Women Are 5-8 Times More Likely To Suffer From This Type Of Disorder. Why?
by Marissa Pomerance
As if women don’t have enough problems, here’s an insane fact to reckon with:
Women are 5-8 times more likely than men to suffer from thyroid disorders, and 1 in 8 women will develop a thyroid condition at some point in her life.
And if you’re wondering why you should care, just note that thyroid disorders are at the root of some of our most frustrating problems, like fatigue, weight gain, depression, and irregular periods. So.
Why are women disproportionately suffering from thyroid disorders?
We set out to get answers. And we found out that the thyroid gender gap actually has a lot to do with our immune systems.
A thyroid disorder could be responsible for your most frustrating symptoms.
Most of us have a vague understanding that the thyroid is linked to hormones, weight gain, and fatigue. But, the thyroid is a pretty multifunctional gland; it also produces hormones that regulates the metabolism, can affect heart rate and energy levels, and even impacts our reproductive hormones.
When the thyroid isn’t functioning properly, it can cause hormones to go haywire, either producing too much or not enough thyroid hormones (known as “T3” and “T4”). And these imbalances can lead to full-on disorders, like:
Hyperthyroidism: this occurs when the thyroid produces too many thyroid hormones. People with hyperthyroidism usually suffer from muscle weakness, weight loss, disturbed sleep, fatigue, and irregular periods.
Hypothyroidism: On the other hand, when the thyroid doesn’t produce enough hormones, you can get hypothyroidism, which leads to symptoms like extreme fatigue, depression, forgetfulness, and weight gain.
Thyroiditis: When the immune system attacks the thyroid, it can create inflammation in the thyroid, which can lead to the above disorders as well.
Goiters: A goiter is an enlarged thyroid gland usually caused by an autoimmune disorder, and causes swelling in the neck.
“doctors have traditionally shrugged off women’s thyroid symptoms, leading real women to continually suffer in silent, invisible ways. ”
And yes, these disorders affect men too, but they disproportionately affect women. And they are increasingly common; in fact, about 60% of people with hypothyroidism don’t know they have it. Yet doctors have traditionally shrugged off women’s thyroid symptoms, or refused to treat them if their thyroid was only “a little bit” out of whack, leading real women to continually suffer in silent, invisible ways.
Like this woman who described her debilitating fatigue, explaining, “I felt exhausted and incapacitated, utterly drained and hollowed out. It was like my brain and body were fading…I could barely function.”
Or this doctor, who was “losing weight at an alarming rate,” explaining, “I was gaunt, haggard, and frail, my muscles trembling so badly when I went down the stairs that I had to clutch the railing for dear life. I was always hungry, even after I ate.”
Before getting officially diagnosed, many women visit doctor after doctor, who give them unhelpful advice to get more sleep, or eat better, or exercise more. And these disorders can be potentially dangerous for us— they can influence our ovulation, our chances of getting pregnant, and cause health problems for mothers and babies during pregnancy.
So why is this happening? And why is it affecting women more than men?
One possible culprit: hormones.
Yes, we know the thyroid is responsible for thyroid hormones. Obvs. And we already know that the thyroid affects our reproductive hormones, which is why thyroid disorders can significantly impact our reproductive health, leading to PMS, endometriosis, PCOS, and infertility.
But, while there’s still not enough research here to fully understand the relationship between the thyroid and reproductive hormones, apparently, our estrogen levels are also linked to the thyroid. One study found that estrogen might even directly affect thyroid cells, influencing the development of certain thyroid disorders. Why does everything come back to estrogen?
According to Dr. Sara Gottfried, estrogen dominance, low progesterone, and adrenal issues all contribute to potential thyroid disorders. In fact, she argues, thyroid disorders first appear for many women during significant hormonal changes, like pregnancy or menopause.
But while our reproductive hormones might play a role in this thyroid disorder gender gap, there’s still a lot we don’t know about this relationship. And the connection between the thyroid and women’s hormones don’t tell the full story.
To dig a bit deeper, we have to look at the connection between thyroid disorders and autoimmune diseases.
Here’s the real culprit: the autoimmune disease gender gap.
Here’s a more compelling theory for the gender gap in thyroid disorders:
“women are more likely to have thyroid disorders because women are more likely to have autoimmune disorders.”
Women are more likely to have thyroid disorders because women are more likely to have autoimmune disorders, and thyroid disorders often are autoimmune disorders.
