Medical Author: Ruchi Mathur, MD, FRCP(C)
Medical Editor: William C. Shiel, Jr., MD, FACP, FACR
- What is hypothyroidism?
- What are the thyroid hormones?
- Thyroid hormone regulation - the chain of command
- What causes hypothyroidism?
- What are the symptoms of hypothyroidism?
- How is hypothyroidism diagnosed?
- How is hypothyroidism treated?
- What is subclinical hypothyroidism?
- What's best for you?
- Hypothyroidism At A Glance
- Hyperthyroidism - Slideshow
- Patient Discussions: Hypothyroidism - Symptoms Experienced
What is hypothyroidism?
Hypothyroidism is a condition characterized by abnormally low thyroid hormone production. There are many disorders that result in hypothyroidism. These disorders may directly or indirectly involve the thyroid gland. Because thyroid hormone affects growth, development, and many cellular processes, inadequate thyroid hormone has widespread consequences for the body.This article will focus specifically on hypothyroidism in adults.
What are thyroid hormones?
Thyroid hormones are produced by the thyroid gland. This gland is located in the lower part of the neck, below the Adam's apple. The gland wraps around the windpipe (trachea) and has a shape that is similar to a butterfly - formed by two wings (lobes) and attached by a middle part (isthmus).The thyroid gland uses iodine (mostly available from the diet in foods such as seafood, bread, and salt) to produce thyroid hormones. The two most important thyroid hormones are thyroxine (T4) and triiodothyronine (T3), which account for 99% and 1% of thyroid hormones present in the blood respectively. However, the hormone with the most biological activity is T3. Once released from the thyroid gland into the blood, a large amount of T4 is converted into T3 - the active hormone that affects the metabolism of cells.
Thyroid hormone regulation- the chain of command
The thyroid itself is regulated by another gland that is located in the brain, called the pituitary. In turn, the pituitary is regulated in part by the thyroid (via a "feedback" effect of thyroid hormone on the pituitary gland) and by another gland called the hypothalamus.The hypothalamus releases a hormone called thyrotropin releasing hormone (TRH), which sends a signal to the pituitary to release thyroid stimulating hormone (TSH). In turn, TSH sends a signal to the thyroid to release thyroid hormones. If a disruption occurs at any of these levels, a defect in thyroid hormone production may result in a deficiency of thyroid hormone (hypothyroidism).
Hypothalamus - TRH
Pituitary- TSH
Thyroid- T4 and T3
The rate of thyroid hormone production is controlled by the pituitary gland. If there is an insufficient amount of thyroid hormone circulating in the body to allow for normal functioning, the release of TSH is increased by the pituitary gland in an attempt to stimulate more thyroid hormone production. In contrast, when there is an excessive amount of circulating thyroid hormone, TSH levels fall as the pituitary attempts to decrease the production of thyroid hormone. In persons with hypothyroidism, there is a persistent low level of circulating thyroid hormones.
What causes hypothyroidism?
Hypothyroidism is a very common condition. It is estimated that 3% to 5% of the population has some form of hypothyroidism. The condition is more common in women than in men, and its incidence increases with age.Below is a list of some of the common causes of hypothyroidism in adults followed by a discussion of these conditions.
- Hashimoto's thyroiditis
- Lymphocytic thyroiditis (which may occur after hyperthyroidism)
- Thyroid destruction (from radioactive iodine or surgery)
- Pituitary or hypothalamic disease
- Medications
- Severe iodine deficiency
The most common cause of hypothyroidism in the United States is an inherited condition called Hashimoto's thyroiditis. This condition is named after Dr. Hakaru Hashimoto who first described it in 1912. In this condition, the thyroid gland is usually enlarged (goiter) and has a decreased ability to make thyroid hormones. Hashimoto's is an autoimmune disease in which the body's immune system inappropriately attacks the thyroid tissue. In part, this condition is believed to have a genetic basis. This means that the tendency toward developing Hashimoto's thyroiditis can run in families. Hashimoto's is 5 to 10 times more common in women than in men. Blood samples drawn from patients with this disease reveal an increased number of antibodies to the enzyme, thyroid peroxidase (anti-TPO antibodies). Since the basis for autoimmune diseases may have a common origin, it is not unusual to find that a patient with Hashimoto's thyroiditis has one or more other autoimmune diseases such as diabetes or pernicious anemia ( B12 deficiency). Hashimoto's can be identified by detecting anti-TPO antibodies in the blood and/or by performing a thyroid scan.
