Do We All Have Thyroid Disorders?

Gillian Goddard

3 min Read Gillian Goddard

Gillian Goddard

Do We All Have Thyroid Disorders?

Q&A on diagnosis

Gillian Goddard

3 min Read

Why does it seem like every mom I know suffers from some form of thyroid disorder (many undiagnosed and just “tired and have mom brain” all the time!)?

—Rachel

In my world, it can indeed seem like everyone has a thyroid issue, so I can see how it would seem that way to you as well! As an endocrinologist, I, of course, see a select sample of the population. Many patients are coming to me for my expertise in thyroid disease. However, I think you are really asking two different questions. First, how common is thyroid disease? And second, is thyroid disease a more pervasive problem than we know because it is being underdiagnosed?  

Let’s address these questions in order. The most common type of thyroid problem is hypothyroidism, or an underactive thyroid. Symptoms of hypothyroidism include fatigue, unexplained weight gain, constipation, brain fog, and heavier, more closely spaced periods. Hypothyroidism is common. The National Institutes of Health estimates that about 5% of Americans over age 12 have hypothyroidism. Women are 5 to 8 times as likely as men to have hypothyroidism.  

Additionally, women are often tested for hypothyroidism, especially while trying to conceive, while pregnant, and in the immediate postpartum period, because these are common times for hypothyroidism to develop. Our guidelines for when to treat hypothyroidism are more strict and specific in pregnant women. All this means that young moms are among the most likely to be diagnosed with hypothyroidism.

The second question is harder. A meta-analysis of thyroid disease in Europe reports that an additional 5% of people may have undiagnosed hypothyroidism. And it is true that young mothers often report symptoms of fatigue and brain fog. Further complicating matters, symptoms like fatigue and brain fog can be due to hypothyroidism but can also be caused by inadequate sleep, or deficiencies in iron or vitamin B12, all of which are common in moms of young children. 

Add to that, the guidelines physicians use to determine when to treat someone recommend not treating most women with “subclinical” hypothyroidism (the name we give when some tests suggest hypothyroidism and others do not). Understanding guidelines and then applying them to a specific patient is complex (a conversation for another day), and there are many pressures on physicians to follow them to the letter. This may mean that fewer patients are treated for their hypothyroidism than would benefit from treatment.

What is the takeaway here? Yes, hypothyroidism is quite common, and women in their childbearing years are especially likely to be diagnosed with new hypothyroidism. There are certainly some women with hypothyroidism who are not diagnosed and some women with “subclinical” hypothyroidism who are not treated who may benefit from treatment. There are also other problems common in moms, like iron deficiency, B12 deficiency, and sleep deprivation that cause similar symptoms.

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Gillian Goddard

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My new book, “The Unexpected: Navigating Pregnancy During and After Complications” is available for preorder at the link in my bio!

I co-wrote #TheUnexpected with my friend and maternal fetal medicine specialist, Dr. Nathan Fox. The unfortunate reality is that about half of pregnancies include complications such as preeclampsia, miscarriage, preterm birth, and postpartum depression. Because these are things not talked about enough, it can not only be an isolating experience, but it can also make treatment harder to access.

The book lays out the data on recurrence and delves into treatment options shown to lower risk for these conditions in subsequent pregnancies. It also guides you through how to have productive conversations and make shared decisions with your doctor. I hope none of you need this book, but if you do, it’ll be here for you 💛

#pregnancy #pregnancycomplications #pregnancyjourney #preeclampsiaawareness #postpartumjourney #emilyoster

My new book, “The Unexpected: Navigating Pregnancy During and After Complications” is available for preorder at the link in my bio!

I co-wrote #TheUnexpected with my friend and maternal fetal medicine specialist, Dr. Nathan Fox. The unfortunate reality is that about half of pregnancies include complications such as preeclampsia, miscarriage, preterm birth, and postpartum depression. Because these are things not talked about enough, it can not only be an isolating experience, but it can also make treatment harder to access.

