Fatigue? Unexplained weight gain and dry skin? Could it be Hashimoto’s disease?
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Maybe you feel worn out. Perhaps you’re also having trouble losing weight. Generally, you just don’t feel 100%.
Could it be Hashimoto’s disease? This common autoimmune thyroid disorder is when your immune system (which fights off viruses and bacteria), mistakenly attacks a part of your body. In this case, it’s your thyroid – a gland located at the base of your neck – and can cause low thyroid hormones levels (hypothyroidism).
Hypothyroidism affects one in 33 Australians and Hashimoto’s is one of the most common thyroid conditions in first-world countries.
While symptoms can be subtle, untreated Hashimoto’s can cause long-term problems with your heart, memory and fertility. Here is what you need to know.
What happens when you have Hashimoto’s?
Your thyroid gland is a butterfly-shaped gland in the neck. It is essential in regulating things like muscle function, digestion, metabolism, the heart and lungs. In children, thyroid hormones are also needed for normal growth and development.
Hashimoto’s thyroid disease, named after the Japanese doctor who discovered it in 1912, is also known as Hashimoto’s thyroiditis or chronic lymphocytic thyroiditis. The disease can cause the immune system to mistakenly produce proteins called antibodies (thyroid peroxidase and thyroglobulin). These can cause inflammation and long-term damage to the thyroid gland. Over time, as thyroid tissue is inflamed and/or destroyed, there can be a decrease in the production of thyroid hormones (hypothyroidism).
Hashimoto’s can present subtly at first. If you only have antibodies with no change in thyroid levels, it is likely you won’t have any symptoms.
However, as the disease progresses, you may experience fatigue, weight gain (or difficulty losing weight), increased sensitivity to the cold, constipation, dry skin, muscle aches, irregular or heavy menstrual cycles, enlarged thyroid (goitre) and occasionally hair loss, including at the ends of your eyebrows.
What causes Hashimoto’s thyroid disease?
Several risk factors can contribute to the development of Hashimoto’s including:
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genetic risk – your risk is higher if you have family members with Hashimoto’s
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gender – women are up to ten times more likely than men to develop the disease
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age – you are more likely to develop the disease from 30 to 50 years of age
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autoimmune condition – having another autoimmune condition like systemic lupus, Type 1 diabetes and celiac disease increases your risk
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excessive iodine intake and radiation exposure may also increase risk in people who are already genetically at greater risk.
What are the long-term risks?
Long-term, untreated Hashimoto’s thyroiditis can cause heart issues, higher cholesterol levels, nerve damage (peripheral neuropathy), reduced cognition and infertility.
In pregnancy, Hashimoto’s has a higher risk of pre-eclampsia (high blood pressure affecting several organs), premature birth, placental abruption (when the placenta separates from the inner wall of the uterus before birth) and, in severe cases, pregnancy loss.
The disease has also been linked with an increased risk (but low incidence) of the lymphocytes of the thyroid turning into cancer cells to cause thyroid lymphoma.
How is Hashimoto’s diagnosed?
Diagnosis can be confirmed with a blood test to check thyroid levels and antibodies.
Thyroid peroxidase antibodies are commonly present but about 5% of patients test antibody-negative. In those people, diagnosis depends on the thyroid levels, clinical presentation and ultrasound appearance of general inflammation. An ultrasound may not be required though, especially if the diagnosis is obvious.
Three hormone levels are tested to determine if you have Hashimoto’s.
Thyroid stimulating hormone (TSH) is produced by the brain to speak to the thyroid, telling it to produce two types of thyroid hormones – T3 and T4.
If you have either relative or absolute thyroid hormone deficiency, a test will show the stimulating hormones as high because the brain is trying to get the thyroid to work harder.
Patho/Wikimedia Commons, CC BY-SA
Can it be treated?
The management of Hashimoto’s depends on the severity of the thyroid levels. Up to 20% of the population can have antibodies but normal thyroid levels. This is still Hashimoto’s thyroid disease, but it is very mild and does not require treatment. There is no current treatment to reduce antibody levels alone.
Because thyroid peroxidase antibodies increase the risk of abnormal thyroid levels in the future, regular thyroid testing is recommended.
When the thyroid stimulating hormone is high with normal thyroid hormone levels it is termed “subclinical hypothyroidism”. When it is paired with low hormone levels it is called “overt hypothyroidism”. The first is a mild form of the disease and treatment depends on the degree of stimulating hormone elevation.