Lymphocytic thyroiditis following hyperthyroidism
Thyroiditis refers to inflammation of the thyroid gland. When the inflammation is caused by a particular type of white blood cell known as a lymphocyte, the condition is referred to as lymphocytic thyroiditis. This condition is particularly common after pregnancy and can actually affect up to 8% of women after they deliver. In these cases, there is usually a hyperthyroid phase (in which excessive amounts of thyroid hormone leak out of the inflamed gland), which is followed by a hypothyroid phase that can last for up to six months. The majority of affected women eventually return to a state of normal thyroid function, although there is a possibility of remaining hypothyroid.
Thyroid destruction secondary to radioactive iodine or surgery
Patients who have been treated for a hyperthyroid condition (such as Graves' disease) and received radioactive iodine may be left with little or no functioning thyroid tissue after treatment. The likelihood of this depends on a number of factors including the dose of iodine given, along with the size and the activity of the thyroid gland. If there is no significant activity of the thyroid gland six months after the radioactive iodine treatment, it is usually assumed that the thyroid will no longer function adequately. The result is hypothyroidism. Similarly, removal of the thyroid gland during surgery will be followed by hypothyroidism.
Pituitary or Hypothalamic disease
If for some reason the pituitary gland or the hypothalamus are unable to signal the thyroid and instruct it to produce thyroid hormones, a decreased level of circulating T4 and T3 may result, even if the thyroid gland itself is normal. If this defect is caused by pituitary disease, the condition is called "secondary hypothyroidism." If the defect is due to hypothalamic disease, it is called "tertiary hypothyroidism."
Pituitary injury
A pituitary injury may result after brain surgery or if there has been a decrease of blood supply to the area. In these cases of pituitary injury, the TSH that is produced by the pituitary gland is deficient and blood levels of TSH are low. Hypothyroidism results because the thyroid gland is no longer stimulated by the pituitary TSH. This form of hypothyroidism can, therefore, be distinguished from hypothyroidism that is caused by thyroid gland disease, in which the TSH level becomes elevated as the pituitary gland attempts to encourage thyroid hormone production by stimulating the thyroid gland with more TSH. Usually, hypothyroidism from pituitary gland injury occurs in conjunction with other hormone deficiencies, since the pituitary regulates other processes such as growth, reproduction, and adrenal function. Medications
Medications that are used to treat an over-active thyroid (hyperthyroidism) may actually cause hypothyroidism. These drugs include methimazole (Tapazole) and propylthiouracil (PTU). The psychiatric medication, lithium (Eskalith, Lithobid), is also known to alter thyroid function and cause hypothyroidism. Interestingly, drugs containing a large amount of iodine such as amiodarone (Cordarone), potassium iodide (SSKI, Pima), and Lugol's solution can cause changes in thyroid function, which may result in low blood levels of thyroid hormone.
Severe iodine deficiency:
In areas of the world where there is an iodine deficiency in the diet, severe hypothyroidism can be seen in 5% to 15% of the population. Examples of these areas include Zaire, Ecuador, India, and Chile. Severe iodine deficiency is also seen in remote mountain areas such as the Andes and the Himalayas. Since the addition of iodine to table salt and to bread, iodine deficiency is rarely seen in the United States.
What are the symptoms of hypothyroidism?