The book lays out the data on recurrence and delves into treatment options shown to lower risk for these conditions in subsequent pregnancies. It also guides you through how to have productive conversations and make shared decisions with your doctor. I hope none of you need this book, but if you do, it’ll be here for you 💛

#pregnancy #pregnancycomplications #pregnancyjourney #preeclampsiaawareness #postpartumjourney #emilyoster
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We are better writers than influencers, I promise. Thanks to our kids for filming our unboxing videos. People make this look way too easy. 

Only two weeks until our book “The Unexpected” is here! Preorder at the link in my bio. 💙

We are better writers than influencers, I promise. Thanks to our kids for filming our unboxing videos. People make this look way too easy.

Only two weeks until our book “The Unexpected” is here! Preorder at the link in my bio. 💙
...

Exciting news! We have new, high-quality data that says it’s safe to take Tylenol during pregnancy and there is no link between Tylenol exposure and neurodevelopmental issues in kids. Comment “Link” for a DM to an article exploring this groundbreaking study.

While doctors have long said Tylenol was safe, confusing studies, panic headlines, and even a lawsuit have continually stoked fears in parents. As a result, many pregnant women have chosen not to take it, even if it would help them.

This is why good data is so important! When we can trust the data, we can trust our choices. And this study shows there is no blame to be placed on pregnant women here. So if you have a migraine or fever, please take your Tylenol.

#tylenol #pregnancy #pregnancyhealth #pregnancytips #parentdata #emilyoster

Exciting news! We have new, high-quality data that says it’s safe to take Tylenol during pregnancy and there is no link between Tylenol exposure and neurodevelopmental issues in kids. Comment “Link” for a DM to an article exploring this groundbreaking study.

While doctors have long said Tylenol was safe, confusing studies, panic headlines, and even a lawsuit have continually stoked fears in parents. As a result, many pregnant women have chosen not to take it, even if it would help them.

This is why good data is so important! When we can trust the data, we can trust our choices. And this study shows there is no blame to be placed on pregnant women here. So if you have a migraine or fever, please take your Tylenol.

#tylenol #pregnancy #pregnancyhealth #pregnancytips #parentdata #emilyoster
...

How many words should kids say — and when? Comment “Link” for a DM to an article about language development!

For this graph, researchers used a standardized measure of vocabulary size. Parents were given a survey and checked off all the words and sentences they have heard their child say.

They found that the average child—the 50th percentile line—at 24 months has about 300 words. A child at the 10th percentile—near the bottom of the distribution—has only about 50 words. On the other end, a child at the 90th percentile has close to 600 words. One main takeaway from these graphs is the explosion of language after fourteen or sixteen months. 

What’s valuable about this data is it can give us something beyond a general guideline about when to consider early intervention, and also provide reassurance that there is a significant range in this distribution at all young ages. 

#cribsheet #emilyoster #parentdata #languagedevelopment #firstwords

How many words should kids say — and when? Comment “Link” for a DM to an article about language development!

For this graph, researchers used a standardized measure of vocabulary size. Parents were given a survey and checked off all the words and sentences they have heard their child say.

They found that the average child—the 50th percentile line—at 24 months has about 300 words. A child at the 10th percentile—near the bottom of the distribution—has only about 50 words. On the other end, a child at the 90th percentile has close to 600 words. One main takeaway from these graphs is the explosion of language after fourteen or sixteen months.

What’s valuable about this data is it can give us something beyond a general guideline about when to consider early intervention, and also provide reassurance that there is a significant range in this distribution at all young ages.

#cribsheet #emilyoster #parentdata #languagedevelopment #firstwords
...

I saw this and literally laughed out loud 😂 Thank you @adamgrant for sharing this gem! Someone let me know who originally created this masterpiece so I can give them the proper credit.

I saw this and literally laughed out loud 😂 Thank you @adamgrant for sharing this gem! Someone let me know who originally created this masterpiece so I can give them the proper credit. ...