Overt hypothyroidism warrants treatment. The main form of this is thyroid hormone replacement therapy (levothyroxine) with the dose of the drug adjusted until thyroid levels are within the normal range. This is usually a lifelong treatment but, once the dose is optimised, hormone levels usually remain relatively stable.
In some people with very enlarged thyroid glands causing compressive symptoms (such as difficulty swallowing or breathing), thyroidectomy (surgical removal of the thyroid) is considered.
Hashimoto’s thyroiditis is a common condition caused by your body’s immune system incorrectly damaging to your thyroid and can go undetected. Long-term, untreated, it can cause issues with your heart, cognition, and fertility. It can be diagnosed with a simple blood test. Speak to your doctor if you have any concerns as early diagnosis and treatment can help prevent complications.
Aakansha Zala, The University of Queensland
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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Relationships: When To Stick It Out & When To Call It Quits
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Like A Ship Loves An Anchor?
Today’s article may seem a little bit of a downer to start with, but don’t worry, it picks up again too. Simply put, we’ve written before about many of the good parts of relationships, e.g:
Only One Kind Of Relationship Promotes Longevity This Much!
…but what if that’s not what we have?
Note: if you have a very happy, secure, fulfilling, joyous relationship, then, great! Or if you’re single and happy, then, also great! Hopefully you will still find today’s feature of use if you find yourself advising a friend or family member one day. So without further ado, let’s get to it…
You may be familiar with the “sunk cost fallacy”; if not: it’s what happens when a person or group has already invested into a given thing, such that even though the thing is not going at all the way they hoped, they now want to continue trying to make that thing work, lest their previous investment be lost. But the truth is: if it’s not going to work, then the initial investment is already lost, and pouring out extra won’t help—it’ll just lose more.
That “investment” in a given thing could be money, time, energy, or (often the case) a combination of the above.
In the field of romance, the “sunk cost fallacy” keeps a lot of bad relationships going for longer than perhaps they should, and looking back (perhaps after a short adjustment period), the newly-single person says “why did I let that go on?” and vows to not make the same mistake again.
But that prompts the question: how can we know when it’s right to “keep working on it, because relationships do involve work”, as perfectly reasonable relationship advice often goes, and when it’s right to call it quits?
Should I stay or should I go?
Some questions for you (or perhaps a friend you might find yourself advising) to consider:
- What qualities do you consider the most important for a partner to have—and does your partner have them?
- If you described the worst of your relationship to a close friend, would that friend feel bad for you?
- Do you miss your partner when they’re away, or are you glad of the break? When they return, are they still glad to see you?
- If you weren’t already in this relationship, would you seek to enter it now? (This takes away sunk cost and allows a more neutral assessment)
- Do you feel completely safe with your partner (emotionally as well as physically), or must you tread carefully to avoid conflict?
- If your partner decided tomorrow that they didn’t want to be with you anymore and left, would that be just a heartbreak, or an exciting beginning of a new chapter in your life?
- What things would you generally consider dealbreakers in a relationship—and has your partner done any of them?
The last one can be surprising, by the way. We often see or hear of other people’s adverse relationship situations and think “I would never allow…” yet when we are in a relationship and in love, there’s a good chance that we might indeed allow—or rather, excuse, overlook, and forgive.
And, patience and forgiveness certainly aren’t inherently bad traits to have—it’s just good to deploy them consciously, and not merely be a doormat.
Either way, reflect (or advise your friend/family member to reflect, as applicable) on the “score” from the above questions.
- If the score is good, then maybe it really is just a rough patch, and the tools we link at the top and bottom of this article might help.
- If the score is bad, the relationship is bad, and no amount of historic love or miles clocked up together will change that. Sometimes it’s not even anyone’s fault; sometimes a relationship just ran its course, and now it’s time to accept that and turn to a new chapter.
“At my age…”
As we get older, it’s easy for that sunk cost fallacy to loom large. Inertia is heavy, the mutual entanglement of lives is far-reaching, and we might not feel we have the same energy for dating that we did when we were younger.
And there may sometimes be a statistical argument for “sticking it out” at least for a while, depending on where we are in the relationship, per this study (with 165,039 participants aged 20–76), which found:
❝Results on mean levels indicated that relationship satisfaction decreased from age 20 to 40, reached a low point at age 40, then increased until age 65, and plateaued in late adulthood.
