10 Things You Shouldn’t Say to Someone With an Underactive Thyroid


There are some things you just shouldn’t say to hypothyroid patients. Those of us with an underactive thyroid already have a hard time trying to cope with managing the condition. I don’t like to complain, but I feel like this is needed. We really dislike hearing any of the comments below. 

1. “You just need a good night’s sleep!”

No. No, no, no, no, no. Believe us, we’ve tried! We’re so fatigued that we often sleep more than anyone else we know. So believe us when we say that sleeping any more than we already do isn’t going to help. Having an underactive thyroid means our thyroid is just that — underactive. This means our metabolism is quite a bit slower than yours, so we don’t have as much energy as we should. This means we get easily tired and often feel tired all the time. In fact, it’s more than just being tired. It’s “every second I’m consciously having to keep each eyelid open” tired. It’s “I’m scared to blink or I’ll fall asleep” tired.

2. “You’ve got medicine now. You must be fine!”

Nope, not necessarily. It can take months or even years for people to get their thyroid medication right. And even when we do finally get our thyroid medication right, we often also have other conditions that have developed because of the thyroid not being adequately treated for quite some time. This includes vitamin deficiencies, adrenal problems, mental health conditions and acid reflux to name just a few. So don’t just assume we’re OK once we get medication for it.

3. “Be patient.”

Being told to give the thyroid medication time to work can be so frustrating. If we become impatient, frustrated and fed up with waiting for our medication to start working, don’t blame us. We’ve probably had a long battle with getting this diagnosis in the first place, since so many doctors pass hypothyroidism off as other conditions like depression, chronic fatigue syndrome and fibromyalgia. We don’t want to be told to be patient any longer.

4. “Just eat less and exercise more!”

The main purpose of thyroid hormones, produced by the thyroid gland, is to ensure our metabolism is running properly, and the metabolism’s job is to produce heat and fuel to keep us warm and give us energy. Now, being underactive, we don’t have enough of those thyroid hormones, so our metabolism doesn’t work properly. Therefore, people with an underactive thyroid have a slow metabolism and will have symptoms associated with a slow metabolism, such as cold intolerance, extreme tiredness and weight gain. We gain weight and often can’t control it. We also struggle to lose it. Some even diet and force exercise regimes and end up gaining more weight. Can you imagine how hard that is to deal with?

Only when our thyroid hormone levels are corrected — thus correcting our metabolic function — do we have a chance of losing the weight and stop gaining it at all. Not to mention that most of us don’t have the energy to move any more than we already do because of the slow metabolism. Most of us aren’t pigging out on doughnuts and ice cream all day. We just fell victim to a rubbish thyroid and inadequate metabolism, so please don’t tell us that we just need to eat less and exercise more. That includes the doctors who sometimes tell us this. My endocrinologist told me I needed to see a nutritionist. I didn’t. I lost the thyroid weight just by correcting my thyroid hormone levels.

5. “It’s all in your head. You just need to let go.”

My own doctor told me this. Needless to say, I haven’t seen that doctor since. Unless you’re in our shoes, you can’t say what is and isn’t real. Do you know our minds and bodies as well as we do? No. Inadequately treated thyroid problems can lead on to so many other things, such as depression. When I told my doctor that despite my test results being fine I still felt increasingly unwell and depressed, he told me that I was just depressed and my ongoing fatigue, muscle aches and pains, acid reflux, migraines, mood swings, brittle hair and nails were “all in my head.” I was imagining them all apparently. I was an attention seeker and a hypochondriac — or so he thought. As soon as I realized that going by TSH levels alone was inaccurate, I had him test my other levels, changed my thyroid medication and all my symptoms disappeared, including the depression. So it wasn’t all in my head.

Don’t judge someone or tell them they’re wrong about their own body when they know it much better than you. They know when something isn’t right, so don’t laugh off their ideas and suggestions or insist that they’re reading too much into it.

6. “You’re so hormonal!”

Don’t judge us because of our health condition. Don’t assume anything we say that you disagree with is because our thyroid hormones make our moods and emotions go up and down. We can be mad, annoyed or irritated for legitimate reasons. Maybe we’re fed up of battling this health condition, but don’t assume that it’s just because of our thyroid hormones being off. We’re entitled to express strong opinions without our health condition being blamed.

7. “You have this condition because of ___.”

Insert “not wearing a coat when you go out,” “your diet,” “not eating enough fruit and vegetables” here. Sure, those things won’t help your thyroid, but it doesn’t tend to cause thyroid problems single-handedly. It makes me laugh. I’ve heard “you don’t wear enough layers” from “experts” around me as the cause for my hypothyroidism, and when I try to explain that I actually have Hashimoto’s, an autoimmune disease which is affecting my thyroid and the cause for its dysfunction, they just go blank.

8. “The thyroid gland doesn’t even do anything!”

This not only belittles what we’re going through, which is incredibly hard to cope with by the way, but it also makes you appear ignorant. Sure, I didn’t even know where the thyroid was when I was first diagnosed, but don’t assume it doesn’t do anything. It actually does a lot of important stuff. The thyroid gland produces hormones needed for every process and cell of the body, so when this goes wrong, a lot of other stuff does, too! Patients have a whole host of symptoms and problems. Yep, that little butterfly-shaped gland in your neck is important for nearly every single function and cell in your body. That’s how important it is. 

9. “You’re borderline/subclinical hypothyroid, so you’re fine!”

This one goes out to the doctors. I was told this one myself. “Borderline” is just a term doctors use when you’re just outside of their test ranges, and they consider you “not bad enough” to treat yet. Why are they not treating individuals as individuals? Most people with “borderline” hypothyroidism get increasingly worse if their doctor won’t treat them. I did.

10. “You’ve lost the weight because you’ve been dieting/cutting out gluten/exercising more. Not because you changed thyroid medication.”

Doctors and other people say this, and it’s hurtful and ignorant. If we’ve changed thyroid medication to correct our metabolism and are able to maintain a healthy weight again, then don’t tell us that it’s actually because of increased exercise or a better diet when you have no idea. As already mentioned, correcting thyroid levels means we have better metabolic function. If we say this is the big reason for weight loss and healthy weight maintenance, then chances are we’ve had a hard and long battle to be able to correct our metabolic function. Don’t put it down. Sure, a better diet and more movement will help, but if we tell you it’s from a change in thyroid meds, respect that.

Follow this journey on The Invisible Hypothyroidism.

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