Perimenopause comes with a whole host of symptoms, like brain fog, low sex drive, poor energy, and loss of muscle mass. These symptoms can be extremely bothersome and hard to treat. Could testosterone help? Comment “Link” for a DM to an article about the data on testosterone treatment for women in perimenopause.

#perimenopause #perimenopausehealth #womenshealth #hormoneimbalance #emilyoster #parentdata

Perimenopause comes with a whole host of symptoms, like brain fog, low sex drive, poor energy, and loss of muscle mass. These symptoms can be extremely bothersome and hard to treat. Could testosterone help? Comment “Link” for a DM to an article about the data on testosterone treatment for women in perimenopause.

#perimenopause #perimenopausehealth #womenshealth #hormoneimbalance #emilyoster #parentdata
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What age is best to start swim lessons? Comment “Link” for a DM to an article about water safety for children 💦

Summer is quickly approaching! You might be wondering if it’s the right time to have your kid start swim lessons. The AAP recommends starting between 1 and 4 years old. This is largely based on a randomized trial where young children were put into 8 or 12 weeks of swim lessons. They found that swimming ability and water safety reactions improve in both groups, and more so in the 12 weeks group.

Below this age range though, they are too young to actually learn how to swim. It’s fine to bring your baby into the pool (if you’re holding them) and they might like the water. But starting formal safety-oriented swim lessons before this age isn’t likely to be very helpful.

Most importantly, no matter how old your kid is or how good of a swimmer they are, adult supervision is always necessary!

#swimlessons #watersafety #kidsswimminglessons #poolsafety #emilyoster #parentdata

What age is best to start swim lessons? Comment “Link” for a DM to an article about water safety for children 💦

Summer is quickly approaching! You might be wondering if it’s the right time to have your kid start swim lessons. The AAP recommends starting between 1 and 4 years old. This is largely based on a randomized trial where young children were put into 8 or 12 weeks of swim lessons. They found that swimming ability and water safety reactions improve in both groups, and more so in the 12 weeks group.

Below this age range though, they are too young to actually learn how to swim. It’s fine to bring your baby into the pool (if you’re holding them) and they might like the water. But starting formal safety-oriented swim lessons before this age isn’t likely to be very helpful.

Most importantly, no matter how old your kid is or how good of a swimmer they are, adult supervision is always necessary!

#swimlessons #watersafety #kidsswimminglessons #poolsafety #emilyoster #parentdata
...

Can babies have salt? 🧂 While babies don’t need extra salt beyond what’s in breast milk or formula, the risks of salt toxicity from normal foods are minimal. There are concerns about higher blood pressure in the long term due to a higher salt diet in the first year, but the data on these is not super compelling and the differences are small.

Like with most things, moderation is key! Avoid very salty chips or olives or saltines with your infant. But if you’re doing baby-led weaning, it’s okay for them to share your lightly salted meals. Your baby does not need their own, unsalted, chicken if you’re making yourself a roast. Just skip the super salty stuff.

 #emilyoster #parentdata #childnutrition #babynutrition #foodforkids

Can babies have salt? 🧂 While babies don’t need extra salt beyond what’s in breast milk or formula, the risks of salt toxicity from normal foods are minimal. There are concerns about higher blood pressure in the long term due to a higher salt diet in the first year, but the data on these is not super compelling and the differences are small.

Like with most things, moderation is key! Avoid very salty chips or olives or saltines with your infant. But if you’re doing baby-led weaning, it’s okay for them to share your lightly salted meals. Your baby does not need their own, unsalted, chicken if you’re making yourself a roast. Just skip the super salty stuff.

#emilyoster #parentdata #childnutrition #babynutrition #foodforkids
...

Is sleep training bad? Comment “Link” for a DM to an article breaking down the data on sleep training 😴

Among parenting topics, sleep training is one of the most divisive. Ultimately, it’s important to know that studies looking at the short- and long-term effects of sleep training show no evidence of harm. The data actually shows it can improve infant sleep and lower parental depression.

