Q: Iím exhausted all the time, achy, tired and Iím not sleeping well. Iíve done enough reading to know it is possible I have yeast overgrowth, but thyroid dysfunction and fibromyalgia have similar symptoms. How can I get the right diagnosis and the right treatment?
A: There are many similarities in these three conditions, and fatigue and exhaustion are often the primary symptoms common to all three.
Many yeast and hypothyroid patients will describe exhaustion as their main symptom.
Sleeping too much, waking up tired and low energy all go hand in hand with fatigue and exhaustion. Brain fog or fuzzy thinking is also common to all three, but itís usually not the primary complaint. Inability to concentrate and poor memory are also related to fatigue and exhaustion.
However, there is a difference in that achy, tired feeling. For people with yeast overgrowth or hypothyroidism, the complaint is usually a general achiness, heaviness in the body and tiredness. For patients with fibromyalgia, the complaint is pain Ė sometimes debilitating Ė in specific muscles and joints. In fact, to get a diagnosis of fibromyalgia, a rheumatologist will test for pain in 14 well-defined ďtrigger points Ē for fibromyalgia. If you have pain in at least 11 of these points, that helps confirm a diagnosis.
There are some other overlapping symptoms of yeast overgrowth, hypothyroidism and fibromyalgia that are not well known:
Insulin resistance is also associated with yeast, hypothyroidism and fibromyalgia, although the risk of insulin resistance is higher in people with hypothyroidism. Thatís because imbalance in the endocrine system and thyroid is part of the hypothalamic-pituitary axis that becomes out of balance due to stress, whether itís physical or emotional.
Yet we know that insulin resistance can result from yeast overgrowth, since dysbiosis can cause fluctuations in blood sugar. The sugar cravings that go with yeast overgrowth trigger cravings and cause roller coaster blood sugars that in turn trigger more cravings.
Many people with fibromyalgia have sugar cravings Ė and blood sugar swings Ė triggered by complex biochemical imbalances related to brain and enzymatic chemistry.
Of course, those of you with yeast overgrowth know there is a high correlation between yeast and chemical sensitivities, but this can also happen in people with hypothyroidism and fibromyalgia.
Chemical sensitivities and these three conditions may be a chicken and egg situation. Itís hard to tell which comes first, so we have to look at the cascade effect of all three.
In people with yeast overgrowth, permeable or leaky gut allows antigens and pathogens to aggravate the immune system and can trigger an autoimmune condition. Among those autoimmune conditions is a type of hypothyroidism called Hashimotoís disease, and that can lead to hypometabolic conditions that are known to contribute to fibromyalgia, so there can actually be a close link between all three.
An extreme allergy or sensitivity to any substance Ėand that includes food allergies, celiac disease, yeast overgrowth and even mercury toxicity Ė can start you down the autoimmune path to hypothyroidism and fibromyalgia.
In hypothyroidism, both the immune and endocrine systems may be dysfunctional, and that can leave you sensitive to yeast, when you previously didnít have that problem.
Mood can be affected by all three conditions, but yeast overgrowth usually triggers a chronic mid-level depression, while thyroid and fibromyalgia patients can in some cases experience severe clinical depression trigged by their conditions.
Digestive problems are very common across all three conditions. Alternating diarrhea and constipation are common complaints as are general digestive disturbances like irritable bowel syndrome, indigestion and unusual stools. These symptoms are somewhat less common in people with fibromyalgia.
Q: So how do you sort out which is which?
A: Itís really tricky. Most of the doctors I know that deal with this type of thing will look for some evidence of the different conditions and for the fundamental differences that are not that difficult to recognize.
For fibromyalgia, as I mentioned before, the trigger point exam in which pressure is placed on 14 precise sets of spots can help a doctor make a diagnosis.
With hypothyroidism, a doctor will do some of the standard evaluations, at least feeling the thyroid, looking for lumps or nodules, testing for slow reflexes. A doctor should examine at the patient. If she is missing the outer third of her eyebrows, her hair is thinning and she is gaining weight, or she has puffiness in the face, hands or feet, those are all well-recognized clinical signs of hypothyroidism. Most doctors also will evaluate thyroid levels in the blood, at the very least a Thyroid Stimulating Hormone (TSH) blood test.
Some will perform examine thyroid levels in more detail with tests like T3, T4, free T3 and the TRH test, which evaluates thyroid function under stress. Some holistically oriented doctors consider basal body temperature a way to diagnose hypothyroidism, and a history or log of very low waking temperatures may aid in diagnosis. Saliva testing is also gaining popularity among some practitioners.
With yeast, your doctor can order fecal testing from a reputable lab like Great Smokies that can help pinpoint a diagnosis, although it is not as simple or straightforward as some other diagnoses.
Q: Then what?
A: The biggest caution is against a ďone shot doc.Ē Beware of a doctor who thinks everything is caused by yeast or by thyroid dysfunction or by fibromyalgia.
But at the same time, seeing one of these conditions is a smoke signal that there could be something else to look for, so the best doctors tend to know that if you have one of the three conditions, you particularly want to make sure that you rule out the others. This should be an automatic requirement. For example, if you have been diagnosed with hypothyroidism, the least your doctor should do is have you fill out the yeast questionnaire and test your trigger points. This is critical because treating only one of the two or three conditions will not resolve many of your symptoms. For example, if you have yeast and hypothyroidism, but only the yeast is treated, youíre still not going to feel better.
You and your doctor need to look at all your symptoms. Make sure your doctor is looking at everything thatís going on in your body. The doctors who will take time to do this are most often holistic doctors, osteopaths, naturopaths, chiropractors, and some of the more enlightened hormonal doctors (gynecologists or endocrinologists).
Q: Are treatments different for each of these?
A: Yes, the treatments will be different and you will need treatment specific to each of the conditions.
Of course, a good diet is essential for all three. A sugar- and yeast-free diet is an important part of treating yeast overgrowth, but itís also helpful for hypothyroidism and fibromyalgia, too. You can learn more about diet for people with thyroid and metabolic conditions in my book, The Thyroid Diet.
If you are diagnosed with yeast overgrowth, you may be given prescription antifungal drugs, or recommended antifungal herbs and supplements. People with hypothyroidism can be treated with various prescription thyroid medications. It may take some trial and error to determine which drug and dosage work best for you. Fibromyalgia is most often treated with prescription pain medications, medicines that help you sleep and relax, physical therapy.
For more information on thyroid disease, visit Mary Shomon’s websites at www.thyroid-info.com and thyroid.about.com. You can also sign up for a free newsletter on thyroid disease at www.thyroid-info.com/newsletters. More information on fibromyalgia is available at www.cfsfibromyalgia.com.
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