Hypothyroidism

What is Hypothyroidism (Underactive Thyroid Function)?

In hypothyroidism, the production of thyroid hormones (thyroxine) is impaired.

Common Causes

  1. Hashimoto's Thyroiditis – An autoimmune condition where the body's immune system attacks the thyroid gland, leading to decreased function.

  2. Iodine Deficiency – Iodine is essential for the proper synthesis of thyroid hormones.

  3. Postpartum Thyroiditis – A decrease in thyroid function following childbirth.

  4. Genetic Factors – A family history of thyroid disorders may increase the risk.

  5. Medications – Certain drugs, such as lithium and amiodarone, can affect thyroid function.

  6. Total Thyroidectomy or Radioactive Iodine Treatment – Surgical removal of the thyroid gland or treatment with radioactive iodine can lead to hypothyroidism.

Symptoms

Symptoms of hypothyroidism may include:

  • Fatigue

  • Cold intolerance

  • Constipation

  • Dry skin

  • Weight gain

  • Facial puffiness

  • Changes in voice tone

  • Coarse hair and skin

  • Muscle weakness

  • Muscle pain and stiffness

  • Heavy or irregular menstrual cycles

  • Hair loss 

  • Slow heart rate (bradycardia)

  • Depression

  • Memory problems

Diagnosis

Laboratory Tests:

  • Thyroid-Stimulating Hormone (TSH)

  • Thyroid Hormones (FT4, FT3)

  • Antibodies (Anti-TPO, Anti-Tg)

TSH measurement also plays an essential role in managing hypothyroidism. Based on TSH results, the doctor determines the appropriate dosage of medication.

Certain medications and supplements, such as biotin, which is found in multivitamins, can affect test results. Before undergoing testing, consult your doctor about any medications or supplements you are taking.

Treatment

Hypothyroidism is typically treated with levothyroxine, which is taken daily. This medication restores thyroid hormone levels and alleviates hypothyroid symptoms.

Most people begin to feel better within one to two weeks of starting treatment. Levothyroxine therapy is usually lifelong.

Is the Dosage Correct?

To determine the correct dose of levothyroxine, your doctor will check your TSH levels 6–8 weeks after starting treatment.

Taking too much levothyroxine may cause side effects such as:

  • Fatigue

  • Increased appetite

  • Sleep disturbances

  • Heart palpitations

How to Take Levothyroxine Correctly

  • Take levothyroxine on an empty stomach, ideally at the same time every day—30–60 minutes before breakfast or before taking other medications.

  • If taken at night, ensure at least 4 hours have passed since your last meal.

  • Do not skip doses or stop the medication because you feel better. If you stop taking it, hypothyroid symptoms will gradually return.

  • If you miss a dose, take two pills the next day.

Medications and Supplements That Affect Levothyroxine Absorption

Consult your doctor if you take any of the following, as they may interfere with levothyroxine absorption:

  • Iron supplements or iron-containing multivitamins

  • Aluminum hydroxide, found in antacids

  • Calcium supplements

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