Even so, while sleep training can be a great option, it will not be for everyone. Just as people can feel judged for sleep training, they can feel judged for not doing it. Engaging in any parenting behavior because it’s what’s expected of you is not a good idea. You have to do what works best for your family! If that’s sleep training, make a plan and implement it. If not, that’s okay too.

What’s your experience with sleep training? Did you feel judged for your decision to do (or not do) it?

#sleeptraining #newparents #babysleep #emilyoster #parentdata

Is sleep training bad? Comment “Link” for a DM to an article breaking down the data on sleep training 😴

Among parenting topics, sleep training is one of the most divisive. Ultimately, it’s important to know that studies looking at the short- and long-term effects of sleep training show no evidence of harm. The data actually shows it can improve infant sleep and lower parental depression.

Even so, while sleep training can be a great option, it will not be for everyone. Just as people can feel judged for sleep training, they can feel judged for not doing it. Engaging in any parenting behavior because it’s what’s expected of you is not a good idea. You have to do what works best for your family! If that’s sleep training, make a plan and implement it. If not, that’s okay too.

What’s your experience with sleep training? Did you feel judged for your decision to do (or not do) it?

#sleeptraining #newparents #babysleep #emilyoster #parentdata
...

Does your kid love to stall right before bedtime? 💤 Tell me more about their tactics in the comments below!

#funnytweets #bedtime #nightimeroutine #parentinghumor #parentingmemes

Does your kid love to stall right before bedtime? 💤 Tell me more about their tactics in the comments below!

#funnytweets #bedtime #nightimeroutine #parentinghumor #parentingmemes
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Got a big decision to make? 🤔 Comment “Link” for a DM to read about my easy mantra for making hard choices. 

When we face a complicated problem in pregnancy or parenting, and don’t like either option A or B, we often wait around for a secret third option to reveal itself. This magical thinking, as appealing as it is, gets in the way. We need a way to remind ourselves that we need to make an active choice, even if it is hard. The mantra I use for this: “There is no secret option C.”

Having this realization, accepting it, reminding ourselves of it, can help us make the hard decisions and accurately weigh the risks and benefits of our choices.

#parentingquotes #decisionmaking #nosecretoptionc #parentingadvice #emilyoster #parentdata

Got a big decision to make? 🤔 Comment “Link” for a DM to read about my easy mantra for making hard choices.

When we face a complicated problem in pregnancy or parenting, and don’t like either option A or B, we often wait around for a secret third option to reveal itself. This magical thinking, as appealing as it is, gets in the way. We need a way to remind ourselves that we need to make an active choice, even if it is hard. The mantra I use for this: “There is no secret option C.”

Having this realization, accepting it, reminding ourselves of it, can help us make the hard decisions and accurately weigh the risks and benefits of our choices.

#parentingquotes #decisionmaking #nosecretoptionc #parentingadvice #emilyoster #parentdata
...

Excuse the language, but I have such strong feelings about this subject! Sometimes, it feels like there’s no winning as a mother. People pressure you to breastfeed and, in the same breath, shame you for doing it in public. Which is it?!

So yes, they’re being completely unreasonable. You should be able to feed your baby in peace. What are some responses you can give to someone who tells you to cover up? Share in the comments below ⬇️

#breastfeeding #breastfeedinginpublic #breastfeedingmom #motherhood #emilyoster

Excuse the language, but I have such strong feelings about this subject! Sometimes, it feels like there’s no winning as a mother. People pressure you to breastfeed and, in the same breath, shame you for doing it in public. Which is it?!

So yes, they’re being completely unreasonable. You should be able to feed your baby in peace. What are some responses you can give to someone who tells you to cover up? Share in the comments below ⬇️

#breastfeeding #breastfeedinginpublic #breastfeedingmom #motherhood #emilyoster
...

Potty training can feel like a Mount Everest-size challenge, and sadly, our evidence-based guidance is poor. So, I created a survey to collate advice and feedback on success from about 6,000 participants.