Remember our list of thyroid diseases above? Let’s take a closer look. First, hyperthyroidism; the most common cause of hyperthyroidism in women is Graves disease, which is an autoimmune disease. And hypothyroidism? One of the most common causes of hypothyroidism in women is Hashimoto’s disease, which is also an autoimmune disease. Thyroiditis? Caused by an immune system issue i.e. it’s an autoimmune disorder. Goiters? More common in women than men, and, you guessed it, usually caused by autoimmune disorders. You get the idea.
The most common types of thyroid issues are, in essence, autoimmune disorders, so doesn’t it now seem incredibly obvious that if women are more susceptible to autoimmune diseases, they’ll be more likely to develop autoimmune-related thyroid conditions?
But, there’s still a piece of the puzzle we haven’t discussed; why are women more likely to suffer from autoimmune disorders in the first place?
Why women are disproportionately suffering from autoimmune disorders.
Like thyroid conditions, there’s a huge gender gap in autoimmune disorders. While about 8% of the population suffers from autoimmune diseases, women make up 78% of cases, and recent research has shed light on this discrepancy, providing us with some very interesting answers.
Here’s some good and bad news; women’s immune systems are stronger and more reactive than men’s. This can actually be great for us, because we’re less susceptible to infectious diseases as our bodies respond to infections and vaccines with more antibodies. But, this becomes a problem when our immune systems overreact and attack our own bodies, which is how autoimmune diseases originate.
To get very granular, some scientists believe this immune overreaction is due to our second X chromosome, which carries many of the genes required in the immune response. Since we have two of these chromosomes, and men only have one, it makes sense that women would have more genes related to immunity. But women’s tendency towards autoimmunity could also be an evolutionary response to pregnancy (or the expectation of pregnancy). The theory is complex, so try to stay with us, but the general idea is that without constant pregnancies throughout our adult lives (which usually suppress the immune response), our immune systems compensate by always going into overdrive when we’re not pregnant. To make matters worse, estrogen (of course) stimulates the immune response, while androgens (a male sex hormone) suppress immunity. So our female-specific hormones are also ramping up our immune systems, sending them into overdrive, while men’s hormones help guard against this immune overreaction.
If you decided to skip that dense, science-y paragraph, here’s what you need to know; there are very complex, gender-specific genetics, evolution, and science at play. Women are more likely to suffer from autoimmune disorders not just because the world is fucked and diseases are sexist, but because of intricate, biological factors specific to women’s bodies, genes, and hormones.
“our chromosomes, hormones, and that whole we-can-have-a-baby thing are giving us overdramatic immune systems.”
So, our chromosomes, hormones, and that whole we-can-have-a-baby thing are giving us overdramatic immune systems, making us more susceptible to autoimmune disorders, which are giving us thyroid disorders. There you have it.
Now…what do we do about it? The short answer: get a blood test. The long answer…well, that’s a bit more complicated.
What you need to know about thyroid testing.
Thyroid disorders feel universal; so many women get them, and we all feel like we’re suffering from one. I mean, our weight gain and constant fatigue and extreme PMS must be caused by something, right? And yet, getting diagnosed is a complicated, exhausting process. The symptoms are vague, and often confused with other diseases. And of course, the medical community doesn’t have a great track record when it comes to taking women’s pain seriously.
But, understanding the testing and diagnosis process can arm you with the right information. For example, it’s possible to detect a thyroid condition from simple blood tests. But most doctors look at just one hormone—TSH, the Thyroid Stimulating Hormone. This hormone usually gives you a broad picture of your thyroid function, as testing this hormone can tell you about the large changes in your overall thyroid hormone levels. While these tests are considered very accurate, they might not tell the full picture.
For example, a “normal” TSH test result actually doesn’t rule out the possibility of hypothyroidism. If your tests come back normal, then ask your doctor to also test your other major thyroid hormones, like T3 and T4. These results can give you a more focused, granular look at exactly what’s happening with each thyroid hormone.
Dragging yourself to countless appointments with internists, gynecologists, and endocrinologists before getting a straight answer is exhausting. But, almost no one tells us that our thyroid symptoms could be caused by an underlying autoimmune disorder. So advocating for yourself when you’re suffering from amorphous, easily-dismissed symptoms might not be easy, but it’s necessary.
Because you deserve answers. And you deserve to not feel shitty.
Marissa Pomerance is the Managing Editor of The Candidly. She’s a Los Angeles native and lover of all things food, style, beauty, and wellness. You can find more of her articles here.
