About three years ago – not long after my mum’s sudden death – I noticed that I was putting on weight. I wasn’t eating any more than usual, and I am very active. I couldn’t understand what was happening... my solution was simple: eat less and move more. I started doing more exercise – upping it from my usual 45 minutes a day to an hour or two. I’d never counted calories before, but I cut down my intake to a strict 1,000-a-day regime. But the weight gain continued.
As I continued to put on weight, I began to feel tired. Assuming that the fatigue was caused by overdoing the exercise, I dialled it back a bit. I tried a no-fat vegan diet for six months. My body shape was fluctuating every day – sometimes swollen with a belly so distended I looked pregnant, sometimes close to the lean physique I had complacently enjoyed all my life. I tried a keto diet – eating only meat, green veg, nuts, seeds and fats, but no sugars whatsoever. I stuck with it for eight miserable months. No change.
I was 44 years old. I bought some scales for the first time in my life but, looking at pictures of myself from that time, my body was by no means overweight. On the scales, I was bang-on average for my height and age. What had started off as a mild weight gain was rapidly turning into a mental problem. I was developing body dysmorphia.
Like a lot of naturally slim athletic people, I had always been dismissive of eating disorders – but I now have gre
at empathy for anyone who is suffering from any issues to do with their body image and eating. It is hell – the obsession, the fear of eating too much, or eating the wrong thing, the constant state of guilt and self-loathing.
I noticed that minor injuries weren’t healing. I had always been a very fast healer, but now, bruises, cuts and even blisters would take weeks to go. My hair started falling out – my hairbrush was always full and the shower plug kept getting blocked. My eyebrows, always quite thick, had thinned out.
During this time, my relationship with my husband – which had been at times difficult – reached a new low. I had no libido, and he was bemused by my reaction to the changes in my body (“But I still fancy you, so what’s the problem?”). I wondered if I was over-reacting to a natural ageing process.
Eventually, after a month spent doing Crossfit five days a week, and cycling or climbing on my day off, I spoke to a nutritionist who told me to stop everything. I am eternally grateful to him for his intervention.
He spotted immediately what was wrong with me: I had an endocrine issue. He suggested that I went to my GP to get tested for hypothyroidism, an endocrine system disorder where the thyroid gland does not produce enough of the hormones needed to regulate metabolism. In the meantime, he suggested I reduce my exercise to 30 minutes a day, max – and eat properly again.
When I went to my GP, she insisted my weight was fine, and that I needed to learn to accept that my metabolism will naturally slow down in my 40s. But I pushed for a hypothyroidism test. After a further appointment, she finally agreed.
Hypothyroidism is a rare condition, affecting 15 in every 1,000 women (and just one in 1,000 men). But last week, TV presenter Anna Richardson revealed how she put down her tiredness, irregular periods, brain fog and gaining a stone in weight with the menopause – and even tried treating the symptoms for three years with HRT – before being diagnosed with an underactive thyroid.
The thyroid gland – a small, butterfly-shaped organ in the neck – controls the release of thyroid hormone thyroxine into the body. T4 (thyroxine) goes around the blood and gets transformed into a more radical element called T3, which then stimulates pretty much all the metabolic reactions in the body, from digestion, to energy release, to powering your muscles.If the thyroid gland is malfunctioning (ie underproducing T4), the pituitary gland (the tiny gland in the front of the brain) compensates by producing TSH (thyroid stimulating hormone) to try to activate the thyroid gland.
So it stands to reason that if your thyroid hormone levels are low, TSH will be high. Rather than check T3 or T4 levels, the standard blood test looks for TSH instead.My results came back: TSH normal. All other hormone levels normal, so I wasn’t peri-menopausal either, which also presents similar symptoms.
I wasn’t happy. To me, my symptoms were clear. I decided to make use of my private health insurance. I called an endocrinologist in London and, based on my symptoms, he was certain I had hypothyroidism. The test results came back: T4 low, T3 off-the-scale low, TSH normal.
Having batted with mid-life weight gain and tiredness for two years, I was finally diagnosed correctly.
I found out that my pituitary gland, for some reason, was not recognising the low level of thyroid hormones. I had a scan done of my pituitary gland to ensure that it wasn’t affected by a tumour (it’s wasn’t), and I was given a prescription for T4 (thyroxine) and T3 (liothyronine) replacement tablets.
Thyroxine (T4) is a synthetic version of the main hormone secreted into the bloodstream by the thyroid gland, and readily available on the NHS. When she saw my results, my GP happily prescribed it. However, she refused to prescribe Liothyronine (T3), saying she believed it was ineffective.
In October 2017, the NHS announced it would stop prescribing Liothyronine (T3), a hormone pill taken by more than 13,000 patients with underactive thyroids, after the manufacturer raised the price by more than 5,000 per cent – from 16p per tablet to £9.22. Last week, a new report commissioned by the Department of Health and Social Care found evidence that local healthcare commissioners are refusing to pay for the medication, despite national guidance stipulating that they should.
I offered to buy a two-month supply of T3 over the counter in the chemist. The pharmacist looked up at me and said: “Do you *really* need this?” I showed her my prescription.
“If you buy it privately, it’ll be £1,600.”
Liothyronine is insanely expensive in the UK – and I can understand why the NHS is loathe to prescribe it – but you can buy a month’s supply over the counter in France, Greece or Spain for just €3. Many hypothyroid suffers now face regular trips to the Continent t
o stock up on their life-changing medicine.
I am still prescribed T4 by my GP, but get a friend to buy my T3 in Greece. My body is still liable to weight gain if I don’t watch my diet, but I am happy to accept that as part of growing older. My libido is back (although my marriage didn’t make it – for other reasons than the thyroid issue, although I’m sure it acted as a catalyst). I heal well and I feel as energetic as I ever did. The endocrinologist tests me every six months to ensure that my levels are not dropping or rising too high, and adjusting my doses accordingly.
Thyroid levels do fluctuate, even when you are on a regime of tablets. They are hormones, after all, and we all know that they are always in flux. There could be many causes for my condition: was it brought on by the sudden, traumatic death of my mum? Was it genetic (she had had chronic fatigue, but I don’t think she was ever checked for a thyroid disorder)? Was it as a result of problems in my marriage?I will never know for sure. I’m just glad I had the tenacity to get to the bottom of it.