I thought my hot flushes, thinning hair and brain fog were caused by the menopause. Then doctors discovered the chilling condition that was really to blame… and it mostly affects women

Mother of five Amanda Marshall had toddler twins, so she initially dismissed her hair loss as an ongoing postpartum problem. But soon he started experiencing hot flashes and his heart was pounding. She told herself that since she was in her early 40s, she must be going through menopause. But when the Devon farmer and small business owner began experiencing what he thought was a panic attack a few months later, he became worried and went to see a GP in October 2016. And he wasn’t expecting what he discovered.

‘I lead an active lifestyle, so I ignored my symptoms for a long time,’ she says. ‘They came at me.’ Amanda, who is already a mother of three children with her ex-husband, had twins named Ben and Toby (12) with her partner Mark in 2013. Three years later, she began to notice her hair breaking.

Amanda, now 50, says: ‘I started having hot flashes that came and went quickly throughout the day. My heart was pounding and I was out of breath as I walked up the hill after tending to my farm animals.’

‘I was in my 40s at the time, so I thought maybe I was in menopause. I would come in extremely hot and out of breath. Then one day I was standing by the stables and my heart started beating so fast I could feel it in my chest and I had to bend over. I believed I was having a panic attack and thought maybe that wasn’t what I thought it was. That’s when I went to the doctor.’

Luckily for Amanda, her doctor took immediate action, starting her on beta blockers for her heart, getting blood tests done, and noticing a lump in her neck. ‘Within ten days I was with an NHS specialist,’ he says. An Ear, Nose, and Throat (ENT) specialist examined the lump and determined that it was the thyroid gland. Amanda was then referred to an endocrinologist, who said she had Graves’ disease. ‘I’ve never heard of this before,’ he says.

According to the British Thyroid Foundation, around one in 20 people in the UK live with a thyroid condition. And 90 percent of them are women. Most thyroid disorders are autoimmune conditions in which antibodies either destroy thyroid cells (hypothyroidism) or stimulate the thyroid to produce excess thyroid hormone (hyperthyroidism).

Thyroid hormones regulate metabolism, explains Professor Kristien Boelaert, consultant endocrinologist and president of the Society of Endocrinology and the British Thyroid Society. ‘Hyperthyroidism is too much thyroid hormone and hypothyroidism is not enough. If you consume too much, your metabolism will speed up; “Your heart beats faster, you lose weight, you get hot and sweat,” he says. ‘With hypothyroidism the opposite happens, so everything slows down; You gain weight, you get tired, you become constipated and your skin becomes rough and dry.’

Graves’ disease causes hyperthyroidism; but Amanda says it didn’t cause her to lose weight. ‘Sixty to 80 percent of hyperthyroidism in the UK is caused by Graves’ disease, an autoimmune condition,’ says Professor Boelaert. ‘This means you are producing antibodies against your thyroid. In Graves’ disease, these antibodies stimulate the thyroid gland to produce more thyroid hormone.’

Standard treatment is to start antithyroid medication that will block the enzyme responsible for thyroid hormone synthesis. The most commonly used was carbimazole, and that’s what Amanda was prescribed in the hopes of getting her thyroid back under control. It usually lasts for about 18 months, but because Amanda’s levels were not regulated, after nine months specialists decided to operate on her thyroid and remove it completely. If left untreated, Graves’ disease can cause heart failure and even be fatal.

Professor Boelaert says that if medication does not cause regression of the disease, there are two more treatment options. “One is to administer radioactive iodine, and the other is to perform surgery to remove the thyroid gland.” Surgery was very common 60 years ago, he explains, but is used less often now, except in very resistant cases like Amanda’s, in favor of lower-risk treatments.

Amanda Marshall initially dismissed her hair loss in her forties as a postpartum problem that persisted after giving birth to twins.

Around 1 in 20 people in the UK live with a thyroid condition – 90 per cent of whom are women

Following the surgery, Amanda now needs to take thyroxine medication every day to replace the lost thyroid hormones. Ironically, being in her fifties, she now finds herself actually facing menopause. ‘I thought: “Give me a break!” “But I have to pull up Bridget Jones’s big pants and get on with my job,” he says. ‘I get hot flashes occasionally and have trouble sleeping but I’ve started HRT and that’s helping too.’

Amanda says she is struggling to cope with daily stress and suffers from brain fog. ‘I drop more balls than I juggle now,’ she says, combining dairy farming with caring for a horse, three donkeys, two dogs and chickens, as well as running 3 Donkeys women’s dungaree clothing brands.

Professor Boelaert says overactive thyroids and Graves’ disease are often confused with menopause. ‘Symptoms are often vague and often confused with menopause. “The peak period when Graves’ Disease occurs is in women around the age of 40, and women often think it is menopause because they sweat, feel restless and cannot sleep well,” he says. ‘It’s 10 times more common in women than men and your doctor may initially think it’s because you’re going through a change.’

He says it is important to receive treatment, and if left untreated, it can lead to irregular heartbeats and heart failure. But the good news is that diagnosis is simple with a blood test. ‘If you’re worried, have your doctor do a blood test,’ says Professor Boelaert. But he warns against using an at-home kit. ‘Over-the-counter tests are not validated and unreliable. Always see your doctor.’

• 3donkeys.co.uk
• british-thyroid-association.org