Table of ContentsView AllTable of ContentsHypothyroidism and Thyroid FatigueHyperthyroidism and Thyroid FatigueTreatmentOther CausesCoping
Table of ContentsView All
View All
Table of Contents
Hypothyroidism and Thyroid Fatigue
Hyperthyroidism and Thyroid Fatigue
Treatment
Other Causes
Coping
Fatigue is a common symptom of thyroid disease.If you’ve ever experienced thyroid fatigue, you’re aware that it isn’t like having a night of poor sleep or feeling overly stressed. For many people, fatigue related tothyroid diseaseis so extreme that it interferes with daily life.
Adjusting your thyroid medication dose (under the guidance of your healthcare provider), improving your sleep habits, and addressing other factors that may be making the issue worse, can all help relieve thyroid fatigue and improve your overall quality of life.
Fatigue is a nearly universal symptom ofhypothyroidism(an underactive thyroid), and it may be a sign that your thyroid levels are poorly regulated.This medical condition occurs as a result of a decrease in thyroid hormone production.
Thyroid fatigue can develop slowly or come on suddenly, leaving you barely able to lift your head off the pillow in the morning. With thyroid fatigue, you may:
In the morning, you may find it difficult to get out of bed and start your day.
Fatigue can also be a symptom of hyperthyroidism (anoveractive thyroid).Hyperthyroidism commonly causes:
Difficulty sleeping can be due to the stress that hyperthyroidism puts on your body, including:
If your fatigue has to do with your thyroid disease, you may need some medication adjustments:
Keep in mind that co-occuring health issues and other medications (lithium among them) can affect thyroid function, too.Talk to your healthcare provider about whether you need to adjust your dose so that you can feel your best. Don’t try to make these changes on your own.
Other Causes of Fatigue
If your thyroid disease is controlled and you’re still experiencing persistent fatigue, there are other causes to explore with your healthcare provider.
Depression
Fatigue is a common symptom of depression, likely due to changes in neurotransmitter chemicals that act on the brain. Other influences, such as trouble sleeping or social isolation, also may play a role.People with hypothyroidism and hyperthyroidism often have symptoms of depression.
A 2018 systematic review found that patients withHashimoto’s disease, a condition that causes hypothyroidism, are more likely to develop depression and anxiety than those without the condition. In fact, around 24% of this population experiences depression, and nearly 42% deals with anxiety.
See your healthcare provider if you’re experiencing symptoms ofdepression, as treatment can make a difference. It often involves taking an antidepressant, seeing a mental health professional for psychotherapy, or a combination of the two.
Sleep Apnea
Because the amount of oxygen you’re getting is reduced, frequent apnea can wake you up and interrupt your sleep. It can also make you feel exhausted.
Besides snoring, fatigue, and grogginess, other common symptoms of sleep apnea include:
Hypothyroidism is linked to sleep apnea since having low levels ofthyroid hormonecan affect your breathing.A 2016 systematic review of studies found that 30% of adults newly diagnosed with hypothyroidism also hadobstructive sleep apnea.
Anemia
Iron Deficiency
Many people diagnosed with thyroid disorder also experienceiron deficiency.It often leads to anemia, though some people may experience a related fatigue withoutthe presence of anemia. If this is the case for you, treating iron deficiency can significantly improve your symptoms of fatigue.
Fibromyalgia
Poor Sleep Habits
While insomnia and poor sleep quality may be associated with your underlying thyroid disease, sleep habits may be contributing to your fatigue, too. Most adults need about seven hours of sleep each day, though it can vary.
Taking steps toimprove sleep habits, like limiting screen time before bed and keeping the room temperature comfortable, can help.
Additional Considerations
Besides the conditions listed above, there are many other potential causes of fatigue. It’s a symptom of health problems that include:
There’s also the possibility of medication side effects, getting too much or too little exercise, and not eating a consistently healthy diet.
