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Hypothyroidism

What is Hypothyroidism?

Hypothyroidism is a condition in which the Thyroid gland does not produce enough thyroid hormones to meet the body’s needs (Low or normal T3 / T4 and high hypothyroid TSH). This lack of thyroid hormone gives rise to hypothyroid symptoms like weight gain, swelling over face and feet, constipation, tiredness, hair fall and irregular periods.

However, these hypothyroid symptoms are often present in other conditions like Polycystic ovary syndrome, low haemoglobin levels (Anaemia in medical terminology) or even changes of menopause. It is important to visit your Endocrinologist to understand whether your problems are really because of other conditions or hypothyroidism (though people are often convinced that hypothyroid medications will solve all their issues).

My approach

  1. Hypothyroid treatment is usually lifelong, so I believe in treating those who will truly benefit from hypothyroid treatment rather than starting treatment based on blood reports alone. I do this because I put myself in the person’s shoes and imagine starting hypothyroid medications – this is something that I will have to do for the REST OF MY LIFE. It is not a decision I take lightly. It is the easiest thing for me to start the hypothyroid medications, but I don’t have to take them for the next 20-30-40 years of my life.
  2. Taking concerning patient choice into considerations is also important. I have people who have high hypothyroid TSH Levels (~ 20 mIU/ml) but are perfectly healthy who opt to avoid hypothyroid medications.
  3. I prefer taking a detailed history to understand if the hypothyroid symptoms are really because of the thyroid. If I am convinced that hypothyroid symptoms seem to stem from a thyroid problem or the reports are definitively suggesting a problem that needs treatment, I start the hypothyroid treatment.
  4. While seeing people already taking hypothyroid medications, I try to empower them to understand their reports and give them a normal range appropriate for them. I encourage them to see me only if the information has high hypothyroid TSH levels to avoid an unnecessary visit to the clinic; this reduces cost for patients.
  5. In people with stable thyroid levels and regular doses of meds, I encourage patients to avoid checking their thyroid too frequently unless experiencing some specific symptoms. There can be slight fluctuations in the TSH levels. Still, people often panic even if a decimal point raises the TSH. This leads to a lot of unnecessary panic, anxiety and sleepless night, which is counter-productive.

People usually have many questions about taking medicine correctly, what food they need to avoid. Please watch my video for more details.

TELETHYROIDOLOGY

Frequently Asked Questions

How do you diagnose hypothyroidism?

We will check how your thyroid gland is working by measuring the thyroid hormones T3 and T4. TSH (Thyroid Stimulating Hormone) is the signal your brain gives to the thyroid gland to produce more thyroid hormone. In the case of hypothyroidism, the T3 and T4 are low, while TSH levels are high.

The most common symptoms you may notice are tiredness, constipation, increased sensitivity to cold, hair fall, muscle cramps and swelling on the face, neck and feet. You could notice swelling in your neck, which could eventually get diagnosed as hypothyroidism. Usually, there will be some symptoms, and it is rare that the condition gets diagnosed while you are getting tested for something else.

We will help you by supplying the thyroid hormone in the form of a tablet. This is T4, which will normalize your T4 levels and will also get converted to T3 in the body. Once your thyroid hormone levels are normal, the TSH will also start getting normal.

Once you start thyroid medicine, you have to take it lifelong. Once the thyroid gland starts producing less thyroid hormone, it cannot go back to producing a higher amount of the hormone. This is why you need to take medications. Please consult with us before stopping your medications.

You have to take your thyroid medication on an empty stomach. Take it with room temperature water when you wake up in the morning. Wait for 30 to 45 minutes before consuming any other solid or liquids.

Avoid medicines such as iron or calcium tablets, or acidity tablets and foods containing soya for at least 4 hours after you have taken the thyroid medicine.

There are no side effects of taking the thyroid hormone; we will just give you the missing hormone in a tablet form. Also, we will check your symptoms and adjust your dose. The medicine will contain T4, which you see in your report. It is a safe medicine and can even be given to newborn babies if required.

Yes, you can safely take the thyroid hormone supplementation during pregnancy. In fact, it is very important to do so. Your baby does not produce the thyroid hormone for the first 3 months during pregnancy and gets it from you for normal brain development. Not treating hypothyroidism during pregnancy can increase bleeding, increase blood pressure and may sometimes cause an early delivery. So continue your thyroid medicine as prescribed during pregnancy.

We will decide whether you have to continue or stop thyroid medication after pregnancy based on your initial reports when you started your medication. If you plan to conceive again, we will ask you to continue the medications. Please do not stop the supplementation without consulting with us.

We will refer to a thyroid antibody estimation test when the TSH report is borderline high. This can show if the thyroid gland was injured and if the borderline TSH can rise in future. We will check the TSH value, antibody positivity, age, fertility status and presence and absence of thyroid gland enlargement to decide if you need medication or if you should stop.

You may find it a little difficult to lose the extra weight when you have hypothyroidism, but you can still manage it better. Eat healthy, exercise regularly and take your medication as prescribed.

There are no home remedies to treat hypothyroidism, but you can maintain healthy lifestyle habits, such as eating right, exercising and getting enough sleep, to manage the condition.

Not treating hypothyroidism before or during pregnancy can affect both mother and baby. It can cause poor brain development in the baby and also increase the risk of miscarriage, premature delivery or higher levels of blood pressure in the mother.

If you have been diagnosed with hypothyroidism, it is important to start your medication and treatment as suggested by us. Not treating hypothyroidism could lead to complications such as infertility, heart problems, injury to nerves, and in severe cases, can also turn fatal.