18-05-2025
I was lazy, crazy and couldn't cope, but I knew it wasn't depression. It took years for doctors to listen
Like most young women in their early 20s, Chloe Ford had just entered the working world and secured her first full-time job. It was an admin role at a local business and she was living with her boyfriend, now-husband.
She looks back on a chapter that should have been an exciting, fun time in her life but remembers spending it in bed feeling desperately exhausted. Friends were working their nine to five jobs and managing to party all night, then take part in fun adventures such as hiking challenges – but Ford was missing out.
'I had exhaustion, sore eyes, weight gain, loss of general happy energy and then brain fog as well,' she says. 'The best way I can describe it is like clouds filling the space in my mind where my intelligence was supposed to be.'
'I was coming home from work at 5pm and I'd be in bed by 6pm. I was just drained, completely drained,' Ford adds.
Being so tired and lethargic was out of character for her. 'I was an energetic, sporty person and had a horse at the time, which involved getting up and out early, before work, and then going to the stables after work too.'
Alongside all the normal nervousness and anxiety that comes with starting a first job, she worried that colleagues thought she wasn't very bright because she kept having to pause when talking. 'I was stopping mid-sentence and I could see people getting frustrated with me,' she says.
From 21, Ford kept making appointments with her GP, desperate for answers. But doctors were very quick to diagnose her with poor mental health.
'At every appointment, I'd detail all my symptoms but was told I was too young for it to be anything other than depression,' she explains. 'They'd also weigh me at each appointment and confirm that I'd put on weight. I'd already noticed this myself because my jeans were tighter and my face looked different. But the GP acknowledging it would really upset me.'
On one visit, she asked for a blood test and the doctor turned her away, telling her that she was depressed and gave her a number to call for support. 'I couldn't believe that I wasn't being listened to,' she says.
'I didn't think I had depression and I was worried because I felt as if my brain was getting slower, and in all honesty, dumber. I hated getting that 'stuck in my throat' moment when words were lost to me.'
During this time, she didn't take any long-term leave from work but had more sick days compared to colleagues. 'My immune system was so rubbish that I would catch every single bug under the sun and I would be ill all the time – it was so frustrating and I just couldn't work out what was wrong,' Ford says.
'At one desperate point, I thought that it could just be me – maybe I was just lazy and couldn't cope with a full-time job. I felt like I was crazy. I knew I had all these symptoms but all the medical professionals were brushing them off.'
Finally, a diagnosis
Around 18 months after first seeking help, when she was 22, Ford saw a female GP. 'I walked into the appointment and as I sat down, she asked me what was wrong and I just burst into tears,' she recalls. 'She listened to me and said she thought I needed a full blood count to determine what was wrong.'
That was the turning point because, four days later, the results came back and showed she had severe hypothyroidism, also known as an underactive thyroid.
It's a condition that affects 1-2 per cent of the population and is more common in women than men. It occurs when the immune system attacks the thyroid glands – a small gland in the neck, shaped like a butterfly or bow tie, just in front of the windpipe.
As a result, the thyroid can't make enough of the hormone thyroxine (also called T4), which is responsible for regulating metabolism (the chemical reactions in our body), explains Dr Nicola Zammitt, a consultant endocrinologist in Edinburgh.
Tiredness is one of the main symptoms of hypothyroidism. 'It feels like there isn't enough gas in the tank,' she says. 'Everything's slowed down too much. There's a tendency to put on weight, to feel the cold more and your bowels slow down, so people tend to be constipated,' she says.
Other symptoms include depression, slow movements and thoughts, muscle aches and weakness, dry and scaly skin, brittle hair and nails, a loss of libido, pain and numbness in the hands and fingers, as well as irregular or heavy periods.
'The diagnosis was a massive relief and made so much sense,' Ford says. 'It confirmed that I really was ill and that it wasn't just in my head and, most importantly, it meant that I could be treated.'
Why hypothyroidism is so difficult to spot
While Ford's road to diagnosis was long, it shouldn't have to be. 'Confirming a diagnosis of hypothyroidism is straightforward and involves a simple, cheap blood test that any GP is able to do,' explains Dr Zammitt, who is also a trustee for the British Thyroid Foundation. The blood sample then goes to a biochemistry lab and results show whether a thyroid is working normally, is underactive or overactive.