Coping With Fatigue
Talk to your healthcare provider about making some lifestyle changes to deal with your fatigue, especially if your medication has been adjusted. Here are some tips to try:
Get More Rest
If you’re routinely exhausted even though your thyroid treatment is optimized, you may be tempted to continue blaming your thyroid. Some people may be more at risk for sleep disruptions, and factors like circadian rhythm (your internal sleep-wake clock) may play a role.
Try to get at least eight hours of sleep each night. If you feel better and more energetic, your problem may be chronicsleep deprivationrather than a poorly treated thyroid problem. Keep in mind that you may simply need more sleep than you used to, but quantity isn’t the only factor.
A sleep diary can help you to recognize patterns and spot factors that might be disturbing your sleep quality, too, so you can make the necessary changes. You can also can look for an app for your smartphone or tablet that will help you track your sleep.
For chronic sleep problems, your healthcare provider may recommend over-the-counter sleep aids likemelatonin.You also can discuss antidepressants, anti-anxiety medications, or prescription sleep medications.
Change Your Diet
Some people report that changing their diet has improved their fatigue, whether that’s eliminating gluten, sugar, or dairy, or just cutting out processed foods.
Exercise
Exercising at least several times a week can help you feel more tired at night and sleep more soundly, too. Just be sure you’ve finished your workout several hours before it’s time for bed so your body has time to settle down for sleep.
Talk with your healthcare provider, though. Exercise can complicate certain health conditions, such asmyalgic encephalomyelitis/chronic fatigue syndrome(ME/CFS), which may be a co-occurring health condition.
Manage Stress
Stress can have an extremely negative effect on both your quantity and quality of sleep. It can be a contributing factor in thyroid disorder.Take time out for yourself to do enjoyable, relaxing activities so your stress won’t pile up. You’ll also sleep better.
Try some stress-busting activities such as boxing, yoga, writing in a journal, painting, playing an instrument, getting a massage, going for coffee with a friend, or squeezing a stress ball.
Summary
When you have thyroid disease, it can make you feel exhausted all of the time. Unfortunately, you may continue to experience fatigue even after a healthcare provider provides treatment for your thyroid condition.
Your healthcare provider may need to adjust your thyroid medication to help with your exhaustion. Making lifestyle changes may also help, such as getting more rest, keeping a sleep diary, eating a healthier diet, managing stress, and taking time to relax.
17 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.American Thyroid Association.Hypothyroidism.Wilson SA, Stem LA, Bruehlman RD.Hypothyroidism: Diagnosis and Treatment.Am Fam Physician. 2021 May 15;103(10):605-613. PMID: 33983002Rhodes MA, Adams CS, Bragg S, Christian N.Thyroid and Parathyroid Conditions: Hyperthyroidism.FP Essent. 2022 Mar;514:11-17. PMID: 35235281Lee SY, Pearce EN.Hyperthyroidism: A Review.JAMA. 2023 Oct 17;330(15):1472-1483. doi:10.1001/jama.2023.19052National Institute of Mental Health.Depression.Ghanean H, Ceniti AK, Kennedy SH.Fatigue in patients with major depressive disorder: prevalence, burden and pharmacological approaches to management.CNS Drugs. 2018;32(1):65-74. doi:10.1007/s40263-018-0490-zSiegmann E-M, Müller HHO, Luecke C, Philipsen A, Kornhuber J, Grömer TW.Association of depression and anxiety disorders with autoimmune thyroiditis: a systematic review and meta-analysis.JAMA Psychiatry. 