Hypothyroidism is what happens when your thyroid gland is not producing enough thyroid hormone and your body feels sluggish.

The symptoms of each diagnosis are the same. An underactive thyroid is more common in women, but the reasons are unknown.

Subclinical Hyperthyroidism: is when your labs are mildly abnormal but you do not experience any symptoms.Depending on your age, other medical problems, and labs values, this may or may not need treatment.

The most common cause of hypothyroidism in the U.S. is Hashimoto’s Thyroiditis. This occurs when your body is making thyroid antibodies to attack your thyroid gland. It is followed by iatrogenic (after thyroid removal or radioactive iodine) or other inflammatory causes.

Symptoms

Hypothyroidism Symptoms

The most common symptoms of hypothyroidism are:

  • Fatigue / sluggishness (mental and physical)
  • Cold intolerance
  • Constipation
  • Hair loss
  • Weight gain

Other underactive symptoms may include:

  • Depression
  • Abnormal blood pressure
  • Heart arrhytmias
Diagnosis

Hypothyroidism Diagnosis

The best test to determine if you have an underactive thyroid is a blood test called TSH (thyroid stimulating hormone).

  • TSH will be high if the thyroid is not working enough.

If your TSH is found to be abnormally high (giving you a presumptive diagnosis of hypothyroidism), other blood tests may include:

  • FT4 (free T4)
  • TT3 (total T3)
  • Thyroid antibodies (TPO, TgAb) – are useful in Hashimotos diagnosis and monitoring of Hashimotos treatment.

If a thyroid nodule is palpated, your thyroid endocrinologist will likely order a thyroid ultrasound.

Treatment

Hypothyroidism Treatment

An underactive thyroid is treated with thyroid replacement hormone, most commonly in the form of T4. Your dose of medication will be titrated based on your labs and hypothyroid symptoms. Most patients do very well and are stabilized on the correct dose of medication within a few months.

Can diet or any complementary therapies help thyroid issues?

  • In general, the are no randomized controlled trials demonstrating that diet or any complementary therapies significantly alter thyroid function or successfully treat thyroid cancer, hypothyroidism or hyperthyroidism.
  • However, there are some programs that discuss ‘thyroid healthy’ foods and lifestyles that may or may not have merit.
Pregnancy

Hypothyroidism and Pregnancy

The levels of thyroid hormone circulating in the body fluctuate normally during pregnancy. However, maternal hypothyroidism during pregnancy can develop, most commonly from Hashimoto’s disease.

Hypothyroidism during pregnancy needs to be treated and addressed to prevent complications such as congestive heart failure, postpartum hemorrhage, anemia, or pre-eclampsia in the mother and low birth weight, mild to severe congenital defects, or neonatal hypothyroidism in the fetus. Treatment during pregnancy is important and adjustment of medication is common as thyroid hormone requirements increase 25-50% during pregnancy. Hypothyroidism in the postpartum period occurs in 5-10% of women, and is higher in women with other autoimmune disorders, positive thyroid antibodies or a previous history of thyroid dysfunction. Many of these women will initially have hyperthyroidism that will progress to hypothyroidism. Most women will recover normal thyroid function 1-2 years after delivery.