Why are women who suffer extreme sickness in pregnancy told it’s all in their heads?

[helvella]

An interesting article by a doctor who has also suffered.

Why are women who suffer extreme sickness in pregnancy told it’s all in their heads?

theguardian.com/lifeandstyl...

Triggered by the identification of GDF15 in that, I looked it up in relation to thyroid and found the paper below. Knowing that hyperthyroidism has been associated with hyperemesis gravidarum, the possibility of GFD15 being the causative factor could be why.

It also makes this post on-topic!

Elevated Serum Growth Differentiation Factor 15 Levels in Hyperthyroid Patients

Jiejie Zhao1†, Min Li1†, Ying Chen1, Shengjie Zhang2, Hao Ying2, Zhiyi Song3, Yan Lu1, Xiaoying Li1, Xuelian Xiong1* and Jingjing Jiang1*

1Department of Endocrinology and Metabolism, Fudan Institute of Metabolic Diseases, Zhongshan Hospital, Fudan University, Shanghai, China

2CAS Key Laboratory of Nutrition, Metabolism and Food Safety, Shanghai Institutes for Biological Sciences, University of Chinese Academy of Sciences, Chinese Academy of Sciences, Shanghai, China

3Department of Endocrinology and Metabolism, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China

Background: Recent studies have shown that growth differentiation factor 15 (GDF15), a member of the transforming growth factor-β (TGF-β)/bone morphogenetic protein (BMP) superfamily, plays an important role in appetite, type 2 diabetes, and cardiovascular diseases. Since thyroid hormone has pleiotropic effects on whole-body energy metabolism, we aimed to explore the effect of thyroid hormone on circulating GDF15 levels in humans and GDF15 genes expression in C57BL/6 mice.

Methods: A total of 134 hyperthyroid patients and 105 healthy subjects were recruited. Of them, 43 hyperthyroid patients received thionamide treatment for 3 months until euthyroidism. Serum GDF15 levels were determined using the enzyme-linked immunosorbent assay (ELISA) method. To determine the source for the increased circulating GDF15, C57BL/6 mice were treated with T3, and GDF15 gene expressions in the liver, skeletal muscle, brown adipose tissue (BAT), inguinal white adipose tissue (iWAT), epididymal white adipose tissue (eWAT) were analyzed by quantitative real-time polymerase chain reaction (PCR).

Results: Serum GDF15 levels were significantly elevated in hyperthyroid patients as compared with healthy subjects (326.06 ± 124.13 vs. 169.24 ± 82.96 pg/mL; P < 0.001). After thionamide treatment, GDF15 levels in hyperthyroid patients declined markedly from 293.27 ± 119.49 to 118.10 ± 71.83 pg/mL (P < 0.001). After adjustment for potential confounders, serum GDF15 levels were independently associated with hyperthyroidism. T3 treatment increased GDF15 expression in the brown adipose tissue of C57BL/6 mice.

Conclusions: Serum GDF15 levels were elevated in patients with hyperthyroidism and declined after thionamide treatment. Thyroid hormone treatment upregulated GDF15 expression in mice. Therefore, our results present the clinical relevance of GDF15 in humans under the condition of hyperthyroidism.

frontiersin.org/articles/10...

[JGBH]

I suspect because it has been a misogynist tradition to make women feel inferior and consequently insecure therefore more easy to control. Way back doctors were men so that explains it. Even though now there are many doctors who are women the stigma is still prevalent because of the habit of a lifetime in medical circles. By the way, it’s not just in pregnancy that women are told ‘’it’s all in their heads’…

The majority of doctors still think they know it all…. when, as we only know too well, they clearly don’t. No insult to you as a man, btw.

[LindaC in reply to JGBH]

Sadly, I've long recognized that female GPs - older ones [yet not always] who've likely has a hard time - often seem to mimic those who domineered them. No excuse but it's kind of an explanation for them!

In respect of endocrinology, I don't just question their lack of knowledge but the 'sanity' of some... where the actual evidence - patient sitting before them - is clearly ILL. Anathema! xox

[helvella Administrator in reply to LindaC]

Not an uncommon observation.

[LindaC in reply to helvella]

😅 Fortunately it isn't; they'd have had me locked up by now were it not so common! 🐍👽😂

[BeePurple in reply to JGBH]

So very true. Anything to do with women's health is generally ignored. It hurts most when it's a woman treating you this way. They let the sisterhood down. At least we are no longer being locked in asylums because of our health issues. Oh wait, some people are still being sectioned because thyroid conditions mimic serious mental health issues. Makes you furious.