2018;75(6):577. doi:10.1001/jamapsychiatry.2018.0190Sorensen JR, Winther KH, Bonnema SJ, Godballe C, Hegedüs L.Respiratory manifestations of hypothyroidism: a systematic review.Thyroid. 2016;26(11):1519-1527. doi:10.1089/thy.2015.0642National Heart Lung and Blood Institute.What is sleep apnea?.van Vliet NA, Kamphuis AEP, den Elzen WPJ, Blauw GJ, Gussekloo J, Noordam R,et al.Thyroid Function and Risk of Anemia: A Multivariable-Adjusted and Mendelian Randomization Analysis in the UK Biobank.J Clin Endocrinol Metab. 2022 Jan 18;107(2):e643-e652. doi:10.1210/clinem/dgab674Garofalo V, Condorelli RA, Cannarella R, Aversa A, Calogero AE, La Vignera S.Relationship between Iron Deficiency and Thyroid Function: A Systematic Review and Meta-Analysis.Nutrients. 2023 Nov 15;15(22):4790. doi:10.3390/nu15224790Haliloglu S, Ekinci B, Uzkeser H, et al.Fibromyalgia in patients with thyroid autoimmunity: prevalence and relationship with disease activity.Clin Rheumatol. 2017;36(7):1617–1621. doi:10.1007/s10067-017-3556-2Harvard Health Publishing.How much sleep do you actually need?Maisel P, Baum E, Donner-Banzhoff N.Fatigue as the chief complaint—epidemiology, causes, diagnosis, and treatment.Dtsch Arztebl Int. 2021;118(33-34):566-576. doi:10.3238/arztebl.m2021.0192Addanki S, Patel K, Patel L, Smith B, Patel P, Uppalapati S,et al.Thyroid Function and Sleep Patterns: A Systematic Review.Cureus. 2024 Jun 29;16(6):e63447. doi:10.7759/cureus.63447Latimer KM, Gunther A, Kopec M.Fatigue in Adults: Evaluation and Management.Am Fam Physician. 2023 Jul;108(1):58-69. PMID: 37440739Willems JIA, van Twist DJL, Peeters RP, Mostard GJM, van Wijngaarden RFATL.Stress-Induced Graves Disease: Spontaneous Recovery After Stress Relief.J Endocr Soc. 2023 Dec 13;8(1):bvad157. doi:10.1210/jendso/bvad157
17 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.American Thyroid Association.Hypothyroidism.Wilson SA, Stem LA, Bruehlman RD.Hypothyroidism: Diagnosis and Treatment.Am Fam Physician. 2021 May 15;103(10):605-613. PMID: 33983002Rhodes MA, Adams CS, Bragg S, Christian N.Thyroid and Parathyroid Conditions: Hyperthyroidism.FP Essent. 2022 Mar;514:11-17. PMID: 35235281Lee SY, Pearce EN.Hyperthyroidism: A Review.JAMA. 2023 Oct 17;330(15):1472-1483. doi:10.1001/jama.2023.19052National Institute of Mental Health.Depression.Ghanean H, Ceniti AK, Kennedy SH.Fatigue in patients with major depressive disorder: prevalence, burden and pharmacological approaches to management.CNS Drugs. 2018;32(1):65-74. doi:10.1007/s40263-018-0490-zSiegmann E-M, Müller HHO, Luecke C, Philipsen A, Kornhuber J, Grömer TW.Association of depression and anxiety disorders with autoimmune thyroiditis: a systematic review and meta-analysis.JAMA Psychiatry. 2018;75(6):577. doi:10.1001/jamapsychiatry.2018.0190Sorensen JR, Winther KH, Bonnema SJ, Godballe C, Hegedüs L.Respiratory manifestations of hypothyroidism: a systematic review.Thyroid. 2016;26(11):1519-1527. doi:10.1089/thy.2015.0642National Heart Lung and Blood Institute.What is sleep apnea?.van Vliet NA, Kamphuis AEP, den Elzen WPJ, Blauw GJ, Gussekloo J, Noordam R,et al.Thyroid Function and Risk of Anemia: A Multivariable-Adjusted and Mendelian Randomization Analysis in the UK Biobank.J Clin Endocrinol Metab. 2022 Jan 18;107(2):e643-e652. doi:10.1210/clinem/dgab674Garofalo V, Condorelli RA, Cannarella R, Aversa A, Calogero AE, La Vignera S.Relationship between Iron Deficiency and Thyroid Function: A Systematic Review and Meta-Analysis.Nutrients. 2023 Nov 15;15(22):4790. doi:10.3390/nu15224790Haliloglu S, Ekinci B, Uzkeser H, et al.Fibromyalgia in patients with thyroid autoimmunity: prevalence and relationship with disease activity.Clin Rheumatol. 