How long does potty training take? We found that there is a strong basic pattern here: the later you wait to start, the shorter time it takes to potty train. On average, people who start at under 18 months report it takes them about 12 weeks for their child to be fully trained (using the toilet consistently for both peeing and pooping). For those who start between 3 and 3.5, it’s more like nine days. Keep in mind that for all of these age groups, there is a range of length of time from a few days to over a year. Sometimes parents are told that if you do it right, it only takes a few days. While that is true for some people, it is definitely not the norm.

If you’re in the throes of potty training, hang in there! 

#emilyoster #parentdata #pottytraining #pottytrainingtips #toddlerlife

Potty training can feel like a Mount Everest-size challenge, and sadly, our evidence-based guidance is poor. So, I created a survey to collate advice and feedback on success from about 6,000 participants.

How long does potty training take? We found that there is a strong basic pattern here: the later you wait to start, the shorter time it takes to potty train. On average, people who start at under 18 months report it takes them about 12 weeks for their child to be fully trained (using the toilet consistently for both peeing and pooping). For those who start between 3 and 3.5, it’s more like nine days. Keep in mind that for all of these age groups, there is a range of length of time from a few days to over a year. Sometimes parents are told that if you do it right, it only takes a few days. While that is true for some people, it is definitely not the norm.

If you’re in the throes of potty training, hang in there!

#emilyoster #parentdata #pottytraining #pottytrainingtips #toddlerlife
...

For children or adults with severe food allergies, they can be incredibly scary and restrictive. We may imagine that it’s easy to deal with a peanut allergy by, say, not eating peanut butter sandwiches. But for someone with a severe version of this allergy, they may never be able to go to a restaurant, for fear of a severe reaction to something in the air. Right now, there’s only one approved treatment for severe allergies like this and it’s limited to peanuts.

This is why the new medication Xolair is very exciting. It promises a second possible treatment avenue and one that works for other allergens. A new trail analyzed data from 177 children with severe food allergies. Two-thirds of the treatment group were able to tolerate the specified endpoint, versus just 7% of the placebo group. This is a very large treatment effect, and the authors found similarly large impacts on other allergens. 

There are some caveats: This treatment won’t work for everyone. (One-third of participants did not respond to it.) Additionally, this treatment is an injection given every two to four weeks, indefinitely. This may make it less palatable to children. 

Overall, even with caveats, this is life-changing news for many families!

#xolair #foodallergies #allergies #peanutallergy #emilyoster #parentdata

For children or adults with severe food allergies, they can be incredibly scary and restrictive. We may imagine that it’s easy to deal with a peanut allergy by, say, not eating peanut butter sandwiches. But for someone with a severe version of this allergy, they may never be able to go to a restaurant, for fear of a severe reaction to something in the air. Right now, there’s only one approved treatment for severe allergies like this and it’s limited to peanuts.

This is why the new medication Xolair is very exciting. It promises a second possible treatment avenue and one that works for other allergens. A new trail analyzed data from 177 children with severe food allergies. Two-thirds of the treatment group were able to tolerate the specified endpoint, versus just 7% of the placebo group. This is a very large treatment effect, and the authors found similarly large impacts on other allergens.

There are some caveats: This treatment won’t work for everyone. (One-third of participants did not respond to it.) Additionally, this treatment is an injection given every two to four weeks, indefinitely. This may make it less palatable to children.

Overall, even with caveats, this is life-changing news for many families!

#xolair #foodallergies #allergies #peanutallergy #emilyoster #parentdata
...

If you have a fever during pregnancy, you should take Tylenol, both because it will make you feel better and because of concerns about fever in pregnancy (although these are also overstated).

The evidence that suggests risks to Tylenol focuses largely on more extensive exposure — say, taking it for more than 28 days during pregnancy. There is no credible evidence, even correlational, to suggest that taking it occasionally for a fever or headache would be an issue.

People take Tylenol for a reason. For many people, the choice may be between debilitating weekly migraines and regular Tylenol usage. The impacts studies suggest are very small. In making this decision, we should weigh the real, known benefit against the suggestion of this possible risk. Perhaps not everyone will come out at the same place on this, but it is crucial we give people the tools to make the choice for themselves.

