Informational Posts / Supporting a Thyroid Patient

The ‘Spoon Theory’ Perfectly Captures Managing Thyroid Fatigue

Originally published on 29th July 2016
Last updated on 25th November 2023

A ‘Spoonie’? What’s a ‘Spoonie’? 

The spoon theory is a metaphor those with a disability, chronic illness, health condition or autoimmune disease, may use to explain the reduced amount of energy available for activities of daily living and tasks.

This can be in day to day living or just during flare ups.

It’s a very popular term in the chronic illness community. And yes, thyroid disease can be a chronic illness.

Rachel Flare Up

The idea of the Spoon Theory, created by Christine Miserandino, is that many people with a disability, chronic illness, health condition and/or autoimmune disease, for example, must carefully plan their daily activities to use their ‘spoons’ (unit of energy) wisely. [1]

Whilst people with no ongoing health issues do not need to worry about running out of energy.

‘Spoons’ are a unit of measurement used to track how much energy a person has throughout the day. A ‘Spoonie’ is the person managing their ‘spoons’ (energy).

If you imagine that each activity requires a certain number of spoons, which will only be replaced as the person rests, then it’s easy to grasp that if you run out of spoons, you have no choice but to rest until your spoons are replenished.

You can imagine having ten spoons each day, and tasks such as showering or bathing requiring two spoons, and walking for half an hour (for example, home from work) requiring six. Those with a thyroid condition may have to work out what activities they can afford to do each day, so as not to run out of spoons (energy) and be left exhausted.

As other people without a health issue do not feel the impact of spending ‘spoons’ for mundane tasks such as bathing and getting dressed, they may not realise the amount of energy used by those who do need to plan their energy usage just to get through the day. They do not tend to have a limited amount of energy, as most daily tasks could never get close to exhausting them, unlike those with hypothyroidism or Hashimoto’s, for example.

Since Christine Miserandino created the Spoon Theory, which has had many, many views and shares, the word ‘spoonie’ and #spoonie has been used on social media sites to connect people living with reduced energy levels and raise awareness of the constraints of the health conditions we live with.

Even those who have their hypothyroidism well-treated, like myself, tend to be more at risk of over exhausting and expecting too much of ourselves, compared to other people.

It takes balance, patience and a lot of practice to learn how to use our energy efficiently. Sometimes we try our best and it’s still out of our control. Thyroid flares can come out of nowhere. Sometimes we have less spoons on some days compared to others, for example, if we’ve had a bad nights sleep or have a cough or cold, then we’re starting the day with less energy already.

We have to juggle and manage a lot, and many of us also have families and children to juggle, alongside our health conditions. We should never feel sorry for having to say ‘no’ at times and putting our foot down. We should never feel sorry for putting ourselves first and being assertive.

So be a spoonie, and be proud. You’re a spoonie superhero!


Be Your Own Thyroid Advocate Book CoverSee also:

The book Be Your Own Thyroid Advocate: When You’re Sick and Tired of Being Sick and Tiredwhich builds on this article in detail.

You can click on the hyperlinks in the above post to learn more and see references to information given.



About Author

Rachel Hill is the highly ranked and multi-award winning thyroid patient advocate, writer, speaker and author behind The Invisible Hypothyroidism. Her thyroid advocacy work includes writing articles, authoring books, producing her Thyroid Family email newsletters and speaking on podcasts and at events about the many aspects thyroid disease affects and how to overcome these. She is well-recognised as a crucial and influential contributor to the thyroid community and has a large social media presence. Her bestselling books include "Be Your Own Thyroid Advocate" and "You, Me and Hypothyroidism".


  • Christina Gaura
    February 19, 2019 at 10:24 am

    I am so intrigued by this theory. I am a 50 year old woman that was diagnosed with congestive heart failure several years ago. I was told the heart failure may have been due to a virus; I’m a teacher and around lots of germs. I also have psoriasis being treated with biologics. About a year ago, after a good recovery from the heart failure (it’s been a long journey), I was asking why still so tired. After some bloodwork, I was diagnosed with hypothyroidism. I am somewhat better but still tired. I often wonder if the crux of my problems come from the thyroid. I rest so much and don’t appear to be sick to others. I still work full time and manage family life. This spooning theory is spot on. I do find myself, rationing my tasks. If I can wait to do something, I do. Thanks you for sharing your journey. I plan to check out your book.

    • Rachel Hill
      February 19, 2019 at 10:26 am

      Hi Christina, thank you for sharing your journey. I do talk about the spoon theory some more in my book, as well as have a chapter for the friends and family of those with hypothyroidism and try and help them understand a bit more.


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