Why thyroid disorders can often be missed – or dismissed

At 52, Cindy Vogel started to feel more tired than usual. Even after a full night of sleep, her brain felt foggy, and she was so exhausted that it interfered with everyday household tasks. At first, she ignored it.

“I thought I was just getting older, and things were changing,” says the now-53-year-old administrative coordinator. She said she hoped it wasn’t dementia, and after expressing her concerns to loved ones, they told her not to worry; she was probably just going through perimenopause. “I even did therapy because my husband thought I was just depressed. But I wasn’t,” Vogel says.

She finally got bloodwork done and learned she had Hashimoto’s disease, an autoimmune condition that causes hypothyroidism, or underactive thyroid.

The thyroid is a butterfly-shaped gland in your neck. It produces hormones that help regulate important physiological functions including your metabolism, energy, heart rate, body temperature and mood, says Ruchi Gaba, associate professor of endocrinology at Baylor College of Medicine.

When the thyroid doesn’t work as it should, either producing too little or too much of these hormones, you can end up with a variety of vague but potentially severe symptoms affecting many different parts of your body and brain.

More than one million Australians are living with an undiagnosed form of thyroid disorder, according to the Australian Thyroid Foundation. And in their lifetime, one in 10 Australians will be affected by some form of thyroid disorder

While experts say thyroid dysfunction is generally simple to diagnose and treat, it’s also easy to dismiss symptoms or blame them on other causes, including ageing-related health changes, as Vogel did.

Think of your thyroid as your body’s speed control. Hyperthyroidism happens when the thyroid releases too much thyroid hormone, which Gaba says can cause anxiety, diarrhoea, weight loss and insomnia. Hypothyroidism is the opposite, stemming from too little thyroid hormone. This is what can be easily confused with ageing-related changes.

“It slows down the entire body,” says Huda Al-Bahadili, an endocrinologist at WashU Medicine. With hypothyroidism, she says, people may experience fatigue, weight gain, feeling cold or sensitivity to cold, constipation, difficulty concentrating, brain fog, and dry skin and hair.

As Vogel describes, these symptoms can often be debilitating. “I’m a morning person, and I had no motivation,” she says. “I’d get eight to nine hours of sleep, and by noon I was ready for a nap, and I’m not a napper.” The cognitive effects made it hard to retain information. “