The symptoms of hypothyroidism are often subtle. They are not specific (which means they can mimic the symptoms of many other conditions) and are often attributed to aging. Patients with mild hypothyroidism may have no signs or symptoms. The symptoms generally become more obvious as the condition worsens and the majority of these complaints are related to a metabolic slowing of the body. Common symptoms are listed below:- Fatigue
- Depression
- Modest weight gain
- Cold intolerance
- Excessive sleepiness
- Dry, coarse hair
- Constipation
- Dry skin
- Muscle cramps
- Increased cholesterol levels
- Decreased concentration
- Vague aches and pains
- Swelling of the legs
Properly diagnosed, hypothyroidism can be easily and completely treated with thyroid hormone replacement. On the other hand, untreated hypothyroidism can lead to an enlarged heart (cardiomyopathy), worsening heart failure, and an accumulation of fluid around the lungs (pleural effusion).
How is hypothyroidism diagnosed?
A diagnosis of hypothyroidism can be suspected in patients with fatigue, cold intolerance, constipation, and dry, flaky skin. A blood test is needed to confirm the diagnosis.When hypothyroidism is present, the blood levels of thyroid hormones can be measured directly and are usually decreased. However, in early hypothyroidism, the level of thyroid hormones (T3 and T4) may be normal. Therefore, the main tool for the detection of hyperthyroidism is the measurement of the TSH, the thyroid stimulating hormone. As mentioned earlier, TSH is secreted by the pituitary gland. If a decrease of thyroid hormone occurs, the pituitary gland reacts by producing more TSH and the blood TSH level increases in an attempt to encourage thyroid hormone production. This increase in TSH can actually precede the fall in thyroid hormones by months or years (see the section on Subclinical Hypothyroidism below). Thus, the measurement of TSH should be elevated in cases of hypothyroidism.
However, there is one exception. If the decrease in thyroid hormone is actually due to a defect of the pituitary or hypothalamus, then the levels of TSH are abnormally low. As noted above, this kind of thyroid disease is known as "secondary" or "tertiary" hypothyroidism. A special test, known as the TRH test, can help distinguish if the disease is caused by a defect in the pituitary or the hypothalamus. This test requires an injection of the TRH hormone and is performed by an endocrinologist (hormone specialist).
The blood work mentioned above confirms the diagnosis of hypothyroidism, but does not point to an underlying cause. A combination of the patient's clinical history, antibody screening (as mentioned above), and a thyroid scan can help diagnose the precise underlying thyroid problem more clearly. If a pituitary or hypothalamic cause is suspected, an MRI of the brain and other studies may be warranted. These investigations should be made on a case by case basis.
How is hypothyroidism treated?
With the exception of certain conditions, the treatment of hypothyroidism requires life-long therapy. Before synthetic levothyroxine (T4) was available, desiccated thyroid tablets were used. Desiccated thyroid was obtained from animal thyroid glands, which lacked consistency of potency from batch to batch. Presently, a pure, synthetic T4 is widely available. Therefore, there is no reason to use desiccated thyroid extract.As described above, the most active thyroid hormone is actually T3. So why do physicians choose to treat patients with the T4 form of thyroid? T3 [liothyronine sodium (Cytomel)] is available and there are certain indications for its use. However, for the majority of patients, a form of T4 [levothyroxine sodium (Levoxyl, Synthroid)] is the preferred treatment. This is a more stable form of thyroid hormone and requires once a day dosing, whereas T3 is much shorter-acting and needs to be taken multiple times a day. In the overwhelming majority of patients, synthetic T4 is readily and steadily converted to T3 naturally in the bloodstream, and this conversion is appropriately regulated by the body's tissues.
- The average dose of T4 replacement in adults is approximately 1.6 micrograms per kilogram per day. This translates into approximately 100 to 150 micrograms per day.
- Children require larger doses.
- In young, healthy patients, the full amount of T4 replacement hormone may be started initially.
- In patients with preexisting heart disease, this method of thyroid replacement may aggravate the underlying heart condition in about 20% of cases.
- In older patients without known heart disease, starting with a full dose of thyroid replacement may result in uncovering heart disease, resulting in chest pain or a heart attack. For this reason, patients with a history of heart disease or those suspected of being at high risk are started with 25 micrograms or less of replacement hormone, with a gradual increase in the dose at 6 week intervals.
