When we read about undiagnosed diseases in this country, we’re usually reading about such potentially life-threatening illnesses as high blood pressure, diabetes and certain types of cancer. But there may be as many as 13 million people in the US — the vast majority of them women — walking around without knowing they’re suffering from another serious disease. The disease is hypothyroidism, or underactive thyroid, and while it may not shorten their lives, it will certainly affect their quality of life.


The thyroid gland, located in the neck, produces several hormones that help get oxygen to all of the body’s cells. “The thyroid affects every single process, every single tissue in the body,” says Kenneth Blanchard, MD, PhD, Massachusetts endocrinologist and author of What Your Doctor May Not Tell You About Hypothyroidism, to be published by Warner Books this January.

Because the thyroid affects the entire body, when it becomes sluggish, the slowdown can be accompanied by any or all of a vast range of symptoms, including…

  • Extreme fatigue, exhaustion, weakness
  • Mental sluggishness, difficulty concentrating, memory loss
  • Moodiness, irritability, depression
  • Dry, rough, pale skin
  • Coarse hair, hair loss
  • Weight gain
  • Difficulty tolerating cold, cold in extremities, tingling in fingers
  • Muscle aches or cramps
  • Loss of libido (lack of interest in sex)
  • Headaches
  • Hoarseness
  • Tightness in chest or shortness of breath
  • Menstrual irregularities, heavy periods, PMS
  • Infertility and miscarriages
  • Dizziness, loss of equilibrium
  • Constipation, diarrhea, cramps.

These symptoms can appear at any age. The sufferers are almost overwhelmingly women. In some cases, hypothyroidism arises as the result of Hashimoto’s disease, an inflammatory problem in which the body’s own immune system attacks the thyroid gland. Hashimoto’s disease can be the aftermath of any common infection, including ordinary colds. The thyroid gland also may slow down as a result of previous medical treatments, including some drugs, such as radioactive Iodine, radiation treatment (such as radiation therapy to the head and neck given for Hodgkin’s disease) and surgery.

With so many symptoms and so many sufferers, why isn’t the disease recognized more often? According to Dr. Blanchard, there are several reasons. Some women who suffer only vague or mild symptoms may not consider them serious enough to see a doctor. Other women may have only one dominant symptom, and see the wrong specialist for treatment. For instance, a woman may see a psychiatrist for moodiness and be diagnosed and treated for depression. Or she may see a rheumatologist for musculoskeletal problems and receive a diagnosis of fibromyalgia. Other hypothyroid sufferers have been misdiagnosed as having chronic fatigue syndrome, irritable bowel syndrome or a host of other disorders. “I even have some patients who only develop symptoms of hypothyroidism in wintertime, because the demands on the gland are greater then,” says Dr. Blanchard. Such patients may erroneously receive a diagnosis of seasonal affective disorder (SAD).

When a woman does see her physician with a long list of symptoms suggestive of underactive thyroid, the doctor may not put the pieces together. “When a woman with multiple symptoms goes to the doctor, she might be dismissed as another one of those crazy people who come in with a million different complaints. She might even be sent to a psychiatrist,” says Dr. Blanchard. “But a patient with a thyroid problem will have a laundry list of things wrong with them, because that’s the nature of the thyroid affecting the entire body.”

Even when a woman’s doctor is savvy enough to suspect a thyroid disorder, the correct diagnosis still is not certain. In most cases, the doctor will order a thyroid stimulating hormone (TSH) blood test. “But it’s a medical myth that the test will give you a yes or no diagnosis,” says Dr. Blanchard. “I really think this is one of the biggest mistakes in medicine.”

A TSH test often gives false negatives — meaning the test results appear normal even though the patient’s thyroid is clinically underactive. And once the test comes back normal, the patient is told the problem isn’t her thyroid, and she leaves without a proper diagnosis or treatment. If symptoms persist, don’t ignore them. Go back to your doctor.

According to Dr. Blanchard, for the majority of patients with an underactive thyroid, taking some form of thyroid hormone daily — natural or synthetic, pill or liquid — will ease the symptoms.

Keep in mind, however, that with the thyroid, you are once again dealing with the complex world of hormones, which impact multiple body systems. Recent research continues to uncover the intricacies of the thyroid’s impact. Work closely with your medical team, and be certain that hormone activity is monitored closely.

Since you know your body best, listen to it, trust your feelings, and if appropriate, seek medical care from a practitioner who is current on the latest thyroid literature and is willing to listen rather than rely completely on laboratory results. Hypothyroidism is very treatable when handled by an expert.