoimmune thyroid disease, requires some good detective work including testing for all the important markers of thyroid health.
This month, I gave a talk to other doctors and dentists on “The Clinical Management of Weight Reduction in Oral Sleep Apnea”. While reviewing my notes and creating my presentation I came across some interesting research regarding the thyroid and sleep apnea. Before I tell you about this research, it is important to note that many of my patients with thyroid troubles have disordered sleep patterns but this does not necessarily mean that have sleep apnea. One of the key signs that the thyroid has began to under function is feeling tired. In fact, many of my patients report wanting to sleep 9, 10, 11, or even 12 hours at a time- and still feeling fatigued!. On the other end of the spectrum, sometimes sleep can be disturbed when thyroid hormones are out of balance. These patients may feel tired because they have been up many times during the night, which could be a result of hormone imbalance.
Sleep Apnea, is a chronic health condition that is characterized by pauses in breathing while sleeping. These pauses in breathing and lack of oxygen wake people up during the night and the result is un-refreshing, fragmented sleep. The symptoms of sleep apnea include: snoring, restless sleep, gasping for air while sleeping, fatigue, daytime sleepiness, and nasal congestion. Sleep apnea has also been correlated to weight gain, high blood sugar levels and high blood pressure. So how does sleep apnea relate to thyroid disease?
Interestingly enough, studies have found that 25-35% of people with hypothyroidism also have sleep apnea AND sleep apnea may be a disk factor for the development of autoimmune thyroid disease! Research that was reported in a 2012 study published in Endocrine journal revealed that over 50% of people with Obstructive Sleep Apnea (otherwise known as OSA) tested positive for thyroid antibodies (TPO or TG antibodies). These people still had normal levels of TSH, the “gold standard” marker for determining thyroid disease. However, thyroid antibodies can be positive long before TSH changes, and can be an early marker of thyroid dysfunction- especially if the patient has symptoms of thyroid disease!
Testing for sleep apnea requires having your breathing monitored overnight in a sleep lab. As unpleasant as this may sound early detection and early treatment significantly improves health outcomes. Remember, sleep apnea can cause weight gain, high blood pressure and high blood sugar. If you are diagnosed with sleep apnea, using CPAP or Oral Dental Appliance can improve fatigue and increase energy. If you are overweight, working to reduce weight can also be key in reducing symptoms.
If you have symptoms of hypothyroid such as:
Easy weight gain
Puffy face Fatigue
Intolerance to cold
Heavy periods
Dry skin
Brittle nails
I would encourage you to ask your doctor, or work with another healthcare practitioner to have multiple thyroid tests run including TSH, T4, T3 and TPO. I believe wellness requires working with a physician (medical or naturopathic) that is willing to get to the root cause of your symptoms. Don’t be shy to ask questions about your health- taking charge of your health is empowering!
Dr. Emily