Therapy for hypothyroidism is monitored at approximately six week intervals until stable. During these visits, a blood sample is checked for TSH to determine if the appropriate amount of thyroid replacement is being given. The goal is to maintain the TSH within normal limits. Depending on the lab used, the absolute values may vary, but in general, a normal TSH range is between 0.5 to 5.0uIU/ml. Once stable, the TSH can be checked yearly. Over-treating hypothyroidism with excessive thyroid medication is potentially harmful and can cause problems with heart palpitations and blood pressure control and can also contribute to osteoporosis. Every effort should be made to keep the TSH within the normal range.
What is subclinical hypothyroidism?
Subclinical hypothyroidism refers to a state in which patients do not exhibit the symptoms of hypothyroidism. These patients also have a normal amount of circulating thyroid hormone. The only abnormality is an increased TSH on their blood work. This implies that the pituitary gland is working extra hard to maintain a normal circulating thyroid hormone level and that the thyroid gland requires extra stimulation by the pituitary to produce adequate hormones. The majority of these patients can be expected to progress to obvious hypothyroidism, especially if the TSH is above a certain level.While there is some controversy, many endocrinologists will treat such patients, especially if they have a high cholesterol blood level. The abnormal cholesterol profile will likely show improvement with thyroid hormone replacement. If the cholesterol levels are normal, and the patient feels well, it is also reasonable to follow these patients without treatment and repeat the blood TSH and thyroid hormone levels in 4 to 6 months to see if more significant hypothyroidism is apparent. Both of these approaches are reasonable and patients should be encouraged to speak with their physicians about specific concerns and preferences.
What's best for you?
If you are concerned that you may have hypothyroidism, you should mention your symptoms to your physician. A simple blood test is the first step in the diagnosis. From there, both you and your doctor can decide what the next steps should be. If treatment is warranted, it is important for you to let your doctor know of any concerns or questions you have about the options available. Remember that thyroid disease is very common and, in good hands, hypothyroidism is easily addressed and treated.Hypothyroidism At A Glance
- Hypothyroidism refers to any state in which thyroid hormone production is below normal.
- There are many disorders that result in hypothyroidism.
- The thyroid gland is regulated by another gland that is located in the brain, the pituitary.
- Hypothyroidism is a very common condition.
- The symptoms of hypothyroidism are often subtle.
- A blood test is used to confirm hypothyroidism.
- With the exception of certain conditions, the treatment of hypothyroidism requires life-long medication.
Patient Discussions: Hypothyroidism - Symptoms Experienced
I have experienced many symptoms for a number of years. In fact, I was treated for depression instead of hypothyroidism for several years. At times, I thought I was "losing my mind" it was so severe. My symptoms included: confusion, inability to think clearly, total lack of energy, exhaustion, loss of interest in "everything," aches and pains (mainly in my legs/ankles/feet), and gained 35 pounds despite a lack of appetite. This has been a long struggle for me with problems at home and work (to be expected when I cannot think clearly). However, things are improving now -- there is hope! Published: November 07 ::
I am a female 44 yrs old - for the last 3 years I have suffered a progression of symptoms from hair loss, dry skin, fatigue, dizziness, constipation, erratic heavy periods, muscle aches & pains, foggy head, memory failure etc.etc. I have seen endless doctors & specialists - mainly at my own expense - because I would not accept their diagnosis that I was depressed or it was simply my age! My thyroid blood tests are all within the normal range - I contacted Thyroid UK and diagnosed myself as hypothyroid from the info on their website. I finally saw a Dr he diagnosed me from all of my symptoms - many people are hypo even though the blood tests are "within the normal range". Don't waste time doubting yourself - if your GP doesn't believe you find a doctor who works outside the ridiculous NHS restrictions and get treatment. It is estimated that about 1 million people are hypo but undiagnosed/refused treatment by the NHS because they treat the blood tests as gospel. I have been taking thyroxine since April and slowly my life is returning - I still have a long way to go but at least I am on the right track now. Don't accept what the doctors tell you if you know better - there is hope. Published: July 09 ::
