Autoimmune conditions like Hashimoto’s ‘more likely to be dismissed if you’re a woman’

Autoimmune conditions like Hashimoto’s ‘more likely to be dismissed if you’re a woman’ Autoimmune conditions like Hashimoto’s and Graves’ disease now affect one in ten Brits but study suggests GPs are missing them as women wait years for a diagnosis Autoimmune conditions that cause symptoms such as tiredness, low mood and brain fog are being dismissed as psychological, a study shows. Conditions where the body’s immune system malfunctions and attacks healthy tissue are on the rise but experts say they often take “months or years” to be correctly diagnosed by GPs. The Cambridge University study of 6,600 people, published in the Lancet, showed women in particular are more likely to have their symptoms blamed on stress or anxiety. Common conditions being missed include an underactive thyroid, known as Hashimoto’s, an overactive thyroid, called Graves’ disease, lupus and arthritis. They are more common in women and can be hard to diagnose as they often come with common symptoms such as fatigue, bloating, weight gain, muscle pain and rashes. Anxiety and depression are also known symptoms linked to some autoimmune conditions. Dr Melanie Sloan, primary care specialist at Cambridge, said “psychological or mental health explanations can be given too soon", adding: "This is true for both sexes, but our study suggests that females may be particularly vulnerable to these types of misdiagnoses.” A previous Lancet study showed autoimmune conditions are increasing but scientists do not fully understand why. The analysis of 22 million health records show one in ten Brits now have one, 13% of women and 7% of men. Junk food diets and a lack of unprocessed foods like fruit and vegetables diets can cause an imbalance in gut bacteria that influence how the immune system works. The new study, working with the University of East Anglia (UEA), found that 43% of females reported being told their condition was down to a psychiatric cause compared with a third of men. Some 34% of women also reported having symptoms misdiagnosed as psychosomatic - meaning they are triggered by stress or anxiety - compared with 22% of men. Most of the study participants were women and a quarter had autoimmune conditions which affect the thyroid. The butterfly-shaped gland at the front of the neck makes hormones to control your body's metabolism, energy, growth and organ function Hashimoto’s is where the thyroid gland becomes underactive and does not release enough of essential hormones and Graves’ disease sees the gland become overactive and produce too much. Sarah Brookes, certified nutritional therapist and thyroid specialist, commented: “Thyroid symptoms can sometimes appear to be just signs of aging or a result of our modern stressful lifestyles so can be easily dismissed. Symptoms sometimes have to be quite debilitating to prompt investigation and can often be misdiagnosed as chronic fatigue, fibromyalgia and irritable bowel syndrome (IBS).” One in seven women in the study had systemic lupus, which can cause tiredness, rashes and muscle pain. Among the male patients, rheumatoid arthritis, vasculitis and antiphospholipid syndrome - also known as "sticky blood" syndrome - were the most common. Professor David D'Cruz, consultant rheumatologist at Guy's Hospital in London, said: "This is not about saying that a psychiatric diagnosis is never correct. People can have both autoimmune and psychiatric conditions, and it is increasingly understood that psychiatric symptoms can be part of an autoimmune disease, especially in diseases like lupus which can directly affect the brain. "They can also be a very natural response to living with life-changing illnesses. The important message is that when symptoms persist, evolve or involve multiple systems, clinicians must be open minded and consider whether there is an underlying autoimmune disease that has not yet been recognised - and to listen to patients." The study said “historical biases in medicine may persist” including stereotyping females as more “emotional” than males. Reports of being misdiagnosed with a different physical disease was slightly higher among men. Shaista Tayabali, study co-author and patient partner, said: "The differences between the sexes in misdiagnoses for people with autoimmune diseases is stark. The fact that females reported higher rates of psychiatric and psychosomatic misdiagnoses than males, yet reported lower misdiagnoses for other physical diseases, suggests that historical gender biases remain a challenging aspect of the diagnostic journey. "Although labels such as hysteria are outdated, and fortunately rarely used nowadays, as women we still often have a harder time having our symptoms believed and therefore addressed accurately." The findings are published in The Lancet eClinicalMedicine.