2017;36(7):1617–1621. doi:10.1007/s10067-017-3556-2Harvard Health Publishing.How much sleep do you actually need?Maisel P, Baum E, Donner-Banzhoff N.Fatigue as the chief complaint—epidemiology, causes, diagnosis, and treatment.Dtsch Arztebl Int. 2021;118(33-34):566-576. doi:10.3238/arztebl.m2021.0192Addanki S, Patel K, Patel L, Smith B, Patel P, Uppalapati S,et al.Thyroid Function and Sleep Patterns: A Systematic Review.Cureus. 2024 Jun 29;16(6):e63447. doi:10.7759/cureus.63447Latimer KM, Gunther A, Kopec M.Fatigue in Adults: Evaluation and Management.Am Fam Physician. 2023 Jul;108(1):58-69. PMID: 37440739Willems JIA, van Twist DJL, Peeters RP, Mostard GJM, van Wijngaarden RFATL.Stress-Induced Graves Disease: Spontaneous Recovery After Stress Relief.J Endocr Soc. 2023 Dec 13;8(1):bvad157. doi:10.1210/jendso/bvad157
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
American Thyroid Association.Hypothyroidism.Wilson SA, Stem LA, Bruehlman RD.Hypothyroidism: Diagnosis and Treatment.Am Fam Physician. 2021 May 15;103(10):605-613. PMID: 33983002Rhodes MA, Adams CS, Bragg S, Christian N.Thyroid and Parathyroid Conditions: Hyperthyroidism.FP Essent. 2022 Mar;514:11-17. PMID: 35235281Lee SY, Pearce EN.Hyperthyroidism: A Review.JAMA. 2023 Oct 17;330(15):1472-1483. doi:10.1001/jama.2023.19052National Institute of Mental Health.Depression.Ghanean H, Ceniti AK, Kennedy SH.Fatigue in patients with major depressive disorder: prevalence, burden and pharmacological approaches to management.CNS Drugs. 2018;32(1):65-74. doi:10.1007/s40263-018-0490-zSiegmann E-M, Müller HHO, Luecke C, Philipsen A, Kornhuber J, Grömer TW.Association of depression and anxiety disorders with autoimmune thyroiditis: a systematic review and meta-analysis.JAMA Psychiatry. 2018;75(6):577. doi:10.1001/jamapsychiatry.2018.0190Sorensen JR, Winther KH, Bonnema SJ, Godballe C, Hegedüs L.Respiratory manifestations of hypothyroidism: a systematic review.Thyroid. 2016;26(11):1519-1527. doi:10.1089/thy.2015.0642National Heart Lung and Blood Institute.What is sleep apnea?.van Vliet NA, Kamphuis AEP, den Elzen WPJ, Blauw GJ, Gussekloo J, Noordam R,et al.Thyroid Function and Risk of Anemia: A Multivariable-Adjusted and Mendelian Randomization Analysis in the UK Biobank.J Clin Endocrinol Metab. 2022 Jan 18;107(2):e643-e652. doi:10.1210/clinem/dgab674Garofalo V, Condorelli RA, Cannarella R, Aversa A, Calogero AE, La Vignera S.Relationship between Iron Deficiency and Thyroid Function: A Systematic Review and Meta-Analysis.Nutrients. 2023 Nov 15;15(22):4790. doi:10.3390/nu15224790Haliloglu S, Ekinci B, Uzkeser H, et al.Fibromyalgia in patients with thyroid autoimmunity: prevalence and relationship with disease activity.Clin Rheumatol. 2017;36(7):1617–1621. doi:10.1007/s10067-017-3556-2Harvard Health Publishing.How much sleep do you actually need?Maisel P, Baum E, Donner-Banzhoff N.Fatigue as the chief complaint—epidemiology, causes, diagnosis, and treatment.Dtsch Arztebl Int. 2021;118(33-34):566-576. doi:10.3238/arztebl.m2021.0192Addanki S, Patel K, Patel L, Smith B, Patel P, Uppalapati S,et al.Thyroid Function and Sleep Patterns: A Systematic Review.Cureus. 2024 Jun 29;16(6):e63447. doi:10.7759/cureus.63447Latimer KM, Gunther A, Kopec M.Fatigue in Adults: Evaluation and Management.Am Fam Physician. 2023 Jul;108(1):58-69. PMID: 37440739Willems JIA, van Twist DJL, Peeters RP, Mostard GJM, van Wijngaarden RFATL.Stress-Induced Graves Disease: Spontaneous Recovery After Stress Relief.J Endocr Soc. 2023 Dec 13;8(1):bvad157. doi:10.1210/jendso/bvad157
American Thyroid Association.Hypothyroidism.
