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The Diagnosis and Treatment of Hypothyroidism

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Hypothyroidism Diagnosis

Hypothyroidism is a relatively common disorder. It affects more women then men, but I happen to be one of the men who does have it. Symptoms of hypothyroidism include fatigue, gradual weight gain, constipation, muscle aches, joint pain, feeling cold, menstrual irregularities, weakness, hair loss, dry, cold skin and slow reaction time. Many patients will have a goiter (enlarged thyroid). Although it has received much discussion, I believe low body temperature is not a reliable sign of hypothyroidism.

The incidence of hypothyroidism increases with increasing age. In other words, the older we get, the more likely a thyroid deficiency will show up. The most common cause of primary hypothyroidism (hypothyroidism originating in the thyroid gland itself), is Hashimoto’s thyroiditis. Hashimoto's is an autoimmune condition. The body's own antibodies attack the thyroid gland and destroy it, leading to hypothyroidism. Hashimoto’s thyroiditis may be a manifestation of multiple autoimmune syndromes and may occur in families. Hypothyroidism can also be due to a pituitary problem (central hypothyroidism).

Diagnosing all types of hypothyroidism is important, because treatment with thyroid hormone will improve symptoms in patients with hypothyroidism, but is unlikely to help those who do not have hypothyroidism. In primary hypothyroidism, the thyroid gland, located in the neck, is less able to produce the thyroid hormones, T4 and T3. The pituitary gland, located in the head, responds to this deficiency by secreting more TSH. Thus, in more mild cases of primary hypothyroidism, T4 and T3 levels are normal, but the TSH is high. In more severe cases, T4 and T3 levels drop. Although the normal range for TSH is often between 0.5 and 5 mU/mL, values at the high end of the normal range may be abnormal. T3 is the more bioactive hormone compared to T4, but T4 is more stable in the circulation.

My approach to diagnosing hypothyroidism is to start with a careful history and physical. Then an endocrinologist should perform a hands-on thyroid examination to determine if the patient has a goiter.

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EmpowHER Guest

Thank you for this informative post. I was diagnosed with hypothyroidism following the birth of my first son in 2006 and experienced many of the symptoms you have listed. I trusted my doctors completely assuming they knew everything there was to know about this disease, especially when I became pregnant again in late 2008. How wrong I was! Under their care my TSH, the gold standard for measuring thyroid function, rose high above the safe range for pregnancy and I miscarried. I vowed to myself that I would research everything there was to know about hypothyroidism and warn other women. I fulfilled my vow and launched my blog Hypothyroidmom.com in memory of the baby I lost to hypothyroidism.

October 21, 2012 - 5:48am
EmpowHER Guest

Thank you for this useful post. However, hypothyroidism isn't the only condition that may cause the loss of hair in an individual but if the thyroid gland is under controlled and still there is a loss of hair, one must think of some other reasons. Hair loss, if not hereditary caused, may be signal of something ‘unfair’ with the body and one should pay an awareness of it.

December 20, 2010 - 2:53am
EmpowHER Guest

Thank you for the informative post. I am an RN who was just diagnosed with hypothyroidism as well (TSH 122, T4 0.4, positive antibodies and multiple nodules on thyroid ultrasound). I just started levothyroxine 50mcg last week. I am waiting to feel better, and also to see ENT regarding possible biopsies of nodules.

Any words of advice about nodules?


July 24, 2009 - 8:25am
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We value and respect our HERWriters' experiences, but everyone is different. Many of our writers are speaking from personal experience, and what's worked for them may not work for you. Their articles are not a substitute for medical advice, although we hope you can gain knowledge from their insight.


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