1 in 8 women have this frustrating condition in common

Picture the biggest wedding you’ve ever been to. A guest list in the thousands. Overseas cousins flying in, distant relatives you’ve met just once before, neighbours who haven’t lived beside you for the last 15 years. Mehendiwalis, band, baaja and baaraat filled with childhood friends, acquaintances, even gate-crashing strangers who are looking for a good time. About 12.5% of the women there have something in common, one in every eight. And it’s not that they’re going to ask you when you’re getting married or where you bought your jootis. At some point in their lifetime, they will struggle with thyroid problems. 

Rapid weight changes, brain fog, anxiety, dry skin, brittle nails, cold feet, fatigue, eye irritation, constipation — the signs of thyroid problems have more variety than Baskin Robbins, according to experts. Some women are lucky that they get a quick diagnosis and set down a path of recovery. Others go through rounds of tests for various possible ailments that the symptoms could be signalling, before landing on the possibility of thyroid problems.

And sometimes, even when all the elements line up pointing to a thyroid issue and you think you’re finally getting an answer, the tests say otherwise.

Dr Poonam Jain was diagnosed with hypothyroidism while she was in her first year of medical school. “The most common cause of it is an autoimmune condition that attacks the thyroid gland and causes inflammation. Hashimoto’s thyroiditis has been linked to genetic factors, stress, hormones and more. At first, it can be frustrating not knowing what’s causing it. People automatically find a way to blame your lifestyle because of the weight gain,” says Jain.

Going on to study endocrinology herself, she still can’t fully explain why it’s becoming so common now. “Some believe it’s because of growing stress making the immune system attack the body as a reaction and improper diets causing nutritional deficiencies. Maybe it’s because our tests have gotten more refined that we’re finally catching on to it now. But rest assured it’s a treatable condition that can be managed with a combination of medication and lifestyle changes.” 

This butterfly-shaped gland located at the base of our neck, as Dr Manjiri Karlekar, endocrinologist, Zen Multispeciality, describes it, is a major player when it comes to our bodily functions. “It releases hormones that control metabolism, like thyroxine (T4) and triiodothyronine (T3).  These hormones aid in regulating other functions such as body weight, muscle strength, bone loss, and menstruation.”

Since imbalances in the body cause a wide variety of issues, it’s not always easy to diagnose thyroid dysfunction. “If you’re losing a lot of hair and feeling fatigued, they’ll first rule out vitamin D and B12 deficiencies. You might see a gynaecologist because of irregular periods. But that is a part of the diagnostic process. Certain ailments may temporarily be hampering thyroid function, it may not be a disorder in itself. Patience is required, but you must share all your symptoms with a doctor and get a proper diagnosis. Leave Google alone,” says Jain.

Common thyroid problems that women face

An MVP of the endocrine system, the thyroid controls our metabolism which means it’s running the speedometer of how our body is working. The rate at which our heart beats, our digestion and energy levels, body temperature and our mood too.

If there’s too little of the thyroid hormones, then our body works too slowly. An underactive thyroid is called hypothyroidism, the most common form of thyroid dysfunction.

You feel exhausted and sluggish. Even though you’ve been sleeping more than usual, you still feel tired through the day without good reason. Your calorie intake and routine may be the same but you notice you’re gaining excess weight.

“Instead of burning calories for our daily activity, in hypothyroidism, the amount of energy we use at rest also called our basal metabolic rate (BMR) decreases. In turn, the body stores the calories as fat. Even if the number of calories you’re intaking is low or the same as before,” says Jain. You start reaching for a blanket to cover up even though the temperature isn’t dipping low. You start feeling colder than usual, especially in your hands and feet. Energy burn causes heat production, and with a slowed-down BMR, the heat generated is also little, causing you to feel the chill.

Everything slows down in the body. Including the regeneration of skin cells and hair follicles which can cause increased hair loss and dry, flakey skin. “It can all seem so unrelated to the person experiencing it that they can’t wrap their head around what’s happening to their bodies. It takes a toll on your mental health too and the increase in stress about this unknown doesn’t help either,” says psychotherapist Neha Parmar.

Of 5,376 adults in a study across eight major Indian cities, one in every 10 was affected by hypothyroidism. Most cases go undiagnosed. 

And when there’s too much of the thyroid hormone being produced, your body goes into overdrive. “Hyperthyroidism is due to conditions such as inflammation of the thyroid, or Graves’ disease in which the entire thyroid gland might be overactive,” says Karlekar.

Your metabolic rate is off the charts, making you lose weight even if you eat the same or more food than usual. You feel hungrier and have trouble falling asleep. The increased BMR makes you feel jittery, you notice a tremor in your hands and high heart rate, or palpitations. You’re unable to tolerate heat because you’re always feeling hot. Just like everything else, your mind is also constantly racing, making you anxious and irritable. A goitre or enlarged thyroid gland can also develop.

When she was in school Farah’s* friends would be jealous of her. She was always high on energy, and no matter what she ate, she kept losing weight. “On the flip side, I would get bullied for being too thin, called things like lakdi (stick), haddi (bones)and skeleton. What they didn’t see was my inability to sleep and stay asleep. I was irritable and always sweaty. I had such bad anxiety that my parents would attribute to school stresses.”