As regards the metric of relationship duration, relationship satisfaction decreased during the first 10 years of the relationship, reached a low point at 10 years, increased until 20 years, and then decreased again.❞
Source: Development of Relationship Satisfaction Across the Life Span: A Systematic Review and Meta-Analysis
And yet, when it comes to prospects for a new relationship…
- If our remaining life is growing shorter, then it’s definitely too short to spend in an unhappy relationship
- Maybe we really won’t find romance again… And maybe that’s ok, if w’re comfortable making our peace with that and finding joy in the rest of life (this widowed writer (hi, it’s me) plans to remain single now by preference, and her life is very full of purpose and beauty and joy and yes, even love—for family, friends, etc, plus the memory of my wonderful late beloved)
- Nevertheless, the simple fact is: many people do find what they go on to describe as their best relationship yet, late in life ← this study is with a small sample size, but in this case, even anecdotal evidence seems sufficient to make the claim reasonable; probably you personally know someone who has done so. If they can, so can you, if you so wish.
- Adding on to that last point… Later life relationships can also offer numerous significant advantages unique to such (albeit some different challenges too—but with the right person, those challenges are just a fun thing to tackle together). See for example:
An exploratory investigation into dating among later‐life women
And about those later-life relationships that do work? They look like this:
this one looks like the title says it all, but it really doesn’t, and it’s very much worth at least reading the abstract, if not the entire paper—because it talks a lot about the characteristics that make for happy or unhappy relationships, and the effect that those things have on people. It really is very good, and quite an easy read.
See again: Healthy Relationship, Healthy Life
Take care!
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Discipline is Destiny – by Ryan Holiday
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We’ve previously reviewed another of Holiday’s books, The Daily Stoic, and here is another excellent work from the same author.
We’re not a philosophy newsletter, but there are some things that make a big difference to physical and mental health, the habits we build, and the path we take in life for better or for worse.
Self-discipline is one of those things. A lot of the time, we know what we need to do, but knowing isn’t the problem. We need to actually do it! This applies to diet, exercise, sleep, and more.
Holiday gives us, in a casual easy-reading style, timeless principles to lock in strong discipline and good habits for life.
The book’s many small chapters, by the way, are excellent for reading a chapter-per-day as a healthy dose of motivation each morning, if you’re so inclined.
Bottom line: if you’ve noticed that one of the biggest barriers between you and your goals is actually doing the necessary things in a disciplined fashion, then this book will help you become more efficient, and actually get there.
Click here to check out Discipline is Destiny, and upgrade yours!
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Protein vs Sarcopenia
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Protein vs Sarcopenia
This is Dr. Gabrielle Lyon. A medical doctor, she’s board-certified in family medicine, and has also engaged in research and clinical practice in the fields of geriatrics and nutritional sciences.
A quick note…
We’re going to be talking a bit about protein metabolism today, and it’s worth noting that Dr. Lyon personally is vehemently against vegetarianism/veganism, and considers red meat to be healthy.
Scientific consensus on the other hand, holds that vegetarianism and veganism are fine for most people if pursued in an informed and mindful fashion, that white meat and fish are also fine for most people, and red meat is simply not.
If you’d like a recap on the science of any of that:
- Protein: How Much Do We Need, Really?
- Plant vs Animal Protein: Diversity is Key
- Do We Need Animal Products to be Healthy?
Nevertheless, if we look at the science that she provides, the advice is sound when applied to protein in general and without an undue focus on red meat.
How much protein is enough?
In our article linked above, we gave 1–2g/kg/day
Dr. Lyons gives the more specific 1.6g/kg/day for adults older than 40 (this is where sarcopenia often begins!) and laments that many sources offer 0.8g/kg.
To be clear, that “per kilogram” means per kilogram of your bodyweight. For Americans, this means dividing lbs by 2.2 to get the kg figure.
Why so much protein?
Protein is needed to rebuild not just our muscles, but also our bones, joint tissues, and various other parts of us:
We Are Such Stuff As Fish Are Made Of
Additionally, our muscles themselves are important for far more than just moving us (and other things) around.
As Dr. Lyon explains: sarcopenia, the (usually age-related) loss of muscle mass, does more than just make us frail; it also messes up our metabolism, which in turn messes up… Everything else, really. Because everything depends on that.
