Thyroid Thursday Episode 36: Hypothyroidism and Post Meal Fatigue
Do you ever get really tired and fatigued after a meal? Could it have anything to do with your hypothyroid condition?
It sure could! Even if your TSH is normal.
When you eat, your liver and gallbladder release bile salts to support digestion. If you have cholestasis (sluggish bile flow) or are taking bile salt supplements (ox bile), the increased bile salts in your blood can suppress TSH resulting in reduced T4 production and slowed metabolism causing you to be extra tired 40 minutes or so after a meal.
How does this happen?
Research shows that after you eat a large portion of bile salts are reabsorbed by the intestines and enter the blood. Blood levels of bile salt levels peak 30 – 40 minutes after you eat. This elevation of bile salts is mirrored by a drop in TSH and T4. This may be part of an innate response to slow us down just a bit after a meal to give our body time to properly digest our food.
If however you have cholestasis, are consuming ox bile supplements, or already have low TSH and T4 levels (many people may have all three things going on) you may see a significant increase in post meal fatigue. The longer the process goes on, the worse the fatigue and other hypothyroid symptoms may get.
I’ve found ox bile to be a great support product for those with gall bladder problems. But, we do have to be cautious when using ox bile with hypothyroid patients. If you have post meal fatigue you need to consider bile salt suppression of TSH a possible mechanism.
If you are hypothyroid and taking ox bile and you notice you do have post meal fatigue you should try using bile support formulas that don’t contain ox bile. If that doesn’t address the fatigue, work with a functional medicine doctor to identify the root cause of your post meal fatigue.
Dr Eric Balcavage
