Herb Caudill

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A Medical Mystery: Thyroid Hormones, Chronic Fatigue and Fibromyalgia

This post is 5 years old, but I just came across it and it's sent me off into a rabbit hole of learning about hypothyroidism and the community of rogue practitioners that argue for treating CFS as a thyroid problem. 

I've had CFS ever since a sinus infection 7 years ago. I've mostly given up on finding a solution, but periodically check to see if there's any new research. Somehow I'd totally missed the thyroid angle, presumably because I've been told so many times that my thyroid function (measured by TSH) is normal. 

Anyway, @johnlawrenceaspden , if you're still around, I was wondering if this has turned out to be a durable cure for your own chronic condition. 

I also wanted to point out this 2018 study: Higher Prevalence of “Low T3 Syndrome” in Patients With Chronic Fatigue Syndrome: A Case–Control Study 

Here's a quick summary, edited for brevity, highlights mine, from Science Daily:

Chronic fatigue syndrome possibly explained by lower levels of key thyroid hormones

In hypothyroidism, the body tries to encourage thyroid hormone activity by releasing more TSH -- however, this does not happen in patients with chronic fatigue syndrome.

The study's authors hypothesized that CFS is caused by low activity of thyroid hormones in the absence of thyroidal disease.

Led by Dr. Begoña Ruiz-Núñez at the University Medical Center Groningen, The Netherlands, the researchers compared thyroid function and markers of inflammation between 98 CFS patients and 99 healthy controls. Remarkably, the CFS patients had lower serum levels of T3 and T4, but normal levels of TSH.

CFS patients had a lower urinary iodine status and low-grade inflammation, as well as relatively higher levels of "reverse T3" or rT3. This appeared to be due to a shift in hormone production, where the body preferred to convert T4 to rT3 instead of producing T3. The low T3 levels found in CFS patients, coupled with this switchover to rT3, could mean that T3 levels are severely reduced in tissue.

I don't know if this study has been replicated; if it has, it would seem to me to be nearly conclusive evidence in favor of your hypothesis.