This is because our muscles themselves use a lot of our energy, and/but also store energy as glycogen, so having less of them means:
- getting a slower metabolism
- the energy that can’t be stored in muscle tissue gets stored somewhere else (like the liver, and/or visceral fat)
So, while for example the correlation between maintaining strong muscles and avoiding non-alcoholic fatty liver disease may not be immediately obvious, it is clear when one follows the metabolic trail to its inevitable conclusion.
Same goes for avoiding diabetes, heart disease, and suchlike, though those things are a little more intuitive.
How can we get so much protein?
It can seem daunting at first to get so much protein if you’re not used to it, especially as protein is an appetite suppressant, so you’ll feel full sooner.
It can especially seem daunting to get so much protein if you’re trying to avoid too many carbs, and here’s where Dr. Lyon’s anti-vegetarianism does have a point: it’s harder to get lean protein without meat/fish.
That said, “harder” does not mean “impossible” and even she acknowledges that lentils are great for this.
If you’re not vegetarian or vegan, collagen supplementation is a good way to make up any shortfall, by the way.
And for everyone, there are protein supplements available if we want them (usually based on whey protein or soy protein)
Anything else we need to do?
Yes! Eating protein means nothing if you don’t do any resistance work to build and maintain muscle. This can take various forms, and Dr. Lyon recommends lifting weights and/or doing bodyweight resistance training (calisthenics, Pilates, etc).
Here are some previous articles of ours, consistent with the above:
- Resistance Is Useful! (Especially As We Get Older)
- Overdone It? How To Speed Up Recovery After Exercise
- How To Do HIIT (Without Wrecking Your Body)
- Exercises To Do (And Ones To Avoid) If You Have Osteoporosis
Take care!
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GABA Against Stress/Anxiety
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A Neurotransmitter Less Talked-About
GABA is taken by many people as a supplement, mostly as a mood modifier, though its health claims go beyond the recreational—and also, we’re of the opinion that mental health is also just health, and if it works, it works. We’ll explore some of the claims and science behind them today…
What is GABA?
GABA stands for gamma-aminobutyric acid, and it’s a neurotransmitter. It’s a lot less talked-about than for example dopamine or serotonin, but it’s very important nonetheless.
We make it ourselves inside our body, and we can also get it from our food, or supplement it, and some drugs will also have an effect on its presence and/or activity in our body.
What foods is it found in?
- Animals, obviously (just like in human brains*)
- Fermented foods (many kinds)
- Yeast
- Tea
- Tomatoes
- Mulberries
For more details, see:
γ-Aminobutyric acid found in fermented foods and beverages: current trends
*However, we do not recommend eating human brains, due to the risk of CJD and prion diseases in general.
What claims are made about it and are they true?
For brevity, we’ll give a little spoiler up-front: all the popular claims for it appear to be valid, though there’s definitely room for a lot more human trials (we skipped over a lot of rodent studies today!).
So we’ll just drop some of its main benefits, and human studies to back those.
Reduction of stress and anxiety
GABA decreases task-related stress and anxiety within 30 minutes of being taken, both in subjective measures (i.e., self-reports) and in objective clinical physiological measures:
Cognitive enhancement
It’s not a does-everything nootropic like some, but it does have clear benefits to episodic memory:
❝GABA intake might help to distribute limited attentional resources more efficiently, and can specifically improve the identification and ordering of visual events that occur in close temporal succession❞
One of the things that makes this one important is that it also deals with the often-asked question of “does GABA pass the blood-brain barrier”:
❝The present findings do give further credence to the idea that oral ingestion does allow GABA to reach the brain and exert direct effects on cognition, which in the present case were specific to temporal attention.❞
Read more:
Supplementation of gamma-aminobutyric acid (GABA) affects temporal, but not spatial visual attention
Potential for more
We take care to give good quality sources, so the following study comes with a big caveat that it has since been retracted. Why was it retracted, you wonder?
It’s about the sample; they cite “30 healthy adults”, but neglected tp mention that this figure was initially 46. What happened to the other 16 participants is unclear, but given that this was challenged and the challenge not answered, it was sufficient for the journal (Nature) to pull the study, in case of deliberate sample bias.
However! Running the numbers in their results section, a probability of 0.03 is very compelling unless the disappearance of 16 subjects was outright fraudulent (which we regrettably cannot know either way).
