Doing Harm: The Truth About How Bad Medicine and Lazy Science Leave Women Dismissed, Misdiagnosed, and Sick

by Maya Dusenbery

The legacy of this transformation has been a persistent assumption that women’s symptoms are “all in their heads”—until proven otherwise. This assumption has had incredibly long-lasting effects on what is known about women’s health and diseases and how women are treated when they enter the medical system.

Women seemed to be stereotyped as hypochondriacs whose symptoms were often all in their heads, but I didn’t know any women who were hypochondriacs, nor did I see any reason why women would be more hypochondriacal than men.

One of the few exceptions to that rule: among the patients judged to have an intermediate risk, the women were significantly more likely than the men to be advised to lose weight.

According to their calculation, the rate of misdiagnosis translated into at least 11,000 missed heart attacks per year in the United States.

the American Association of Clinical Endocrinologists, urged doctors to “consider treatment for patients who test outside the boundaries of a narrower margin based on a target TSH level of 0.3 to 3.0.” This was in line with what many patients had been saying for years. Once diagnosed, patients with hypothyroidism are treated with supplemental T4 to replace the hormone that their underactive thyroid is no longer producing, and many patients reported that even when their TSH was back in the “normal” range, their symptoms persisted. But the new recommended range sparked great controversy, which has never really been resolved. Most laboratories have stuck with the old reference range of 0.5 to 5.0. Some doctors have adopted the new recommendations in their practice, while others have refused. The disagreement means that one endocrinologist may diagnose and treat hypothyroidism when TSH is over 3, another may tell patients they’re fine until it goes above 5, and still others think that even treating mild hypothyroidism (between 5 and 10) is inappropriate. At the same time, most doctors have accepted a lower normal range for women who are pregnant or trying to be.