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We continue this month with our series on why your brain might not be functioning the way you feel it should.
Hypothyroidism, or an underfunctioning thyroid gland (commonly called low thyroid), is often overlooked by doctors as a cause of poor memory. It’s neglected because many physicians rely solely on a not-very-good blood test to confirm or reject a diagnosis of low thyroid.
The test is called TSH, for thyroid-stimulating hormone. Understand that a blood test result of high TSH=low thyroid function.
For years it’s been gospel that the magic TSH number was 5. Any TSH result higher than 5 merited treatment, otherwise not. Unfortunately, the vast majority of physicians waited until their patients’ TSH surpassed 5 before starting treatment. This can translate into years of a woman feeling crummy due to low thyroid: fatigued, sluggish, and mentally slow.
Yet many physicians, myself included, estimate that almost 25% of women entering menopause show clinical signs of underactive thyroid. Fortunately, more and more endocrinologists now treat any TSH above 3 with thyroid replacement. Some regard a result of even 2.5 or higher as worth watching.
I use the TSH blood test along with basal body temperature testing, which you do yourself, to determine if a woman needs thyroid replacement. If either is abnormal, I write a prescription for Armour thyroid.
Back to the mental changes of low thyroid: the best way to describe them is “fuzzy.” You might have trouble remembering simple things, concentrating, or performing easy tasks like adding a column of figures. The changes can be remarkably subtle, like needing to have a joke explained or being accused of repeating yourself.
Conversely, the two most common words I hear from patients who are a few weeks into thyroid replacement are “sharper” and “warmer.” Their mental function has improved and they’ve stopped feeling cold all the time, one of the hallmark symptoms of underactive thyroid.
David Edelberg, MD