Hypothyroidism

at Concierge Endocrinology of New Jersey

Overview

Hypothyroidism is a condition where the thyroid gland does not produce enough thyroid hormones. These hormones are essential for regulating the body's metabolism — when hormone levels are low, the body's processes slow down.

The most common cause of hypothyroidism is autoimmune disease, specifically Hashimoto's thyroiditis, where the body's immune system attacks the thyroid gland. Other causes include surgical removal of the thyroid, radiation therapy, certain medications, and in some cases, inflammation of the thyroid (thyroiditis).

Hypothyroidism can also result from a lack of iodine in the diet or damage to the pituitary gland. Some individuals are born with a non-functioning thyroid gland (congenital hypothyroidism).

Signs & Symptoms

Feeling cold even when others are comfortable
Feeling tired and fatigued
Dry skin
Constipation
Feeling sad or depressed
Forgetfulness and difficulty concentrating
Weight gain or difficulty losing weight
Thinning hair
Slow heart rate
Joint and muscle pain
Heavy or irregular menstrual periods
Fertility problems in women
Puffy face
Hoarse voice

Causes & Risk Factors

Hashimoto's thyroiditis (autoimmune disease) — the most common cause
Surgical removal of the thyroid gland
Radiation therapy for thyroid cancer or other conditions
Certain medications
Thyroiditis (inflammation of the thyroid)
Iodine deficiency
Pituitary gland damage or disorder
Congenital hypothyroidism (born with non-functioning thyroid)

Diagnosis

Hypothyroidism is diagnosed through blood tests that measure the levels of Thyroid-Stimulating Hormone (TSH) and thyroxine (T4). A high TSH level and a low T4 level indicate an underactive thyroid.

The free T4 test is particularly important as it measures the amount of hormone available for the body to use. Thyroid antibody tests may also be ordered to determine if the cause is autoimmune.

Treatment Options

Daily hormone replacement therapy with levothyroxine (synthetic T4) — the standard treatment
Dosage adjustment based on regular TSH level monitoring
Some patients may benefit from combination therapy with liothyronine (T3) in addition to T4
Lifelong thyroid hormone replacement if the thyroid has been removed
Regular follow-up to ensure proper medication dosing
Awareness of medication interactions — inform your doctor about all other medications being taken

Important Facts

Hypothyroidism is very common and highly treatable with proper medication.

It is important to take thyroid medication consistently, typically on an empty stomach in the morning.

Certain medications, supplements, and foods can interfere with thyroid hormone absorption.

Patients should consult their doctor before making medication changes, with significant weight changes, or when planning a pregnancy.

Medical information adapted from American Thyroid Association. Always consult with your physician for personalized medical advice.

Expert Hypothyroidism Care

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