I was just diagnosed with hypothyroidism yesterday. I was excited. As weird as that sounds, I had struggled for so long with so many of the symptoms: swollen legs, hairloss, fatigue, my mind slipping, my sporadic periods, being cold then hot and severe muscle cramps. It was my sever muscle cramps that actually scared me just last week to the point they made me go to the doctor to get the blood work. I had made an excuse for everything: old age. I just turned 50 and now is the time for the body to go! I'm so excited to get myself back! I started on the medication this morning. Published: June 26 ::
I am a 49-year-old female. I always knew I had a family history of hypothyroidism (my father, his two sister as well as their mother were all diagnosed in their late forties to early fifties) but I didn't have health insurance so hadn't been to see my physician for an exam for over eight years. However, I didn't know there were symptoms for which I should have been vigilant. I started becoming increasingly constipated over the last two to three years. I also began to become increasingly less tolerant of cold. My periods became erratic then quit all together. I slowly began to gain weight (over two years about 20 pounds). I began to feel more and more "bloated" with no appetite. I became increasingly depressed and mentally "fuzzy," forgetting things and just not feeling like myself in terms of mental acuity. I was able to see my physician three weeks ago. I didn't think to mention ANY of these symptoms because I had pretty much justified all of them in my mind, making the assumption they were all "natural" lifecycle changes. My physician took blood work including TSH level, and he put me on levothyroxine three weeks ago. I am starting to feel more like my old self, though I am still working on building up my energy reserve. I just started my period yesterday, which my physician said was due to getting my thyroid level back in the "normal" range. Published: June 25 ::
I had no idea I had hypothyroidism until I had my yearly physical. I felt sleepy all day. Had weight gain and was depressed and moody. I was so tired that when I got up all I could think about was going back to bed. I also had low blood pressure. I have started taking a medication just two weeks ago. I hope this helps someone. Published: July 09 ::
I had weight gain, falling asleep during the day, extreme tiredness, very dry skin and brittle fingernails. I also had a very slow heart beat and a body temperature of around 96. Published: July 08 ::
I am a 35 year old male, and I suffered from almost all these symptoms people have had. I have a family history of hypothyroidism also. The aches were bad and so was the depression, loss of sex drive, and vertigo coupled with anxiety attacks. At times I felt like there was a "weight" holding me down. I couldn’t exercise much, slept for 12 hours at a time. I had a blood test done finally and I was diagnosed. I’m happy to say I feel like I’m a teenager again, depression lifted, sex drive back , and lots of energy.. I feel more alive than ever. Get a test if you have these symptoms listed here. Your life can change like mine did. Thanks. Published: July 08 ::
I’m 21 years old. After my father passed away two years ago I gained 50 pounds without eating. My doctor thought it was severe depression and I believed it as I have been clinically depressed since I hit my teens. After repeatedly getting sick and dizzy and fainting more recently I had blood tests for diabetes and hypoglycemia. As a supplementary test he also did thyroid. I was diagnosed with hypothyroid! I have been on the medication for about a month now I am not noticing a change. My weight went up another 10 pounds despite diet and exercise that had helped me lose 30 pounds. I am not permitted to have caffeine while on this medication because of my already increased heart rate so I am very tired and my mood is just awful. Can anyone offer me advice?
