Importance Score: 60 / 100 🔵
Experiencing constant fatigue and unexplained weight gain? For years, Hannah, a 43-year-old lawyer and mother of three, felt perpetually exhausted, a symptom that doctors often dismissed. However, her persistent weariness signaled a deeper issue: undiagnosed Hashimoto’s thyroiditis, a prevalent autoimmune condition impacting the thyroid. Here’s her story of diagnosis and recovery.
Unexplained Exhaustion: A Mother’s Struggle
One evening, after returning home at 8 pm, Mark Ross discovered his three children, aged 11, 9, and 7, prepared for bed. However, his wife, Hannah, was nowhere to be found. Concerned, he located her upstairs, confined to her bed, overwhelmed by fatigue.
Hannah feebly explained that she was alright, merely drained. As a mother of three who juggled work as a lawyer four days a week, this exhaustion might have seemed reasonable.
However, the same pattern repeated itself the following night and the night after that.
“I was used to feeling utterly depleted, especially by the end of the day, but typically I could push through – I’d consume more coffee or take a swift cold shower to revive myself,” Hannah, a resident of Hertfordshire, explained.
“I’d previously questioned whether this was normal and mentioned it to my doctor on several occasions over the years, but it had always been dismissed – ‘Of course you’re fatigued,’ he’d say, ‘you’re a lawyer with three young children, you have long days – you’ll recover.’”
But this instance was different, Hannah stated: “I managed to feed and bathe the children, but then I felt like I’d encountered a barrier, and I physically couldn’t continue.”
“By the third night, Mark surmised that I was either severely depressed or something was truly amiss with me.”
The Reality: Hashimoto’s Thyroiditis and its Impact
In reality, she was afflicted with undiagnosed Hashimoto’s thyroiditis, an autoimmune condition where the body’s immune system mistakenly attacks the thyroid gland.
This ailment constitutes 90 percent of all instances of hypothyroidism, or an underactive thyroid. Hannah was later informed that she likely had it since her teenage years, clarifying years of debilitating signs and symptoms, including intense fatigue and inexplicable weight gain as a symptom of thyroid issues.
Hypothyroidism is estimated to impact about two in 100 individuals – predominantly women – though numerous others could be affected, as the indicators are frequently overlooked, according to the British Thyroid Foundation.
The thyroid, a butterfly-shaped gland located in the throat, generates hormones that are vital for metabolism and growth, according to Kristien Boelaert, a professor of endocrinology at the University of Birmingham and a consultant endocrinologist at University Hospitals Birmingham.
“When matters go awry, and it malfunctions, your entire metabolism decelerates – impacting brain function, heart rate, and the rate at which food is converted into energy.”
Excessive tiredness is a prevalent indicator of an underactive thyroid.
“I honestly don’t remember a time when I wasn’t tired,” Hannah admits.
“I have consistently been someone who requires ample sleep. While studying for my A-levels, my energy was so low that I struggled to remain awake. This persisted throughout my degree at Cambridge University. As a high achiever, I partially attributed it to always pushing myself to labor intensely.”
“Nonetheless, I’d frequently need to have duvet days. Yet, you simply assume that’s how you are, don’t you? After some time, I visited my GP, who indicated he’d assess my iron levels.”
Iron is imperative for transporting oxygen throughout the body. Deficient iron levels can contribute to perpetual tiredness – however, Hannah’s levels proved to be normal.
Around the age of 19, she also began to gain weight, which is another typical sign of possible thyroid disorders.
“I wasn’t a big eater, certainly no more than my companions,” she recounts. “However, the weight appeared to accumulate regardless. I’m 5ft 5½in and should weigh around 9st 4lb (60kg) – but by 26, I weighed approximately 12stone 2lb (78kg).”
“I’d have to skip meals or drastically reduce portions – and exercise intensely. I would, eventually, manage to barely shed some of the weight, but compared to others, it necessitated months and months of grueling effort.”
“Regrettably, yo-yo weight gain and loss commenced to become a part of my life,” she reflects.
“For my wedding in 2010, for instance, I dieted for months to appear slimmer in the photos. I managed to attain a weight I was content with, but as soon as I relaxed, the weight rapidly accumulated.”
Unfortunately, Professor Boelaert notes, this is a frequent scenario.
Understanding the Symptoms of Hypothyroidism
Metabolism and Weight Gain
“A decelerating metabolism signifies that your body burns fewer calories, even at rest, rendering it remarkably effortless to gain weight and exceedingly challenging to lose it.”
Energy Levels and Sleep Quality
And because your body converts food into energy more slowly, you can experience fatigue (the condition also disrupts your sleep cycle, so any slumber you attain is subpar).