Here’s the study (so take it with a pinch of salt, considering the above), and taken at face value, it shows how GABA supplementation improves accurate reactions to fast-moving visual and auditory stimuli:
RETRACTED ARTICLE: γ-Aminobutyric acid (GABA) administration improves action selection processes: a randomised controlled trial
…so, hopefully this experiment will be repeated, without disappearing participants!
The sweet spot
You may be wondering how something that slows a person down (having a relaxing effect) can also speed a person up. This has to do with what it is and isn’t affecting; think of it like a “focus mode” on your computer or other device that greys-out everything else a bit so that you can focus on what you’re doing.
It’s in some ways (by different neurochemical pathways, though) a similar effect to the “relaxed alertness” created by l-theanine supplementation.
There’s also a sweet spot whereby GABA is toning some things down just the right amount, without adversely affecting performance in areas we don’t want slowed down. For the science of this, see:
Is it safe?
GABA is “Generally Recognized As Safe”. However:
- you should speak with your pharmacist if you are taking any medications for blood pressure or epilepsy, as GABA supplementation may cause them to work too well.
- you should absolutely not take GABA with alcohol or opioids as (dose-dependent for all the substances involved, and also depending on your metabolic base rate and other factors) its acute depression of the CNS can mean you relax and slow down too much, and you may find yourself not breathing often enough to sustain life.
Aside from that, it is considered safe up to at least 1g/kg/day*. Given that popular doses are 120–750mg, and most people weigh more than 750g, this is very safe for most people:
United States Pharmacopeia (USP) Safety Review of Gamma-Aminobutyric Acid (GABA)
Where can I get it?
We don’t sell it, but for your convenience, here’s an example product on Amazon
Enjoy!
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Better Sex Through Mindfulness – by Dr. Lori Brotto
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Female sexuality is such a taboo topic that, if one searches for (ob/gyn professor, women’s health research director, and psychologist) Dr. Brotto’s book on Google or Amazon, it suggests only “lori brotto mindfulness book”. So, for those brave enough to read a book that would have shocked Victorians, what does this one contain?
The focus is on, as the title suggests, better sex, by and for women. That said, it’s mostly because typically women are more likely to experience the problems described in the book; it’s nothing actually intrinsic to womanhood. A man with the same problems could read this book and benefit just the same.
While the book covers many possible problems between the sheets, the overarching theme is problems of the mind, such as:
- Not getting into the mood in the first place
- Losing the mood quickly and easily, such as by becoming distracted
- Difficulty achieving orgasm even when mechanically everything’s delightful
- Physical discomfort creating a barrier to enjoyment
…and yes, that last one is in part mind-stuff too! Though Dr. Brotto isn’t arguing that mindfulness is a panacea, just an incredibly useful tool. And, it’s one she not only explains very well, but also explains from the position of a wealth of scientific evidence… Enough so, that we see a one-star Amazon reviewer from Canada complained that it was too well-referenced! For us, though, it’s what we like to see.
Good science, presented clearly and usefully, giving practical tips that improve people’s lives.
Bottom line: if you’ve ever lost the mood because you got distracted into thinking about taxes or that meeting on Tuesday, this is the book for you.
Click here to check out Better Sex Through Mindfulness—you can thank us later!
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Generation M – by Dr. Jessica Shepherd
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Menopause is something that very few people are adequately prepared for despite its predictability, and also something that very many people then neglect to take seriously enough.
Dr. Shepherd encourages a more proactive approach throughout all stages of menopause and beyond; she discusses “the preseason, the main event, and the after-party” (perimenopause, menopause, and postmenopause), which is important, because typically people take up an interest in perimenopause, are treating it like a marathon by menopause, and when it comes to postmenopause, it’s easy to think “well, that’s behind me now”, and it’s not, because untreated menopause will continue to have (mostly deleterious) cumulative effects until death.
As for HRT, there’s a chapter on that of course, going into quite some detail. There is also plenty of attention given to popular concerns such as managing weight changes and libido changes, as well as oft-neglected topics such as brain changes, as well as things considered more cosmetic but that can have a big impact on mental health, such as skin and hair.
The style throughout is pop-science; friendly without skimping on detail and including plenty of good science.
Bottom line: if you’d like a fairly comprehensive overview of the changes that occur from perimenopause all the way to menopause and well beyond, then this is a great book for that.
Click here to check out Generation M, and live well at every stage of life!
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