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Hypothyroidism describes an underactive thyroid gland. That means your body isn’t producing enough of the hormones that regulate much of your body’s functions. If your thyroid hormones are low, your metabolism slows down and you might feel tired, unusually sensitive to cold or depressed, and you might gain weight.
Untreated hypothyroidism can lead to complications, such as heart disease, goiter, peripheral neuropathy, pregnancy complications and, very rarely, myxedema coma.
The thyroid is a small, butterfly-shaped gland at the base of your neck. In adults who’ve acquired hypothyroidism, the cause is typically Hashimoto disease or Hashimoto thyroiditis, an autoimmune disorder. Rather than fight infection, the immune system attacks the thyroid gland. Hashimoto thyroiditis runs in families, but the cause isn’t known.
Surgery or radioactive iodine therapy for a thyroid disorder, such as hyperthyroidism (overactive thyroid) or thyroid cancer, can damage the gland and lead to an underactive thyroid.
Postpartum thyroiditis is a rare thyroid disease that occurs within a year of pregnancy and can lead to hypothyroidism. Symptoms of postpartum thyroiditis can be improperly attributed to postpartum depression or new parent stress.
Some children are born with a low-functioning or nonfunctioning thyroid. Congenital hypothyroidism is a thyroid disease with no symptoms, but the condition easily can be detected through newborn screening and treated with thyroid hormone replacement medication. If left untreated, congenital hypothyroidism can lead to permanent mental disabilities.
Your primary care provider can assist with testing and treatment for hypothyroidism. If specialized care is needed, you also have the option to consult an endocrinologist. Many Norton Community Medical Associates primary care locations are conveniently colocated with dedicated endocrinology practices across the Louisville area, including Southern Indiana and Elizabethtown, Kentucky, making access to expertise seamless and convenient.
Hypothyroidism symptoms tend to develop slowly and easily can be mistaken for another condition. If you have any of the following symptoms, discuss them with a medical provider or at your next annual checkup. The only way to know whether you have hypothyroidism is a routine blood test to check your thyroid hormone level.
Common hypothyroidism symptoms, according to the American Thyroid Association, include:
A routine blood test can measure the thyroid hormone level in your blood. The test typically looks for thyroid stimulating hormone (TSH), triiodothyronine (T3) and thyroxine (T4).
T3 and T4 are hormones the thyroid makes. TSH is made by the pituitary gland that tells the thyroid how much T4 and T3 to make. If your thyroid isn’t making enough T3 or T4, the pituitary may release excess TSH into your bloodstream.
An elevated level of TSH but normal T4 and T3 can be an indication of subclinical hypothyroidism. It typically has no symptoms but can develop into clinical hypothyroidism with low T4 levels and should be monitored.
Very high or low T4 levels may not mean you have thyroid dysfunction. If you are pregnant or are taking oral contraceptives, your thyroid hormone levels will be higher. Severe illness or the use of corticosteroids (medicines to treat asthma, arthritis, skin conditions and other health issues) can lower T4 levels.
Measuring levels of thyroid antibodies may help diagnose Hashimoto disease, as thyroid antibodies are made when your immune system attacks the thyroid gland.
Other tests may include imaging, such as a thyroid scan, which uses radioactive iodine to help the doctor see your thyroid clearly. This test can show thyroid nodules, which are small, often harmless lumps on the gland. It also can detect inflammation, an enlarged thyroid and other abnormalities.
There is no cure for thyroid disease, but several treatment options can manage hypothyroidism by regulating hormone levels and addressing symptoms with thyroid medication.
Thyroid hormone replacement therapy with a synthetic thyroid hormone such as levothyroxine can improve symptoms significantly. In addition, lifestyle changes — such as a healthy diet rich in iodine and selenium, regular exercise, and stress management techniques — can help.
You’ll need to monitor your thyroid hormone level to ensure the treatment is working and dosage is appropriate.
You’ll likely start to feel better one or two weeks after you begin treatment. Treatment with levothyroxine likely will be lifelong.