How does hypothyroidism affect work? Working with hypothyroidism derails careers, stagnates wages, and pushes people toward disability. Can thyroid problems stop you from working?
Absolutely, data, alongside countless patient stories, paints a grim picture. It’s a pervasive but often overlooked public health failure.
Let’s pull back the curtain and explore the significant impact that hypothyroidism can have on your work life and overall quality of life.
How Does Hypothyroidism Affect Work? The Statistical Reality
European researchers have been leading the way in quantifying the hypothyroidism crisis and its impact on employees, employers, and social services. One review linked hypothyroidism with significantly increased rates of sick leave, reduced productivity, and higher rates of work disability applications. Another concluded that workers with thyroid dysfunction, particularly hypothyroidism, had substantially higher rates of absence due to sickness compared to their healthy colleagues.
Hypothyroidism’s impact on work performance goes beyond missing days. It also leads to presenteeism, where workers show up at their job site while only performing at a small fraction of their full capacity, thanks to symptoms like brain fog, crippling fatigue, and musculoskeletal pain. This can lead to wages lost due to poor work performance and stunted career growth.
A study focused on the economic burden of hypothyroidism revealed that indirect costs, like productivity losses, far outweigh the direct medical costs.
Anecdotally, many U.S. public health officials I’ve spoken with are shocked to learn that over 10% of the U.S. population will develop a thyroid condition at some point in their lives. Most didn’t grasp the cascading tsunami it causes such as housing instability due to income loss and a significantly reduced quality of life. The typical response I received was a baffling combination of ignorance and ego. They essentially say, “I’ve never heard of this, so prove it to me for free.” The burden of education should not fall on exhausted patients.
The Symptoms That Steal Your Paycheck
Let’s examine how some of the symptoms of hypothyroidism hinder your performance at work:
- Crushing fatigue and slow processing speed (“brain fog”): Overwhelming fatigue combined with brain fog can make the simplest tasks feel insurmountable. A report that would normally take 20 minutes to type now takes you a few hours. In a world where commissions and bonuses are often tied to productivity, it’s only a matter of time before your reduced production has a significant financial impact.
- Depression, anxiety, and mood swings: Working with these mental health challenges can lead to being mislabeled as a “poor team player,” “unreliable,” or “unenergetic.” This limits your ability to rise through the ranks.
- Muscle weakness, pain, and stiffness: These symptoms can make physically demanding jobs feel like torture.
- Cold intolerance and weight gain: Low tolerance to cold temperatures can become a constant distraction at work and lead to unsolicited comments about your appearance as you bundle up.
The symptoms of hypothyroidism have a cascading effect on your work performance. As you can note, some of the above-mentioned issues are due to subtle discrimination in the workplace that can affect morale.
Unfortunately, many situations can be a death of a thousand cuts with very little hard proof to be gathered that your workplace has become hostile due to your health condition. In a perfect world, coworkers and managers would be more understanding that workers have energy lows and highs, especially when managing health issues, but as many people find, any personal issue that makes them stand out can make them a target in the U.S. workplace, even if their performance is excellent.
With thyroid conditions, each symptom often amplifies the others, and you end up using all your energy just to appear functional, with little else left for work, family, or fun.
The U.S. Public Health Failure and the “Awareness Gap”
Frankly, the lack of awareness regarding the prevalence of thyroid conditions and their impact on productivity in the U.S. is a public health failure. Our awareness campaigns are frequently met with sorrowful messages from patients whose lives or children’s lives (maternal hypothyroidism is linked to congenital issues) were negatively impacted because of a lack of public health programs and messaging on thyroid health and iodine intake, specifically as a basic element.
The impact of public health programs on the thyroid and nutrition is evident in many South American countries when you talk to citizens of those countries as well as in many European countries. Everyone, from the average person to the physician, has often learned in public school systems that iodine is an essential mineral necessary for thyroid function.
This end result points to just how effective public health programs have been in spreading a message, even if that message needs to be fleshed out to be accurate. When I speak with South American physicians, they often recognize that they never learned and need to learn more about more-than-adequate or excess iodine consumption and the U-curve of benefit for iodine intake as the other part of the picture on thyroid health.
In comparison, the U.S. public school system and other public health programs fail to educate the public about iodine’s impacts the thyroid. In fact, my own endocrinologist and other U.S. endocrinologists I have talked to were not aware that iodine impacts the thyroid in any way, nor that diet could impact symptoms.
Yet we keep hitting a wall of willful neglect when we sound the alarm. Some dietitians laughably blame social media fads for rising hypothyroidism rates (an objective diagnosis). Using TikTok more and then asking to have your blood tested for thyroid hormones does not magically raise TSH levels and lower free T4 levels by social contagion. Other dietitians privately tell us thyroid disorders and working with patients on iodine intake are beyond their expertise. This is malpractice by omission.
Thyroid hormone tests are cheap and minimally invasive with a simple blood draw and cash prices for basic panels (TSH + T4/T3) usually running about $40 to $60 at labs like Quest Diagnostics or LabCorp. Root causes sometimes linked to nutritional deficiency or excess, such as consuming too little or too much iodine, would be easier to address with increased clinical competence.
We have a system that would rather see a patient slide into disability before ordering a full thyroid panel and interpreting it correctly. The reality is that even after that slide into disability and perhaps finally with a diagnosis, the patient will likely remain there, poorly managed. The opportunity cost in human potential and productivity is astronomical.
Fighting for Your Career and Your Health
Ways to prevent hypothyroidism from negatively impacting your career include:
- Become your own expert: Document every symptom you experience and its impact at work.
- Demand comprehensive testing: Don’t settle for just a TSH panel. Request full thyroid panels that include measuring free T3, free T4, and thyroid antibodies (TPO, TgAb) to screen for autoimmune thyroid issues like Hashimoto’s as well. If you need to keep costs low, do make sure at minimum to have a Free T4 test alongside a TSH test, as the two hormones work in tandem, and a TSH test alone is like someone sending you a picture zoomed in on only one seat on a see-saw, suspended up high. Without knowing who is sitting in the other seat, you have no idea if this was an issue of a large weight difference, a jammed fulcrum, or perhaps another issue at play.
- Complete the necessary paperwork: Understand how the process of filing for disability works if hypothyroidism’s impact on your work performance is severe. Diagnosis and documentation are key.
- Connect and advocate: Find patient communities you can share experiences with. You’ll learn more about navigating work while dealing with hypothyroidism and healthcare there than you would from a typical rushed doctor’s appointment. This bottom-up pressure is how we force change.
The data from European researchers shows the economic impact of hypothyroidism is tremendous. Your lived experience proves the human cost is real. It’s time the U.S. medical and public health systems caught up with reality.
Stop Letting Thyroid Problems Dictate Your Future
We’ve created resources to help you cut through the confusion as you navigate your work environment while battling hypothyroidism, so you can protect your health and career.
Our course, "Are You Consuming Too Much Iodine? Excess Intake & Thyroid Disorders," breaks down exactly how to communicate with your doctor, understand your lab test results, and navigate workplace accommodations. Sign up for our newsletter for updates as new resources are published.
