Emily Measures couldn’t remember a time when she didn’t feel cold.

No matter the temperature, or how bundled up she was, her hands and feet were always chilly – so much so, that it even became a family joke.

There were other things too. Her nails would break constantly and were always brittle.

And though her hair was thick and healthy, her eyebrows seemed to barely grow.

‘At the time, I just put those things down to cold weather or low iron levels,’ says the Bristol-based civil servant.

Now, Emily knows these seemingly unrelated symptoms were a sign of something much more sinister.

But it wasn’t until her period suddenly stopped – for five months – that she went to her GP.

‘I had previously had a very regular period, so after four or five months of not getting it, I knew something was wrong,’ says Emily.

Emily Measures couldn’t remember a time when she didn’t feel cold – it even became a family joke

But it wasn’t until her period suddenly stopped – for five months – that she went to her GP

‘I was also having really extreme fatigue and brain fog – I felt like my head was full of cotton wool.

‘I went to see my doctor, and was sent for a blood test, which is how I was finally diagnosed.’

At the age of 31, she received a letter informing her that she had Hashimoto’s disease, a thyroid disorder she was unfamiliar with, which meant she would have to take medication for the rest of her life.

‘I remember reading it in the queue to pick up my medication and feeling so emotional,’ she explaines.

‘I was surrounded by people so I had to hold it in. But I didn’t understand what any of it meant.’

Emily’s condition, also known as hypothyroidism, is not uncommon – experienced by millions of people in the UK, or around two in every 100 adults.

Hashimoto’s disease is an autoimmune disorder where certain immune cells mistakenly attack the thyroid gland, the organ responsible for producing hormones that regulate metabolism, growth, and development.

As a result, the thyroid can slow down or shut off entirely, leaving the body unable to regulate its metabolism.

It was via a letter that Emily was told she had Hashimoto’s disease – a thyroid disorder she had never even heard of

‘I remember reading it in the queue to pick up my medication and feeling so emotional,’ she explains

Common symptoms of the disease include fatigue, weight gain, dry skin, hair loss, muscle weakness, and feeling cold. Additional, less common symptoms may include brittle nails, constipation, a slow heartbeat, hoarse voice, and even breast milk production.

The specific cause of Hashimoto’s is not known, but it often runs in families. Experts suggest that environmental factors such as infections, medications, and hormonal changes may also trigger the condition.

If left untreated, the condition can become life-threatening, causing heart problems and high cholesterol.

But luckily, says consultant endocrinologist Professor Ashley Grossman, once caught, hypothyroidism is easily dealt with.

‘The typical treatment involves taking a daily tablet of thyroxine—also known as T4, the primary hormone produced by the thyroid gland in the neck—on an empty stomach in the morning,’ he explains.

‘For a small number of patients, this treatment might not be sufficient. Some studies have suggested that taking another hormone produced by the thyroid—T3—can benefit these patients.

‘But while patients can buy it privately, it’s incredibly expensive, and many GPs don’t feel happy to prescribe it on the NHS.’

The trouble, says Dr Simon Pearce, professor of endocrinology at Newcastle University, is catching it.

At least one in 20 patients in the UK has some kind of disorder of the thyroid, a butterfly-shaped gland that sits just in front of the voice box

‘Once you or your doctor consider hypothyroidism, then a simple blood test to measure thyroid stimulating hormone (TSH) is enough to make the diagnosis in most cases,’ he explains.

‘The problem is that the symptoms are very non-specific and they creep up on you gradually over many months or years.

‘This means that a lot of people may put down the symptoms of tiredness, constipation or aching to normal life factors such as busy life, overwork, exhausting childcare, insufficient night-time sleep, poor diet etc. So the diagnosis can be delayed or missed.’

The condition is up to ten times more common in women – and cases are on the rise, nearly doubling over the past two decades.

Yet cases are still going undiagnosed, say charities.

A 2019 study by researchers in Portugal estimated that as much as 4.7 per cent of Europe’s population could be living with undiagnosed hypothyroidism.

And a stunning 60 per cent of people with thyroid conditions go undiagnosed, according to the American Thyroid Association.

This can be particularly concerning for women who are trying to conceive or are pregnant, says Prof Grossman.

Research shows that women with thyroid issues have a significantly increased risk of miscarriage, with one study from researchers at the University of Birmingham finding that thyroid antibodies – such as those causing Hashimoto’s – can as much as triple the risk of miscarriage.

The condition can also make it much harder for women to get pregnant in the first place by disrupting ovulation and affecting sex hormones.

‘The one time it’s really important to get your thyroid hormones in check is if you’re thinking about getting pregnant, or are pregnant,’ says Prof Grossman.

‘The first 12 weeks of pregnancy are really important for a baby’s development. And studies have shown that pregnancies don’t go as well if a mother has an elevated TSH.’

Luckily for Emily, she became pregnant relatively easily less than two years after starting medication for the condition.

Her hair loss and brittle nails, as well as her tendency to run cold, have also been resolved since her diagnosis.

Since giving birth to her daughter, however, she says she’s not quite got the correct dose figured out again.

‘It can change depending on what’s happening in your life, and my last dose was specified down to a half-milligram,’ she explains.

‘It’s taken a lot of exploration and research.’