Dr. Catie Duskin

Dr. Catie Duskin.

Do you have symptoms of fatigue, depression, weight gain, dry skin, thinning body hair, or constipation? Many adults can answer yes to any of these nonspecific symptoms. However, if you did answer yes, you may also consider having your thyroid checked. An underlying thyroid deficiency is a common issue in primary care. Here are some commonly asked questions about hypothyroidism.

What is the thyroid and why is it important?

The thyroid is a gland in the front part of the throat. It produces thyroid hormones called triiodothyronine (T3) and thyroxine (T4) in response to signals from a gland in the brain called the pituitary. The pituitary releases Thyroid Stimulating Hormone or TSH to start this process. These hormones help regulate your body’s metabolism.

What is hypothyroidism?

When the thyroid does not produce enough hormone, it can lead to the symptoms discussed above. Most often, hypothyroidism comes from a problem in the thyroid gland. This type of hypothyroidism can develop after surgical removal of the thyroid, as a side effect of some medications, or as a disease of the thyroid gland itself. Although less common, there are also causes of hypothyroidism originating from decreased production of TSH from the pituitary.

What symptoms would I have?

Symptoms of hypothyroidism can vary widely from person to person, and those mentioned above are only a short list of those symptoms commonly experienced. Some people may have one or more of those symptoms. Some patients may not have any symptoms at all, or may have a delay in the onset of symptoms. If untreated, severe hypothyroidism can be life threatening.

How do I get checked?

Fortunately, we can detect hypothyroidism early with simple blood tests. Commonly, primary care physicians will order blood work to measure the TSH level and maybe the free T4 to check for thyroid disease. A diagnosis of the most common forms of hypothyroidism is made if the TSH is high and the T4 is low.  This means that the pituitary increases its signal to the thyroid with more TSH, but the thyroid is not able to appropriately increase production of T4. These hormone levels are not routinely checked. It is important that you discuss concerns of possible hypothyroidism with your physician.

How is hypothyroidism treated?

There are commonly available medications help to increase the amount of thyroid hormone in the blood. Most often we use a medication called levothyroxine to treat hypothyroidism. If you take this medication currently or have been prescribed this medication, it is very important to understand how to take this medication. In order for this medication to be absorbed properly, it should be taken on an empty stomach about an hour before eating. Once you start taking thyroid medication, you need to have regular testing of your thyroid hormone levels.

If you have hypothyroidism or are concerned you may have hypothyroidism, please discuss your concerns with your primary care provider. It is an often overlooked diagnosis that can make a huge difference in your life.

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