However, it can be difficult for doctors to spot that a patient's symptoms are a result of a thyroid problem, and refer them for this test, she notes. This is because the main symptom – tiredness – is a common symptom of many illnesses, meaning it can sometimes take a while for patients to be diagnosed, she says.
The other tell-tale sign of hypothyroidism is weight gain and most cases of hypothyroidism occur in midlife. 'So, imagine a woman in her 40s or 50s saying that she's put on weight and is feeling sluggish – very often, doctors will think these are simply symptoms of the menopause,' Dr Zammitt notes.
While hypothyroidism can occur at any age, most cases are among the over-50s.
The most common cause is autoimmune disease, where antibodies (cells produced by the immune system to fight off infection) mistakenly attack the thyroid gland, damaging it, Dr Zammitt says. Doctors don't yet know what causes the immune system to overreact in this way.
Some babies are born with an underactive thyroid, which is called congenital hypothyroidism (which all babies in the UK are screened for within the first few weeks of life), but this is relatively uncommon, Dr Zammitt notes.
Living with hypothyroidism
While you can't cure hypothyroidism, Ford takes a medication called T4 levothyroxine. It's a daily tablet that replaces the thyroxine that her body can't make enough of on its own and reduces the severity of her brain fog, tiredness and other symptoms.
'I still have flare-ups,' she notes. 'I don't know what causes them – it could just be a bug – but I'm just really rubbish on those days. I feel slow and I find it really hard to talk. The brain fog will get so bad that I just cannot function. It really gets me down.'
Ford still works a full-time job, has a four-year-old son and is also a newly published author, finding solace in writing as something she could do, even when she felt short of energy. Her first novel Work Trip – a rom-com that sees two colleagues who dislike each other forced together while travelling for work – is out now, and she has another book out in October called House Party. 'I'm not very good at practising rest,' she admits.
'My experience has left me wondering how many people suffer with thyroid issues for a long time without realising the cause, or that there are treatments available,' she says.
There main consequences of an undiagnosed underactive thyroid relate to symptoms going untreated, as it can lead to high cholesterol, which raises the risk of heart disease and strokes, Dr Zammitt says.
A lack of treatment can also lead to a rare complication called myxoedema, which is a severely underactive thyroid that can cause the heart rate, body temperature and sodium levels to become worryingly low, she notes. Symptoms of myxoedema include confusion and a drop in alertness.
'An untreated thyroid can ultimately lead to hospitalisation, intensive care and even death, though this is extremely uncommon as most people would get a diagnosis and take their medication to prevent these complications,' Dr Zammitt says.
Those who have autoimmune hypothyroidism are also slightly more likely to develop other autoimmune conditions, such as Type 1 diabetes, coeliac disease or Addison's disease, she adds.
'For people who have an underactive thyroid, or have undiagnosed symptoms, my biggest piece of advice would be to advocate for yourself,' Ford says. 'I know it can be easier said than done but push for appointments and tests when things don't feel right but keep pushing until you get the care you deserve.
'Also, while it's a condition that you're going to have forever, it's not all doom and gloom. You can hold down a job, have a family and even turn a hobby into a new career.'
Hypothyroidism FAQs
What does our thyroid gland do?
The thyroid gland sits in the lower part of the neck and is shaped a little bit like a bow tie or butterfly, explains Dr Zammitt.
'The thyroid hormones it produces act as the accelerator pedal for our body's metabolism (the chemical reactions in our body),' she says. 'They enter the nucleus of our cells and affect what the cell does and what it produces, which has a knock on effect on metabolism.'
They have effects on your gut (the rate at which food passes through it), your heart (how fast it beats) and your brain (causing low mood for underactive thyroid and anxiety and irritability for overactive thyroid), says Dr Zammitt.
'So the effects of these hormones are felt throughout the whole body,' she says.
What is hypothyroidism?
Hypothyroidism, also known as an underactive thyroid, occurs when the thyroid gland doesn't produce enough thyroid hormones.