Wilson SA, Stem LA, Bruehlman RD.Hypothyroidism: Diagnosis and Treatment.Am Fam Physician. 2021 May 15;103(10):605-613. PMID: 33983002
Rhodes MA, Adams CS, Bragg S, Christian N.Thyroid and Parathyroid Conditions: Hyperthyroidism.FP Essent. 2022 Mar;514:11-17. PMID: 35235281
Lee SY, Pearce EN.Hyperthyroidism: A Review.JAMA. 2023 Oct 17;330(15):1472-1483. doi:10.1001/jama.2023.19052
National Institute of Mental Health.Depression.
Ghanean H, Ceniti AK, Kennedy SH.Fatigue in patients with major depressive disorder: prevalence, burden and pharmacological approaches to management.CNS Drugs. 2018;32(1):65-74. doi:10.1007/s40263-018-0490-z
Siegmann E-M, Müller HHO, Luecke C, Philipsen A, Kornhuber J, Grömer TW.Association of depression and anxiety disorders with autoimmune thyroiditis: a systematic review and meta-analysis.JAMA Psychiatry. 2018;75(6):577. doi:10.1001/jamapsychiatry.2018.0190
Sorensen JR, Winther KH, Bonnema SJ, Godballe C, Hegedüs L.Respiratory manifestations of hypothyroidism: a systematic review.Thyroid. 2016;26(11):1519-1527. doi:10.1089/thy.2015.0642
National Heart Lung and Blood Institute.What is sleep apnea?.
van Vliet NA, Kamphuis AEP, den Elzen WPJ, Blauw GJ, Gussekloo J, Noordam R,et al.Thyroid Function and Risk of Anemia: A Multivariable-Adjusted and Mendelian Randomization Analysis in the UK Biobank.J Clin Endocrinol Metab. 2022 Jan 18;107(2):e643-e652. doi:10.1210/clinem/dgab674
Garofalo V, Condorelli RA, Cannarella R, Aversa A, Calogero AE, La Vignera S.Relationship between Iron Deficiency and Thyroid Function: A Systematic Review and Meta-Analysis.Nutrients. 2023 Nov 15;15(22):4790. doi:10.3390/nu15224790
Haliloglu S, Ekinci B, Uzkeser H, et al.Fibromyalgia in patients with thyroid autoimmunity: prevalence and relationship with disease activity.Clin Rheumatol. 2017;36(7):1617–1621. doi:10.1007/s10067-017-3556-2
Harvard Health Publishing.How much sleep do you actually need?
Maisel P, Baum E, Donner-Banzhoff N.Fatigue as the chief complaint—epidemiology, causes, diagnosis, and treatment.Dtsch Arztebl Int. 2021;118(33-34):566-576. doi:10.3238/arztebl.m2021.0192
Addanki S, Patel K, Patel L, Smith B, Patel P, Uppalapati S,et al.Thyroid Function and Sleep Patterns: A Systematic Review.Cureus. 2024 Jun 29;16(6):e63447. doi:10.7759/cureus.63447
Latimer KM, Gunther A, Kopec M.Fatigue in Adults: Evaluation and Management.Am Fam Physician. 2023 Jul;108(1):58-69. PMID: 37440739
Willems JIA, van Twist DJL, Peeters RP, Mostard GJM, van Wijngaarden RFATL.Stress-Induced Graves Disease: Spontaneous Recovery After Stress Relief.J Endocr Soc. 2023 Dec 13;8(1):bvad157. doi:10.1210/jendso/bvad157
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