The next step in thyroid recovery is honing in on thyroid comorbidities. These are conditions that are present for those struggling with thyroid disease – not thyroid disease itself.
In this article, I’ll talk you through thyroid comorbidities, why they matter, and what to look out for to ensure that you feel your best after taking the appropriate steps. Let’s get into it.
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Thyroid comorbidities are important because those with thyroid disease may go on medications, change their diets, or steadily improve their thyroid levels – and yet, so often, they still fail to do better. Thyroid comorbidities may be at the heart of this issue.
Over 90% of those with thyroid disease have additional medical problems. In many cases, they have more than one – it is common to have multiple comorbidities. They are super common and they affect you very directly, causing symptoms and influencing your thyroid.
Key Insight: Various comorbidities are more apt to cause thyroid disease, but also disrupt how your body uses thyroid hormones in general. Even when your thyroid is “fixed,” these comorbidities can continue to cause issues for it.
Let’s talk through some of the most common symptoms and how various comorbidities may be at the source of them:
As we go through, I’m going to touch on the top fourteen comorbidities and what you need to know about them. While there are others, these are the ones worth keeping top of mind.
We are too often quick to assume that sleep apnea is only an issue for older men with big bellies. The truth is that people of all sizes, genders, and shapes can struggle with sleep apnea.
And, it’s extremely common! If you cannot get to sleep well, cannot stay asleep, or don’t feel refreshed – you need to consider the role of apnea.
This is even more true if you’re told that you don’t breathe well at night or snore quite a bit. Sleep apnea can be a big player here.
We even have data saying that those with Hashimoto’s thyroiditis and hypothyroidism have over three times the rate of obstructive sleep apnea (compared to the general population).
Key Insight: Your first step should be to see a sleep specialist and do a home study. This could be all you need to get to the root of this issue.
Anemia is a broad category and it involves a spectrum. The mildest version is what we know as latent iron depletion (LID). Even in the mildest stages, significant symptoms can emerge.
This is especially likely for someone going through heavy menstrual cycles, hair loss, and fatigue issues, and we have seen data that over 84% of those with thyroid disease have anemia issues.
How do you screen for anemia? Iron panels, ferritin especially, can be super helpful. If ferritin is below 100, you may already be symptomatic.
Key Insight: It is so important to dig into the causes of anemia or LID. So, beginning by establishing a baseline of your own iron health can be a great place to start.
Simply by having thyroid disease, you should automatically consider screening for celiac disease. That is because the two of them are more common together.
It’s good to screen for celiac, but it’s tough to screen for it when someone is on a gluten-free diet. It makes it a bit more difficult to figure it out.
Key Insight: Why not go gluten-free? The odds are likely that you are not celiac (around 97% of people do not have it). And, if you are already gluten-free, you can’t screen for it effectively.
There has been data saying that around 55% of people with hypothyroidism have abnormalities in their kidney function. It is a big deal.
What do you do? The first is to manage your hypothyroidism, with the second step being to follow up with appropriate renal care in general.
That can mean close management through a lifestyle diet, but this is a critical part of feeling well and we need to pay attention to our kidney health.
Data suggests that those with thyroid disease carry three times the risk of heart disease. But, what do you do if you suspect that you may be struggling with your cardiovascular health?
Start by taking a closer look. Calcium scores can be helpful, follow up with a cardiologist, and be present if you suffer from any chest pains or tightness after activity.
This can be suspected when there is fatigue, unexpected pain, or a past diagnosis of mood symptoms. Studies suggest that this can be present in 69% of those with hypothyroidism.
It can also be enmeshed in ways with thyroid disease where it’s tough to distinguish the chicken from the egg. Many with thyroid disease have anxiety and depression, though.
Start with a primary care doctor and make sure that it is being addressed. There are loads of options involving diet, exercise, and other options. It really deserves your attention.
We suspect this thyroid comorbidity when we see higher levels of blood sugar in various ways. Morning fasting glucose or a three-month blood sugar average.
