Thyroid function is impaired in most chronic fatigue and fibromyalgia patients. I was not aware of this for years because my thyroid blood tests were always in the normal range. Then in 2002 I was diagnosed with "silent thyroiditis" which is a period of hyperthyroidism that lasts several weeks followed by a period of hypothyroidism. Doctors do not know what causes silent thyroiditis and there is really no treatment other than to ride out the roller coaster of symptoms after which one's thyroid blood tests return to normal. The experience led me to suspect that my thyroid function was never normal. Most of the time I had symptoms of hypothyroidism - I had a low body temperature around 97 degrees, a slow pulse and I was chronically constipated. I remember not being able to drink beverages with ice in them because I would get so cold I would shiver afterwards for hours. This alternated with short episodes of symptoms of hyperthyroidism when my resting pulse was faster and I felt hot. I was convinced that something was wrong with my thyroid function. I read everything I could find about the thyroid and consulted five endocrinologists including one from the Mayo Clinic. I had slightly elevated antibodies for both hypo and hyper thyroidism but otherwise my TSH was normal. No one could make a definitive diagnosis or recommendation. This was the lowest point of my health when there was no stability in my functioning. With my primary care doctor's approval I made the decision to have a total thyroidectomy. This was by far the most risky experiment I ever did in my quest for better health. The laboratory analysis of my removed gland reported that I had "lymphocytic thyroiditis consistent with clinical history of Hashimoto's thyroiditis".
Following my surgery I was not able to tolerate thyroid replacement in the form of T4, which agitated my nervous system. I was able to tolerate Amour thyroid in low doses but as my thyroid blood levels approached normal my symptoms of hypothyroidism increased. This was very strange indeed. Finally I found Wilson's Thyroid Syndrome website on the internet. Dr. Denis Wilson discovered that after periods of stress or trauma some individuals develop the symptoms of hypothyroidism which include low body temperature, constipation and fatigue even though their thryoid blood levels remain normal. Basically these individuals are in a survival mode where their bodies are conserving energy. The symptoms intensify with thyroid replacements in the form of T4 however the condition can be reversed by taking for a period of time the active thyroid hormone T3. The T3 used is obtained from a compounding pharmacy that combines the hormone with a slow release agent and is taken twice a day at increasingly larger doses until the body temperature returns to normal or 98 degrees, then decreased gradually as the body "resets" its metabolism. I was referred to a naturopathic physician in my area named Rick Marschall who had 10 years of experience in treating Wilson's Syndrome. I gradually weaned myself off of Amour and started taking T3 gradually increasing the amount I took to 100 mcg. twice a day to achieve 98.6 degrees. When this occurred a certain kind of fatigue that I had struggled with for 30 years went away and never returned. Gradually I decreased the amount of T3 I took by paying attention to my body temperature, my pulse and stools until I was taking 30 mcg. 2x a day. This process took a year and a half. I then I switched to taking T4 (75 mcg. daily) as my primary source of thyroid replacement, which I tolerate beautifully in addition to a small dose of T3 (10 mcg. a day). My body temperature is 98.2 degrees first thing every morning. Getting my thyroid function back to normal was a big breakthrough in my health and gave me a level of stability that I really needed. It may have not been necessary to have my thyroid gland removed but this is something that I will never know. Wilson's Syndrome is a completely reversible condition and I think that most CFS/FMS patients have this condition because of the incredible stress their bodies are under.
There was a study of 11 patients diagnosed with CFS that were treated with Wilson's protocol. The mean reduction of 5 symptoms including fatigue was from pretreatment 6.82 to post treatment 1.73. Decrease in Fatigue was form 9.18 to 1.45. The article can be found at pubmed PMID 16883675. In addition, if readers are dissuaded from believing in the validity of Wilson's Syndrome because of the American Thyroid Association's position statement, they should read the response to each of the ATA's summary points. It can be found at http://wilsonssyndromeinstitute.org/response.html.
I strongly recommend looking into the Wilson protocol for all who suffer from chronic fatigue and fibromyalgia because I believe it is an important part of the puzzle. The website is: www.wilsonssyndrome.com.