When she started college, her symptoms intensified, including a missed period. One day, a pounding heartbeat made her friends rush her to the ER. That’s when doctors started connecting the dots and looking into thyroid problems.

Are all women at risk of having thyroid problems?

Dr Avinash Phadke writes that scientists have not been able to “understand why women are more prone than men to developing thyroid problems, but it could be linked to autoimmunity which is more commonly found in women than men”. 

Women are more likely to develop autoimmune conditions, while men are more susceptible to infectious diseases. The thyroid cells become the target of autoimmunity. Studies have attributed it to the genes from the X chromosome. With two XX’s in play, women are at a greater risk. 

Integrative physician and gynaecologist Sara Gottfried, MD, implicates oestrogen dominance as a contributing factor to thyroid problems. 

Jain, like many other experts, believes that it’s more linked to the many hormonal changes that women go through in their lifetime, starting from puberty to childbirth and menopause. “Every month we experience hormonal changes with menstruation. Maintaining hormonal balance is a task for most women. Especially if you have thyroid problems in your family, it’s important you get your levels routinely checked.”

Gender aside, contrary to popular belief, thyroid issues don’t pop up suddenly after a certain age. Karlekar says that thyroid problems can be seen in anyone irrespective of their age.

Twinkle Shah was 13 when a ‘prescription gone wrong’ by a gynaecologist triggered something in her body. It started with a stomach ache and she was taken by the dorm teacher at her boarding school to see a gynaecologist. “The doctor prescribed some pills that are apparently used during the ovulation period of older women, I don’t remember exactly what, just that it wasn’t meant for a 13 year old.” She completed the course and felt fine.

A few months later, she returned home for her summer vacation and it started to hit her. She became lethargic and didn’t want to get out of bed. Her mother was down with dengue at the time and her father ordered full-body check-ups for the entire family. When the reports came back, they found she had hypothyroidism.

“I was an athletic person, so for me to just sit in the room and not get out of bed was pretty surprising to him. These were all little signals I had no idea about and didn’t pay attention to. If I didn’t do the full body checkup, I wouldn’t have known I had thyroid problems for the next two to three years.”

Even on medication, the first few years were rough as Shah dealt with weight gain, acne, hair fall, lethargy, mood swings and anger issues. “At age 13, you’re told not to eat chips, chocolates, burgers and pizzas and get on a strict diet. It was a shock for me and I was terrified, like, what even happened!? I was growing up, going through puberty. I’d look at others and wonder ‘why are they like that while I’m like this? It sucked a lot.” 

With supportive parents, she stuck to a balanced diet and got into an exercise routine along with her medications, something she stresses upon. “That balance of eating well and exercising is very important because later on, it gets very messy if not taken care of.”

Tackling thyroid dysfunction

Nutrition and exercise

Karlekar says that thyroid problems need to be controlled with medication when the functions are seriously out of whack, to put it mildly, “but with borderline thyroid derangement or only thyroid swelling with normal hormone levels, medication may not be required”.

For people with hyperthyroidism, dietician Priyanka Sanghvi recommends adding cruciferous vegetables to your plates, like broccoli, cauliflower, cabbage and kale. These can reduce the production of thyroid hormones. Foods low in iodine are also beneficial, such as egg whites, oats, honey, unsalted nuts and nut butter.

Selenium protects the thyroid gland and is an antioxidant. For both hyper and hypothyroidism, selenium intake is important but should be moderate for the former, which is best done with the help of your doctor. Chia seeds, mushrooms and sunflower seeds are rich in natural selenium. Avoid foods high in iodine such as dairy and seafood.

For hypothyroidism, you want these essentials – iodine, selenium and zinc. Go for eggs, meats, fish, gluten-free grains and seeds, maintaining a balance between all. The foods you want to avoid are highly processed food and goitrogens — foods that disrupt thyroid functioning.

Celebrity nutritionist Suman Agarwal advises people facing thyroid-related weight gain to avoid soya-based food, peanuts and bajra. She says, “We are not very strict about removing cauliflower. You can’t really avoid so many foods, just avoid soya bean and peanuts as they might contribute to higher TSH levels and you’ll gain weight. Workouts, on the other hand, are designed around people’s individual body shapes and health issues, not specifically thyroid, so each person will have to find a different workout that suits them.”

Yoga moves to help fight the symptoms of thyroid-related weight and improve your overall health.

Bhujangasana: The cobra pose gently stimulates the neck and throat region, thereby increasing thyroid functioning for those suffering from hypothyroidism.

Matsyasana: The fish pose stretches your neck, stimulating the thyroid glands. It’s great for healing symptoms of thyroid patients, lowering stress levels and reducing the stiffness of muscles and joints.

Marjariasana: The fluid motion in Cat-Cow pose is believed to stimulate your thyroid — it involves neck movement, which also works on the throat chakra.

Sarvangasana: B. K. S. Iyengar champions the shoulder stand as a way to balance the thyroid because it employs a chin lock — it also exerts pressure on the thyroid gland and helps in improving blood circulation and squeezing stagnant secretion.

*Name changed upon contributor’s request for anonymity.

A note of caution: This story is for informational purposes only and contains expert advice and personal experiences. If you find yourself struggling, please consult a healthcare provider for proper guidance.