Are You An Undiagnosed or Misdiagnosed Thyroid Patient?

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Richard Shames, MD is an integrative physician with expertise in thyroid and hormonal issues. For more than three decades, he was worked with patients who have been misdiagnosed, or who have struggled with the health effects of undiagnosed thyroid disease. I had an opportunity to obtain Dr. Shames' thoughts about the millions of undiagnosed thyroid patients, and his concerns about thyroid misdiagnosis.

Mary Shomon: How common is misdiagnosis of thyroid disease?

Richard Shames, MD: Of many common illnesses that might eventually affect many of us, in my opinion, thyroid imbalance is probably the most common and most misdiagnosed of all. The number of prescriptions for thyroid medicines written each year exceeds that for almost any other category of illness. And yet, more than half of the 40 million+ people with a thyroid condition do not even know it, and are frequently diagnosed as having other health issues.

Mary Shomon: What are the symptoms of thyroid imbalances?

Richard Shames, MD: Symptoms of thyroid imbalance occur when the body is either too high or too low in thyroid hormone.

If too high, the condition is called hyperthyroidism, with symptoms of restlessness, insomnia, rapid pulse, excessive sweating, heart palpitations, rapid-fire speech, trembling and shakiness, weight loss, difficulty breathing, and eventually a burned–out fatigue.

When thyroid hormone is too low, things are reversed. While there still may be fatigue as a major symptom, hypothyroidism symptoms also include feeling sluggish, sleepy, slow pulse, diminished sweating, decreased heart activity, slow movements, slow speech, weight gain, thinning hair, unhealthy nails, sluggish or irritable bowels, high cholesterol, abnormal blood pressure, as well as various female issues like irregular cycles, infertility, recurrent miscarriage, or severe menopausal symptoms.

Mary Shomon: Why is thyroid disease often overlooked or misdiagnosed?

Richard Shames, MD: Thyroid hormone is essentially the gas pedal for every activity and chemical reaction in the body. It controls the rate and quality of function for every tissue and organ. Because of the widespread effect of thyroid hormone, imbalances can be easily attributed to a large variety of other illnesses, resulting in a misdiagnosis.

As a result, thyroid imbalance is often misdiagnosed as chronic fatigue syndrome, anemia, alopecia, irritable bowel, skin disorders, estrogen imbalance, high cholesterol, high blood pressure, dry eye syndrome, premature aging, arthritis, chronic sinusitis or cystitis, and many other diseases and conditions.

Mary Shomon: What is the biggest misdiagnosis challenge related to thyroid issues?

Richard Shames, MD: Beyond the misdiagnosis of various diseases, even more people with undiagnosed thyroid issues are mistakenly given a mental health diagnosis. Thyroid imbalances are known to cause a wide variety of mental health symptoms, because thyroid hormone is crucial to healthy brain function.

Hyperthyroidism can cause excess irritability, anxiety, paranoia, or panic. Hypothyroidism, on the other hand, can cause depression, insecurity, memory loss, interrupted sleep, and a feeling of being overwhelmed. These mental health symptoms are not rare occurrences. As I wrote in my book Thyroid Mind Power, multiple research studies have revealed that thyroid imbalance is the root cause of over a third of all depression.

Mary Shomon: What should people do if they suspect they are undiagnosed or misdiagnosed?

Richard Shames, MD: People experiencing any of these symptoms deserve a careful thyroid evaluation – including blood tests, and a clinical thyroid examination by a knowledgeable physician. This is particularly important if there are thyroid, other metabolic/hormonal conditions, or autoimmune disease in the family's medical history.

The blood testing should include not only the standard thyroid test of TSH, but also a Free T4, Free T3, and TPO antibodies, to start.

Mary Shomon: How can people get tested?

Richard Shames, MD: These tests can be requested from your health care practitioners. In the majority of US states, these tests can also be ordered by patients directly, using a "direct-to-consumer" laboratory service. See or MyMedlab for inexpensive ordering of direct-to-consumer thyroid testing with major laboratories.

Obtaining a proper diagnosis is essential, so that a possible underlying thyroid imbalance will not be misdiagnosed as something else. This could save years of poor health and heartache, and also be an opportunity for earlier treatment of the real cause of symptoms.

Richard L. Shames, MD is a practicing physician, researcher, and author of Thyroid Power, Feeling Fat, Fuzzy, or Frazzled? and Thyroid Mind Power. His website is


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