[JGBH in reply to BeePurple]

Indeed!

[LindaC]

Yup, I was as sick as that proverbial dog - 'poisoned pup' - from only six months on; horrific heartburn, vomiting and could barely keep anything down. Then, post-birth, dreadful vertigo... which came and went for decades until 2016.

Those odd few who 'make things up for attention!?' really need to be stood alongside those medics who can't 'tell sh*t from clay' to see just how skewed the preponderance is. 😅

[tattybogle in reply to LindaC]

Fortunately i never found out what vomiting from 6 mths onwards felt like... so mine doesn't count as 'hyperemisis gravida' but i remember what 9 solid months of 24hr a day nausea felt like .... i really never want to go there again.

If i was going to make something up for attention i'd have come up with something better than that.... seem to remember nobody gave a S**T...

[LindaC in reply to tattybogle]

WoW! I did great for first 6 months, then hell - oh how dreadful for you.

No, they simply don't get that people have many individual differences within and between one another AND their own selves. No, seems many of them don't. xox

[tattybogle in reply to LindaC]

actually to be fair, i exaggerated .. i did actually feel great for a whole two weeks before the birth. and a whole 3 weeks after. lol

[LindaC in reply to tattybogle]

My goodness, what a time you had of it! Then doctors re thyroid! xox

[Beads in reply to LindaC]

I was the opposite, felt lousy up until 6 months.

I’d have swung for the doc who said it was all in my head as I was leaning over the sink bringing up absolutely nothing as there was nothing to bring up. Thankfully at that time I had a very nice, middle aged(???) lady doc.

And if it’s all in our head and we’re over reacting females, why was it a man at work that took one look at me one morning and told me I looked green? 🤢

[LindaC in reply to Beads]

Exactly - individuals react differently to others!!! Too many misogynist - incl. females - around, relying on old models of 'patient blaming' because they don't know or even care to know their job!

[nightingale-56 in reply to tattybogle]

I suffered much the same as you for 9 solid months until my daughter was born, and at the same time could not face a cup of tea. I don't particularly like cold drinks so had warm Lemon Barley Water, which was supposed to be good for nausea.

[BB001]

I'm wondering whether this also applies to people who have Graves hypothyroidism?

[Gcart]

Slightly different experience . Been anaemic or very low in range iron all my life. No treatment ever did much to improve . After my first child was born bottom first I had a massive blood loss . Needed about 6 pints of blood transfused to save me .

I felt like super women for about 6 or so months as a result of that .

So when told low iron ‘ normal for you’ I remember how that had made me feel so so well .

I believe some people/bodies just don’t work equally well .

[Hidden]

Does that include the Duchess of Cambridge😊?

[Jazzw in reply to Hidden]

I was just thinking about her too!

[helvella Administrator in reply to Jazzw]

I think it is possible.

A lot of hyperthyroid people have years of simply being full of energy, thin, etc. As no-one checks their thyroid hormone levels regularly, they could be simply towards the high end until, one day, something pushes them further.

[Noelnoel in reply to Hidden]

I was just thinking the same thing. Seem to remember she was hospitalised for extreme sickness and when you take into consideration how very thin she is, then she would fit the profile for being hyper - amongst many other conditions I suppose - but how interesting to speculate whether she could be one of us and as yet undiagnosed

I’d be so interested to know whether even the queen’s physicians have checked and understand her TFTs

[Hidden in reply to Noelnoel]

What fascinates me is that it is often said that she ‘won the generic lottery’, that she lost the baby weight in no time and that she stays thin by running after her kids. I think she is far too thin (not jealous). If you look at pre-wedding pictures, she has a more healthy weight. In some pictures, I think she looks skeletal.

[Noelnoel in reply to Hidden]

She got extremely thin whilst pregnant so there was no baby weight to lose!

[tattybogle in reply to Hidden]

Some of us just don't put 'extra' weight on when pregnant ( apart from the obvious 'baby' component) After each kid i ended up thinner then before..... with smaller boobs .. i think if i'd had a third one i'd have ended up looking like a skeleton too .

[Noelnoel in reply to Hidden]

Have now noticed this post is three weeks old!

[helvella Administrator in reply to Noelnoel]

It really doesn't matter!

It will bring it to the attention of more members who see it in the News Feed.

[Capella1]

I was v sick and its real.

[j9j8j7]

For me the frustrating thing was that a lot of thyroid symptoms are also "normal" in pregnancy so even though I had been on levothyroxine for 6+ years and had a pretty good idea of what it felt like when my dose was too low/high as soon as I was pregnant they just completely dismissed all symptoms as "normal in pregnancy".