#emilyoster #parentdata #tylenol #pregnancy #pregnancytips

If you have a fever during pregnancy, you should take Tylenol, both because it will make you feel better and because of concerns about fever in pregnancy (although these are also overstated).

The evidence that suggests risks to Tylenol focuses largely on more extensive exposure — say, taking it for more than 28 days during pregnancy. There is no credible evidence, even correlational, to suggest that taking it occasionally for a fever or headache would be an issue.

People take Tylenol for a reason. For many people, the choice may be between debilitating weekly migraines and regular Tylenol usage. The impacts studies suggest are very small. In making this decision, we should weigh the real, known benefit against the suggestion of this possible risk. Perhaps not everyone will come out at the same place on this, but it is crucial we give people the tools to make the choice for themselves.

#emilyoster #parentdata #tylenol #pregnancy #pregnancytips
...

Parenting trends are like Cabbage Patch Kids: they’re usually only popular because a bunch of people are using them! Most of the time, these trends are not based on new scientific research, and even if they are, that new research doesn’t reflect all of what we’ve studied before.

In the future, before hopping onto the latest trend, check the data first. Unlike Cabbage Patch Kids, parenting trends can add a lot of unnecessary stress and challenges to your plate. What’s a recent trend that you’ve been wondering about?

#parentdata #emilyoster #parentingtips #parentingadvice #parentinghacks

Parenting trends are like Cabbage Patch Kids: they’re usually only popular because a bunch of people are using them! Most of the time, these trends are not based on new scientific research, and even if they are, that new research doesn’t reflect all of what we’ve studied before.

In the future, before hopping onto the latest trend, check the data first. Unlike Cabbage Patch Kids, parenting trends can add a lot of unnecessary stress and challenges to your plate. What’s a recent trend that you’ve been wondering about?

#parentdata #emilyoster #parentingtips #parentingadvice #parentinghacks
...

As of this week, 1 million copies of my books have been sold. This feels humbling and, frankly, unbelievable. I’m so thankful to those of you who’ve read and passed along your recommendations of the books.

When I wrote Expecting Better, I had no plan for all of this — I wrote that book because I felt compelled to write it, because it was the book I wanted to read. As I’ve come out with more books, and now ParentData, I am closer to seeing what I hope we can all create. That is: a world where everyone has access to reliable data, based on causal evidence, to make informed, confident decisions that work for their families.

I’m so grateful you’re all here as a part of this, and I want to thank you! If you’ve been waiting for the right moment to sign up for full access to ParentData, this is it. ⭐️ Comment “Link” for a DM with a discount code for 20% off of a new monthly or annual subscription to ParentData! 

Thank you again for being the best community of readers and internet-friends on the planet. I am so lucky to have you all here.

#parentdata #emilyoster #expectingbetter #cribsheet #familyfirm #parentingcommunity

As of this week, 1 million copies of my books have been sold. This feels humbling and, frankly, unbelievable. I’m so thankful to those of you who’ve read and passed along your recommendations of the books.

When I wrote Expecting Better, I had no plan for all of this — I wrote that book because I felt compelled to write it, because it was the book I wanted to read. As I’ve come out with more books, and now ParentData, I am closer to seeing what I hope we can all create. That is: a world where everyone has access to reliable data, based on causal evidence, to make informed, confident decisions that work for their families.

I’m so grateful you’re all here as a part of this, and I want to thank you! If you’ve been waiting for the right moment to sign up for full access to ParentData, this is it. ⭐️ Comment “Link” for a DM with a discount code for 20% off of a new monthly or annual subscription to ParentData!

Thank you again for being the best community of readers and internet-friends on the planet. I am so lucky to have you all here.

#parentdata #emilyoster #expectingbetter #cribsheet #familyfirm #parentingcommunity
...

Just eat your Cheerios and move on.

Just eat your Cheerios and move on. ...