Other Symptoms
- Slower mental function
- Persistent cold sensations
- Hoarseness in voice (as throat muscles weaken)
Why Diagnosis is Difficult
“The symptoms are so diverse and apparently unrelated that it simply goes unnoticed, which is why doctors often struggle to diagnose it until it’s considerably advanced,” Professor Boelaert asserts.
“And if left untreated, it can trigger severe complications like elevated cholesterol and atherosclerosis [clogged arteries], as the decelerating metabolism also induces a sluggish breakdown of the removal of “bad” cholesterol from the bloodstream.”
Potential Causes of Hashimoto’s Thyroiditis
Hashimoto’s runs in families – 50 percent of those affected have a family history of the ailment.
Other potential origins might encompass stress and viral infections, or sex hormones encompassing oestrogen, testosterone, and progesterone – though their precise role in the advancement of the disease remains ambiguous, adds Professor Boelaert.
Another plausible contributor is iodine deficiency. “The thyroid necessitates iodine to generate thyroid hormones – as iodine-rich foods feature seafood, shellfish, and dairy, vegans can experience this as an issue”, says Professor Boelaert.
Hannah has since become aware that several distant family members have the condition, implying that her case is genetic.
The perpetual exhaustion while juggling such a high-pressure career – and nurturing a family – was a perpetual struggle, but it was the weight gain that she found particularly challenging. The struggle with thyroid and weight gain was constant.
“It was mortifying and disheartening,” she concedes.
“There are numerous photos that I compelled my husband to delete because I simply disliked my appearance, or my tummy appeared expansive.
“I also cultivated the habit of ensuring I held something in front of my tummy, like a handbag – or ensured a child stood there. I always assumed it was my sole fault that I was heavier.”
Other Symptoms Hannah Experienced
There were further signs of hypothyroidism that Hannah now recognizes. None of these, despite routine medical examinations, were ever connected.
“I’ve also consistently been highly susceptible to cold temperatures and perpetually had frigid hands and feet,” she recounts.
However, it was one night in June 2023, when Hannah was physically incapable of moving out of bed, that resulted in the cause of all her symptoms finally being connected.
Mark, 43, was so anxious about her exhaustion that he insisted she undergo a private medical assessment through his workplace, and this time, they evaluated her thyroid function test.
Diagnosis and Treatment
Testing Thyroid Function
“Thyroid function is gauged by levels of TSH (thyroid stimulating hormone) and free thyroxine (fT4), but TSH is the paramount indicator of thyroid status,” says Professor Boelaert.
“Whilst levels fluctuate considerably, normal TSH levels are generally between 0.27 to 4.2 milliinternational units per litre (miU/L). Hannah’s were 5.72 miU/L.”
Normal levels of fT4 can also differ enormously reliant on the tests. In Hannah’s tests, “normal” levels ranged from 12 to 22 picomoles per litre (pmol/L) – Hannah’s measured 10.4pmol/L.
While these outcomes may not seem vastly distant from the “normal” ranges, Professor Boeleart elucidates that the degree of the symptoms – and the outcomes from your thyroid tests – may not necessarily be correlated.
“Some individuals exhibit very mildly aberrant thyroid function test results and numerous symptoms. Others possess grossly abnormal tests and no symptoms.”
Emotional Impact of Diagnosis
After finally obtaining her diagnosis, Hannah admits she was “quite indignant initially – vexed that I’d been dismissed for so long and had forfeited years of possessing more energy.”
“But then there was solace, of sorts, that I was now going to obtain assistance, my energy levels would improve, and the years of tribulations I’d endured with my weight weren’t my fault.”
Treatment and Recovery
Hannah was prescribed levothyroxine, a synthetic version of the thyroxine hormone produced by the thyroid, which she’ll now have to ingest for the duration of her life.
“You certainly don’t feel improved overnight – it necessitated four months of ‘tweaking’ the dose, but gradually the levels stabilized, and that continual exhaustion did commence to dissipate,” she recounts.
At the time, she weighed around 14st 4lb (92kg – BMI 31.6). She enrolled in an online diet plan, It’s so Simple by Rachael Sacerdoti, recommended by a friend, and the weight diminished – within a year, she had shed nearly 4st (24kg) – transitioning from a size 16 to a size 8/10. Managing thyroid and weight loss became possible.
“I can also now cheerfully work a full day in the office and still return home with the vigor to be with my children and husband,” says Hannah.
“It’s been a prolonged endeavor. Now knowing the wide array of symptoms for hypothyroidism, it appears rather apparent what the predicament was, but for 25 or so years, nobody could piece them all together.”