As she approached 30, Leslie S. began to notice small shifts in her health that all of a sudden seemed to be racking up.
She was in the middle of an important career change, including a cross-country move to work in the tech industry. Though she was excited about the new job, it required a lot more time sitting at a desk. So when she simultaneously began to gain weight, experience depression, and feel inescapably tired, she assumed it must be a result of her busy life. “I’m not working out as much as I used to and I’m sitting at a desk all day, so this must be normal, right?” she remembers thinking.
When her doctor suggested she look at her diet and exercise, hardworking Leslie took the advice to heart. “I went to the gym and joined a meal replacement program where I survived on prepackaged food of up to 1,200 calories per day. Then I started to feel worse. When I looked in the mirror and saw deep, dark circles under my eyes, I knew something was wrong.”
What her doctor had missed were the early signs of a possible thyroid dysfunction. When a new physician finally recommended she test her thyroid-stimulating hormone (TSH) levels, Leslie discovered that she had an underactive thyroid gland, or hypothyroidism.
“I suffered for a long time, but doctors just kept telling me to lose weight. Getting the diagnosis was a huge relief and confirmation that this wasn’t my fault.”
Leslie is not alone. In the U.S., thyroid dysfunctions are among the most commonly underdiagnosed hormonal disorders. Of the 20 million Americans affected — most of whom are women — up to 60% are unaware of their condition according to the American Thyroid Association. Varied symptoms with seemingly baffling origins make getting support particularly tricky. But, when you know what to look out for, thyroid disorders can be easily caught and managed.
The Tiny Thyroid Has a Big Influence on Health
Small but mighty, this butterfly-shaped gland interacts with nearly every organ system in the body. Your metabolism, heart rate, reproductive system, energy levels, and memory are just some of the things that can suffer if your thyroid hormone production starts to get out of balance.
When thyroid hormone levels are low – a condition known as hypothyroidism – the body begins to slow down, often resulting in weight gain, fatigue, depression, constipation, and dry skin. This is most commonly caused by the autoimmune disorder Hashimoto’s disease.
On the other end of the spectrum is hyperthyroidism, which is caused by too much thyroid hormone, often as a result of Graves’ disease. Supercharged production levels can lead to a domino effect of things like weight loss, anxiety, thinning hair, tremors, and muscle weakness.
Thyroid disorders are particularly tough to diagnose as there are no one-size-fits-all symptoms. People can have wildly different experiences with the same type of dysfunction, no symptoms at all, or even get diagnosed with both occurring at alternating times.
Early Signs to Watch For
With such diverse symptoms, thyroid disorders can be hard to diagnose and manage. Gigi Hadid found this out first-hand when she went public with her Hashimoto’s diagnosis in 2016. Since then, she has had to fend off body shamers who alternately think she’s too skinny or too curvy, depending on the state of her symptoms.
But despite these complications, there are a few things that doctors do agree on about the ways in which a thyroid problem may show up.
Skin: The “thyroid-skin connection” is real, experts now acknowledge, though they are still trying to figure out exactly how it works. What they do know is that the thyroid helps to promote optimal skin functioning; if the thyroid isn’t working properly, your skin is no longer able to regulate itself. Both hypothyroidism and hyperthyroidism can cause skin changes. The data suggests that these symptoms – dry, cold, or yellowing skin and puffy eyes in hypothyroidism; flushing, redness, or excessive sweating in hyperthyroidism – may be the first noticeable signs of a thyroid disorder.
Memory: There’s no reason to panic if you experience a little forgetfulness or decreased concentration, but studies do show that hypothyroidism can have a wide range of effects on cognitive functions. If you’re worried that a memory issue may be caused by more than stress or a lack of sleep, don’t be ashamed to ask a friend or a partner if they have noticed any changes.
Mood: A shift in mood is rarely the only symptom you will have, but it can be an additional signal that something is going on. Women with hypothyroidism may experience fatigue and depression, while those with hyperthyroidism may experience an increase in anxiety, restlessness, or irritability.
Fertility: Problems with your thyroid can have a significant impact on fertility. Though experts are still learning about how these disorders can affect female fertility before pregnancy, evidence shows that abnormal TSH levels in women can interfere with ovulation, implantation, and fertilization. Thyroid health is also critical to early pregnancy. A recent study found that one in five women with a history of miscarriage or trouble getting pregnant also had mild thyroid abnormalities, which is why early detection is particularly important for women who want to have children.
As with most medical conditions, getting your hormones tested is the first step to identifying the right treatment path. Standard tests measure the TSH levels in your blood, but that’s just one slice of the pie. It’s important to also check your free T4, free T3, and thyroid antibody (TPOAb) levels to get a complete picture of how your thyroid is behaving in your body.
Find a Lifestyle That Supports Your Thyroid
While medication is often involved in the treatment plan your endocrinologist develops, there are a few diet and lifestyle changes you can make to help support your thyroid naturally.
Reduce or remove gluten and cruciferous vegetables. Reducing inflammation is also a good idea for all women whose thyroid issues are caused by an autoimmune disorder. This is particularly important with gluten, which contains molecules that mimic the appearance of thyroid cells and can confuse your body into attacking the important gland thinking it’s a wheat protein. Try eliminating processed foods, sugar, and especially gluten to see if your symptoms decrease. Medical research has also shown that cruciferous vegetables (like kale, bok choy, cabbage, and cauliflower), or more specifically a substance contained in them called goitrogen, can interfere with how your thyroid produces hormones.
Prioritize sleep. One study found that sleep loss can affect the function of the hypothalamic-pituitary-thyroid axis, which controls things like your metabolism and stress management, and that it can lead to increased TSH, T4, and T3 levels. Regular, healthy sleep (doctors recommend 7 to 9 hours) can help keep your hormones in check.
Keep moving. Routine, moderate exercise — like walking, yoga, or cycling — can help support a healthy thyroid.
Start a stress management practice. Every modern woman is well aware that chronic stress is bad for health, but this is particularly true when it comes to autoimmune disorders.
While there is plenty of research still to be done about thyroid disorders, having your levels tested is the first step to making sure that more women are diagnosed and treated, as Leslie’s story shows.
Since getting diagnosed and finding support, Leslie’s life has changed for the better: “My overall mood has improved, and I have a newfound confidence to stand my ground when something doesn’t feel right and ask for the proper bloodwork to be done. I'm also much kinder to myself.”