I was just diagnosed yesterday with hypothyroidism and the relief is amazing. The symptoms I have are feeling weepy all the time, fatigue, memory and concentration levels at an all time low and my skin is appalling dry and rough. I have high blood pressure and it was by a change of doctor and her giving me a full blood test to see how my hypertension was doing that it was detected. I can’t even begin to explain how much better I feel knowing what the problems are caused by and that it’s going to be a bit of a long road to make things better. It doesn’t matter; point is it is being tackled. Published: July 07 ::
I have hypothyroidism due to the radioactive iodine I took when I was 20. I'm now 42 and have been taking Synthroid for years, but I still struggle with many of the symptoms of hypothyroidism: depression, fatigue, dry skin/hair, etc. Published: July 07 ::
I am a 45 yr old female. I have steadily put on a stone in weight, I have been so dizzy I felt sick, muscle cramps, painful joints, numbness in my arms and legs and a fuzzy head also very forgetful. I felt so ill it was scary! My doctor tried to tell me I was depressed as I have had depression before. I hope this helps other people as I started to think I was going mad! Finally, I have been diagnosed with hypothyroidism. Published: July 02 ::
I am 17 years old now, and I was diagnosed with hypothyroidism when I was 13. Back then, I used to look like a third-grader student lost in a bunch of second-year high school students. Everyone made fun of me. Our pediatrician suggested an endocrinologist. He found out that I have hypothyroidism. He suggested me to another doctor and that doctor suggested me to my current endocrinologist. All of them prescribed me a hormone tablet that I take an hour before breakfast. It really is effective. Published: June 25 ::
I had fertility treatment in order to have my children. In my pregnancy I developed gestational diabetes, pre-eclampsia and HELLP syndrome (hemolysis, elevated liver enzymes and low platelets). I also suffered a stroke and two cardiac arrests while pregnant. That was 9 years ago now. I am 38 and have been suffering with MANY of the symptoms of hypothyroidism. I was checked by a neuro psych for my confusion, by a diet doc for my weight gain and by numerous others for adrenal and pituitary gland problems. All came back normal. My sister has been going through similar problems. Gritty eyes, tired, dark bags under eyes and swollen joints. I could go on. Her doctor did a blood test and it came back normal. However, due to her abnormal clinical presentation he put her on thyroxine a month ago and she is back to her old self! I would love to try the same. I dont know what to say to my doctor. She thinks I am over eating and just not telling her. I was put on a drug to stop me absorbing a third of the fat I eat but nothing happened. I told her it wouldnt work because I am on a vertually fat free diet. Now she wants me to go to another dietician. I have a Bsc and used to be a chef. I can do the maths. I am not putting too much in, it is just that my body is not using it up. Besides which my 30lb weight gain is not the only symptom I need help with. I intend to make another appointment and go in armed with some newly downloaded info. Wish me luck. X Published: June 19 ::
I am 18 years old and I was diagnosed with Hypothyroidism just a few days ago. It has been a long process in diagnosing this problem. For the past couple of years I have been feeling increasingly tired. This year it really has become bad. In the winter I started to develop hives every time I went outside into the cold. Eventually I went an allergist about it where he diagnosed me with Cold-Induced Urticaria (an allergy to the cold). I have also been having seizures, some of which were at school. I have had many other symptoms as well. I have become very forgetful. Often times there is just a haze that just comes over me and I feel so confused. I will often forget the names of common things or words I once knew well. Once I even forgot what a fork was called... pretty sad I know. I have also at times experienced periods of insomnia. I have also been severely depressed for awhile now, oftentimes having many cyclic ups and downs. I have also been experiencing a gradual loss of concentration. I got blood test results back from my allergist who informed me that antibodies were attacking my thyroid. I informed my neurologist (for the seizures) of this and he ordered further testing for my thyroid. Those test results were faxed to my endocrinologist who then diagnosed me with Hashimoto’ s Thyroiditis that caused Hypothyroidism. He has started me on hormone therapy with Levothyroxine. Hopefully this will help many of my symptoms. I am hoping to have my energy back by the fall when I begin university, because this last semester of High School has been awful. My doctor also told me that the hypothyroidism is not related to my seizures, so I still have no clue as to why I am having seizures. My MRI, EEG and CT Scan all came