It's a condition that affects one to two per cent of the population and is more common in women than men. It occurs when the immune system attacks the thyroid glands
As a result, the thyroid can't make enough of the hormone thyroxine (also called T4), which is responsible for regulating the metabolism (the process that turns food into energy), explains Dr Nicola Zammitt, a endocrinologist in Edinburgh.
What is the difference between hypothyroidism and hyperthyroidism?
Hypothyroidism (an underactive thyroid) occurs when the thyroid can't make enough hormones, while hyperthyroidism (an overactive thyroid) is when the gland produces too many thyroid hormones.
Hypothyroidism is more common than hyperthyroidism, Dr Zammitt says.
'You get tired with both an underactive and overactive thyroid, but with an underactive thyroid, it feels like there isn't enough gas in the tank,' she explains. 'Everything's slowed down too much.'
'Whereas with an overactive thyroid, it's like you are exhausted because your metabolism is running too fast,' she explains. 'Your heart races fast, your hands tremble and shake, you feel hot, you feel sweaty, your bowels work too fast (causing diarrhoea).'
What are the causes?
The most common cause of hypothyroidism is antibodies (fighter cells produced by the immune system to fight off infection) mistakenly attacking the thyroid gland which causes damage, Dr Zammitt says. Doctors don't yet know what causes the immune system to overreact in this way.
'This damage blocks the thyroid from making thyroid hormones, and therefore you have to take lifelong thyroid hormone replacement medicine,' she says.
However, an underactive thyroid can also be a result of treatment for an overactive thyroid, which can involve removing the thyroid gland or making it inactive with radio-active iodine. This is done because an underactive thyroid can be easier to manage than an overactive thyroid, she says.
Some babies are born with an underactive thyroid, which is called congenital hypothyroidism (which all babies in the UK are screened for within the first few weeks of life), but this is relatively uncommon, Dr Zammitt notes.
In most cases, hypothyroidism is permanent but it can also be caused by temporary inflammation of the thyroid (thyroiditis), which can occur during pregnancy or be caused by some medications or pregnancy. 'For some people, this is a temporary phenomenon and after a few months, the thyroid recovers,' she adds.
How to know when to get tested?
If you have symptoms of an underactive thyroid, the NHS recommends making an appointment with your GP. The most common signs of the condition are feeling extremely tired, feeling cold more than usual, putting on weight, constipation and brain fog.
If you present with these symptoms, a GP may recommend a blood test to check how much thyroid-stimulating hormone (TSH) and thyroxine (T4) is in your blood.
What are the treatments?
'For most people, once their thyroid has become underactive, it's permanent and they need to take thyroid hormone replacement,' Dr Zammitt explains.
The most common form of replacement is a daily levothyroxine tablet, which is an artificial form of the T4 thyroid hormone.
A patient's starting dosage of this medication is calculated based on their weight, she says. Then, six weeks after starting the medication, patients should receive a blood test to determine whether they are on the correct dosage.
For example, if your body isn't absorbing levothyroxine very well, you might need a change of dose. 'Common supplements like calcium and iron can reduce absorption of levothyroxine, as can medicines to lower stomach acid, such as lansoprazole and omeprazole,' Dr Zammitt notes.
'Hormonal changes can also affect the dose you need,' she says. Women usually need a higher dose during pregnancy and the dose may alter during the menopause, as hormone levels fluctuate, she explains.
'The majority of people take their daily thyroid replacement tablet and can carry on with life as usual and feel fine,' she says. However, some patients are treated with a combination of levothyroxine and an artificial form of T3 as well, Dr Zammitt adds.
Is there a link to thyroid cancer?
Having an underactive thyroid or overactive thyroid does not increase your risk of developing thyroid cancer.
However, some thyroid diseases, such as an enlarged thyroid (medically known as goitre), thyroid nodules (called adenomas) or inflammation of the thyroid (thyroiditis) do increase the risk of hypothyroidism.
What age does hypothyroidism occur?
When it comes to an overactive thyroid, most cases tend to occur in younger people, in their 20s, 30s and 40s, though both can happen at any age.
