Autoimmune conditions in women: Dismissed and misdiagnosed

For years, I knew something was wrong.

I was tired, gaining weight and dealing with joint pain. I was cold all the time. I also felt stressed, worried and depressed.

After researching my symptoms, I asked my doctor to check my thyroid. When the tests came back negative, he told me my thyroid was fine. The explanation he gave me was depression and anxiety.

But that didn’t explain away what I was experiencing.

As I’ve written before, it took years and multiple doctors to get the real answer: Hashimoto’s thyroiditis, an autoimmune condition that attacks the thyroid.

So when I saw new research about women’s autoimmune symptoms being mistaken for psychological problems, it hit close to home.

Because the cost of getting that explanation wrong can be years spent waiting for the care you need.

Quick Answer

Women with autoimmune conditions reported more psychiatric and psychosomatic misdiagnoses than men in a new international study. Persistent symptoms deserve follow-up, even when initial tests are normal or anxiety and depression are present. Bring a symptom timeline and ask what physical causes have been considered and what the next step should be.

What the study found about autoimmune misdiagnosis

Researchers from the University of Cambridge and University of East Anglia examined the reported diagnostic experiences of 6,607 people with autoimmune conditions. The study was published in eClinicalMedicine.

The differences were striking:

• 43% of women reported that their autoimmune symptoms had previously been attributed to a psychiatric cause, compared with 33% of men.
• 34% of women reported a psychosomatic misdiagnosis, compared with 22% of men. That means physical symptoms were attributed to psychological factors.

Women also reported longer waits and more healthcare consultations before diagnosis. The most commonly reported time to diagnosis was one to two years for women, compared with less than three months for men.

Those are the most frequent categories, rather than average waiting times.

The study relied on patients’ accounts. It documents a troubling pattern, but it can’t explain why an individual doctor made a particular decision.

Lead researcher Dr. Melanie Sloan put the concern plainly: “psychological or mental health explanations can be given too soon.”

For anyone still waiting for answers, that possibility deserves attention.

Why Hashimoto’s can complicate the picture

Hashimoto’s develops when the immune system attacks the thyroid, the small gland in your neck that helps regulate how your body uses energy.

Over time, it can leave the thyroid unable to produce enough hormone.

According to the National Institute of Diabetes and Digestive and Kidney Diseases, Hashimoto’s is four to 10 times more common in women than men and often develops in women ages 30 to 50.

When it causes an underactive thyroid, symptoms can include fatigue, weight gain, constipation, feeling unusually cold, and muscle or joint pain. Depression can also occur.

That combination matters. When emotional symptoms and physical changes appear together, both deserve attention.

There’s another important distinction: testing thyroid function and checking for thyroid autoimmunity answer different questions.

TSH and free T4 help show how the thyroid is functioning. Thyroid antibodies, particularly thyroid peroxidase antibodies, can help identify Hashimoto’s.

The American Thyroid Association explains that people can have Hashimoto’s with normal thyroid hormone levels. In that case, you may not need thyroid hormone medication, but your thyroid function should be monitored.

Normal hormone results are useful information, but they don’t diminish or negate your symptoms.

What to ask when symptoms remain unexplained

You shouldn’t have to become your own doctor to get help. But preparing for an appointment can make the conversation more productive.

Bring a timeline. Write down when symptoms began, whether they are worsening, and what has changed. Include physical symptoms alongside changes in mood, sleep or concentration.

Explain how symptoms affect daily life. “I’m tired” is a starting point. “I’m too exhausted to finish grocery shopping” gives your doctor a clearer picture.

Ask what has been considered. Try: “What physical conditions could explain this combination of symptoms, and what makes them more or less likely?”

Clarify what your tests checked. If thyroid concerns fit your symptoms or family history, ask whether testing evaluated thyroid function and whether antibody testing would be appropriate. Not everyone needs every test.

Leave with a follow-up plan. Ask when to return, what changes warrant earlier reassessment, and whether a specialist or second opinion would help if symptoms persist.

Consider your diet. Your physician may not offer diet information because it isn’t a major part of medical school training. But avoiding certain foods and focusing on foods that support thyroid health can be beneficial.

Depression and anxiety deserve proper treatment. They can also coexist with a physical illness. Getting help for one should leave room to investigate the other.

I’ve shared my experience because I know how discouraging it can be to feel unwell and still leave without an explanation that fits.

This research gives women another reason to speak up when symptoms persist.

You deserve a doctor who listens, considers the whole picture and keeps looking when the first answer doesn’t explain what’s happening.

Sources:

• Sex and disease differences in patients’ diagnostic experiences in autoimmune diseases: an international cross-sectional study — eClinicalMedicine
• Females with autoimmune diseases ‘less likely to be believed’ than males and face longer diagnostic delays — University of Cambridge
• Hashimoto’s Disease — National Institute of Diabetes and Digestive and Kidney Diseases
• Hashimoto’s Thyroiditis — American Thyroid Association

FAQ: Autoimmune Diseases and Women: Dismissed and Misdiagnosed