back clear, so I may never know. I am however on 600 mg a day of Carbamazepine. I was on Clobazam, but I had a seizure while I was on it, so I was switched to a high dose of the other medicine. I have looked at the symptoms of Major Depression, and most definitely have been experiencing most, if not all of them. I am hoping this has been caused by the hypothyroidism and will go away once the hormones begin working. I have encountered some pretty arrogant doctors that show absolutely no compassion despite the enormous amount of sudden health concerns I have had to deal with all at once this year. My advice is to hold your ground, be firm, and to go with your gut. Doctors don't know everything; they just like to think they do. If you think something is wrong, go with your instincts and be firm. Published: June 19 ::
I had a very generalized fatigue for about six months. After 2 months, I did go to the doctor and had my thyroid levels checked. They were in the low-normal range. After 6 months, fatigue worsened and I had some other unrelated event that caused me to see a doctor. She wasn't concerned about my thyroid per se, but took the levels again just to be sure. Before getting the blood test results back, I realized I had been suffering from being cold for several weeks--unable to get warm no matter what I did. When I called to tell my doctor that, she confirmed the blood test had shown a significant drop in thyroid hormone since my first visit 4 months ago. With medication, I was feeling better within 2 weeks! Published: June 19 ::
I was just diagnosed with hypothyroidism today when I received the results of a blood test run for a physical. The main symptom was fatigue. I would turn into a pumpkin and sleep on Sundays for three hours or more in the afternoon. I would need afternoon naps. I wondered why I needed so much sleep. I am a 58-year-old female. The fatigue has been going on for about a year. I am slender, and I had sensitivity to cold also. Published: June 17 ::
Two of the major symptoms I experienced when I developed hypothyroidism were extreme insomnia, as well as major anxiety attacks. I was also cold all the time, my skin was dry, my hair started to thin out, and I was extremely tired all the time. Aching muscles and bones were also part of my symptoms. Published: June 17 ::
I am a 38 years female with all the symptoms listed and a known hypothyroid patient. I am also suffering with severe cough which increases during nights and also on sleeping supine. Is this related to thyroid problem please give me suggestion Published: June 16 ::
It is so helpful to read what others are experiencing are the symptoms for hypothyroidism. My blood test was just returned. The TSH result was 2.436 with normal being 5.5. My Doctor faxed me the results saying it was all fine/normal. I have had a very gritty feeling in my eyes for months, no energy, depressed, 1st time ever-- difficulty sleeping (for which she gave me Ambien only to find out it is very habit forming). As it was stated by another comment. Do not give up and assume that our Dr's are always right. We must listen to our bodies and respond by looking further into the problem. I am female/age 67, have played tennis all my life and never had any real health issues. This feeling is not normal and I plan to research it. Thanks to this info on line. Published: June 16 ::
I had trouble swallowing. It felt like I was being strangled all the time, even when lying down. I also felt fatigue anxiety, moodiness, muscle pain (especially in the neck and shoulders), and weight gain. I thought it was depression. For years I was on an antidepressant only to find out that I have hypothyroidism. I also experienced confusion, and was very forgetful, which seemed to appear suddenly. I hope that information will help. Published: June 13 ::
Brain fog puffy eyes bright lights and dizziness. Published: June 13 ::
I have goitre. For three or four years I have been complaining of aching joints and tiredness. My former doctor gave me steroids for the aches and pains and these helped for a year or so. November I returned after 4 years to my former doctor when moving house again. She stopped the steroids as she could not see in my notes why I was given them. Since then I have had blood tests for hypothyroidism which showed everything normal. I have been getting worse. I am tired, have dry hair and loss of hair, brittle nails, gritty eyes, a lump in my throat, put on weight and the pains in my joints and muscles are much worse. Yesterday I had a scan which showed the goitre has grown considerably. I am seeing a specialist next week. If the blood tests I had last week are still showing normal is there any other way to prove the diagnosis? I'm 69 and still working 3 days a week as a skills adviser and 2 days a week voluntarily. I cannot believe what I am experiencing is just old age. Published: June 13 ::
