Is it my glands?
There are so many glands in your body you might think you were one big bag of glands! There's the pituitary, the thyroid, the parathyroid, the adrenal - the list goes on. Each gland produces something different - often hormones, which travel round the body to send messages to other parts, helping to regulate the way your body works. Your thyroid gland produces thyroxine - the hormone that tells your body how fast to tick over.
Women are far more prone to thyroid problems than men. About one in 50 women are diagnosed with underactive thyroid, and the same with overactive, in a lifetime. For men, the equivalent figures are one in 1,000 and one in 500. Thyroid problems usually have an 'autoimmune' cause - your immune system believes one part of your own body is 'foreign' and attacks it.
Treatment for underactive thyroid is with levothyroxine tablets for life. Most people are back to normal within weeks, although your doctor may need to fine-tune your dosage a couple of times. A few people continue to get symptoms, even if their thyroid hormones are within normal limits - speak to your GP if your problems persist. But for most people, all you'll need once you're settled on your treatment is a blood test once a year to check your thyroid levels (and to keep taking the tablets!).
For overactive thyroid, treatment depends on your age, what your main symptoms are, whether your thyroid gland is enlarged etc. Tablets, radioactive iodine or occasionally surgery are among the options your doctor may discuss.
If your thyroid is underactive, your whole body slows down. Symptoms vary, but include feeling tired; putting on weight even though you're not eating more; constipation; feeling cold; dry, lifeless skin and hair; hoarse voice; poor concentration and sometimes memory problems or confusion. A simple blood test can tell if your thyroid is underactive - you won't usually need scans or other investigations.
If your body produces too much thyroxine, your metabolism goes into overdrive. You'll often lose weight even though you're hungry; feel anxious and trembly, or have palpitations; sweat a lot and feel the heat; find it hard to sleep; or feel itchy. Interestingly, tiredness and muscle weakness, along with changes to your periods, are also seen in overactive thyroid.
For overactive thyroid, your specialist may offer treatment with a drink containing radioactive iodine. This isn't the same as radiation treatment for cancer - the iodine builds up in your thyroid and destroys some of the gland, so it doesn't produce so much thyroxine. It should settle your symptoms for good, although you may not produce enough thyroxine in future and need replacement treatment.
You'll need to take some precautions for two to four weeks after the treatment (including sleeping alone, avoiding close contact with children or pregnant women and possibly staying off work if it involves any close contact with others) but this is only temporary. Your specialist can advise you on the specifics.
When a little bow tie gets bigger
Your thyroid sits at the front of your neck, about the position and size of a bow tie. Some conditions cause swelling of your thyroid - do get yourself checked if you notice a lump in your neck.
What else can cause the same symptoms?
So many patients see their GP about feeling tired that there's a medical abbreviation for it - TATT or 'Tired All The Time'. Often there isn't a physical cause found - stress and depression very commonly cause tiredness which can be overwhelming. Your doctor will ask you lots of questions to try to pin down the most likely cause. They'll probably test you for type 2 diabetes which can cause tiredness, feeling thirsty, needing to pass water often and minor infections like repeated boils. They may also want to rule out anaemia, or problems with your liver or your kidneys.
Many medicines (including strong painkillers and tablets used for depression and nerve pain) can cause tiredness and often constipation, weight gain and problems concentrating or even confusion. Unexpected weight loss and tiredness occasionally signal cancer (although less worrying causes are much more likely); and heart problems could be to blame for palpitations. But rest assured, the likelihood is your doctor will be able to reassure you there's no serious cause.
With thanks to 'My Weekly' magazine where this article was originally published.