51% of those with thyroid disease are likely to develop some version of diabetes at some point. This is something very treatable in nearly all cases.
This was the focus of my Metabolism Reset Diet. I would recommend speaking to your doctor if you have prediabetes, but consider the guidelines in the diet to help slow progression.
If you have marked gas or bloating, don’t think that the only solution is to make your diet stricter and stricter and stricter. This can often have the opposite intended effect.
One study showed that 100% of those with hypothyroidism have disorders of gut motility, meaning that the sequence of nerve firing did not work right for them.
That is why it is great to have a thorough evaluation. IBS or IBD can be treated and managed naturally, which means consulting with a medical professional to help.
Key Insight: Relying on a stricter diet can compromise your bowel flora and cause your already bad situation to get worse. We want to reverse that, not make it more difficult for you.
In those who suffer from thyroid disease, there is around an eightfold increase in the risk for non-thyroidal cancers. You want to screen for cancers.
You also want to be aware of any signs of hypercalcemia (high calcium in blood tests). You also want liver function tests, blood count, and other possible signs.
It is so crucial to know at the earliest possible stages, whether or not you may be struggling with a hidden malignancy, So, consistent testing is a must.
This is crazy common. There is around a 393% increased risk of fatty liver for those with thyroid disease. We suspect this when someone has a height-to-waist ratio greater than 0.5.
Key Insight: Much like prediabetes, fatty liver can be reversible through the Metabolism Reset Diet. Please give it a read to see if it can benefit you.
I would consider this less like being overweight and more like “having too much fat in the wrong places.” In most cases, there are plenty of folks who may be carrying “toxic fat.”
We know that there is a much higher rate of obesity with hypothyroidism (somewhere around 30% higher). So, we know it is an issue.
Important to note here is that the weight itself is not a comorbidity in terms of a health risk, but is a huge driver of symptoms (like fatigue, depression, chronic pain, or more).
Key Insight: That extra weight may be a bigger driver of inflammation than anything else you could ever imagine. Instead of going through the wringer with other solutions, start with weight.
This can be a big driver for fatigue, anxiety, digestion, joint pain, and calcium elevations, and there is about a six-fold risk for parathyroid disease for those with thyroid disease.
The only treatment here is surgery, but with the right surgeon, the procedure can be fast, easy, and life-changing. If you suspect it, you should get to the bottom of it.
There is about a 22% increased rate of chronic obstructive pulmonary disease for those with hypothyroidism. This is more probable for those with a history of tobacco use.
A good thing here is to test for any pulmonary issues and to follow up with care as needed.
We think about this for someone who has marked digestive symptoms. Especially when it comes to heartburn, bloating, and bowel irregularities along with low levels of iron.
This affects somewhere around 40% of those with Hashimoto’s disease. It is very common, and very easy to screen with blood markers or other diagnostic tests.
The thing I want you to know is that this list of comorbidities is not exhaustive, and it’s also not surprising if you find yourself struggling with any of them. They are incredibly common.
And, that is why it is critical to work with a good diagnostician. You want someone who can really understand these things and how they relate to thyroid disease.
Learning how to screen and how to treat, particularly how to treat these issues naturally, is so crucial to your overall health. I hope you’ll consider the above.
If you want to get a sense of how your thyroid is feeling today, I’d start by taking the Thyroid Quiz. It can help unlock some tangible next steps for you to regain control of your health.
P.S. Whenever you are ready, here is how I can help you now:
Dr. Alan Glen Christianson (Dr. C) is a Naturopathic Endocrinologist and the author of The NY Times bestselling Hormone Healing Cookbook, The Metabolism Reset Diet, and The Thyroid Reset Diet.
Dr. C’s gift for figuring out what works has helped hundreds of thousands reverse thyroid disease, heal their adrenals, and lose weight naturally. Learn more about the surprising story that started his quest.