I am 80 years old and have been taking medication for 37 years. I now take Levothroid for an underactive thyroid. I have taken 0.75 mgs for several years. I have bouts of depression which I cannot decide if it is an imbalance in my thyroid medication or if I am just suffering from an old-age syndrome. Published: June 12 ::
I went for my physical and spoke to my doctor about constipation and very lengthy menstrual cycles. At first, he was thinking about placing me on birth control and treating me for IBS. Then when he continued with the physical and noticed my dry, flaking skin, he said he wanted to check my thyroid. I had no other symptoms and I had even lost so much weight that I was below normal for my height. Since being placed on Synthroid, my menstrual cycles have straightened right out and my skin has never been smoother. Published: June 11 ::
I have had Hypothyroidism for 13 yrs. and I have taken daily Meds everyday since I was diagnosed. The symptoms for me were: Feeling Cold all the time, No appetite but gaining weight, Urinating once an hour., dry skin, hair loss, constipation, hip joint pain, Once on Meds. (1/2 replacement) I was fine, I get it checked every 6 month and my dosages have never changed. Published: June 09 ::
According to my doctor my T4 levels and my TSH are good. They are in the low range but they say that's okay. I feel terrible. Fatigue, losing hair like crazy and just no energy. Should I try and get my levels in the medium to high range, would that help? Published: June 09 ::
I have been being treated for depression for over 6 years and still feel that there is a problem with my thyroid. I cannot sleep; I am always tired and have no energy at all. I have gained about 25 pounds and have not changed any eating habits to induce this. My skin is very dry and my hair is as well, I lose alot of it in the shower. Hands swollen in the morning and just general aches and pains. I generally feel physically drained every day. I have made an appointment with my husband’s physician and hopefully will get some answers soon. Published: June 05 ::
The confusion/depression part was the most alarming for me. What is worse, though, was that I had a doctor from a very well respected hospital who kept saying I was simply depressed. As I reported more and more symptoms of low thyroid, she kept doubling the dose of antidepressants. At long last, I went back to my family home and consulted my childhood doctor. He took some blood (something the other physician had not done), and had the answer: very low thyroid. I would suggest that my experience is probably not an isolated one. Often, I think, if a doctor sees that a patient has ever been treated for depression (as I had been), they may be tempted to ascribe later symptoms to the same thing. Patients have got to be aggressive on their own behalf. If you feel your doctor is overlooking something, or oversimplifying a situation, and that feeling lasts over time, do not hesitate to get a second opinion. Published: June 03 ::
The first symptoms I experienced for hypothyroidism were: sleepiness, hands tingling, droopy eyelids, swollen ankles and aching joints. Published: May 27 ::
My first symptoms were weight gain, irritability, and feeling tired along with insomnia. Five years later I still feel tired, and am now obese (I've gained 64 lbs.). I've been diagnosed with insulin resistance, hypoglycemia and diabetes. I have digestive issues, fatty liver disease, extremely high and fluctuating blood pressure (causing migraines and vomiting), muscle stiffness, muscle cramps, joint pain and swelling, dry rough skin, mood swings, high cholesterol, and constipation. I also was diagnosed with asthma, which turns out, wasn't asthma, but a reaction to Synthroid. I now take the generic brand, still have symptoms, but no shortness of breath. I follow a very strict diet and exercise regime to no avail, other than I think it helps me sleep better. I'm thinking of turning to alternative therapies, including natural thyroid drugs. But finding a doctor to prescribe them could be difficult. Published: May 27 :: Hypothyroidism Index
Featured: Hypothyroidism Main Article
Hypothyroidism is any state in which thyroid hormone production is below normal. Normally, the rate of thyroid hormone production is controlled by the brain at the pituitary. Hypothyroidism is a very common condition and the symptoms of hypothyroidism are often subtle.
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How Test Results are Interpreted
Once your TSH levels are measured, the following table is used to interpret the results:
| Interpretation of Test Results |
| TSH (high), T4 (normal), T3 (normal) = Mild Hypothyroidism |
| TSH (high), T4 (low), T3 (low/normal) = Hypothyroidism |
| TSH (low), T4 (normal), T3 (Normal) = Mild Hyperthyroidism |
| TSH (low), T4 (High/Normal), T3 (High/Normal) = Hyperthyroidism |
| TSH (low), T4 (low/normal), T3 (low/normal) = Non-thyroidal illness or rare pituitary hypothyroidism |
When I first started treatment for hypothyroidism and had to switch my dosage to natural thyroid supplements . Hypothyroid started to stabilize.
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