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Hypothyroidism
Pronounced hy-poh-THY-royd-izm
Also known as Underactive thyroid, Low thyroid
Hypothyroidism means the thyroid gland is producing too little thyroid hormone, so the body's processes run slow. Tiredness, weight gain, feeling cold, constipation and dry skin are typical, and it is treated with a single daily tablet.
The sets the pace of in every tissue. When it underproduces, everything slows: heart rate, gut transit, thought, temperature regulation, the growth of hair and nails. Because the symptoms are individually so ordinary — tired, gaining weight, low mood, cold, constipated, dry skin, heavy or irregular periods, thinning hair — the condition is easily attributed to a busy life for years before anyone measures it.
What the numbers mean
| Pattern | TSH | Free T4 | What it usually means |
|---|---|---|---|
| Normal | Normal | Normal | The thyroid is working normally |
| Overt hypothyroidism | High | Low | A clearly underactive thyroid; treatment is usually offered |
| Subclinical hypothyroidism | High | Normal | Borderline. Treatment depends on how high the TSH is, on symptoms, on antibodies and on pregnancy plans |
The commonest cause worldwide and here is Hashimoto's thyroiditis, in which the immune system gradually destroys the gland; iodine deficiency, thyroid surgery, radioactive iodine treatment and some medicines account for most of the rest. Pakistan has areas of persistent iodine deficiency despite salt iodisation, which is one reason the condition remains common in mountainous districts.
Treatment is levothyroxine, a replacement for the hormone the gland is not making. Take it on an empty stomach with water, half an hour to an hour before breakfast, and separate it by at least four hours from iron, calcium, antacids and multivitamins, all of which block its absorption. The dose is adjusted by retesting after six to eight weeks, because the level takes that long to settle; testing sooner produces an unstable number and unnecessary changes. Treatment is generally lifelong, and the requirement rises in pregnancy.
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Tests & Diagnostics
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Related terms
- ThyroidThyroid glandThe thyroid is a butterfly-shaped gland in the neck that sets the body's metabolic pace. Too little hormone slows nearly everything down; too much speeds it up.
- TSHThyroid stimulating hormone, ThyrotropinTSH is the pituitary hormone that tells the thyroid how hard to work, and it is the first blood test used to check thyroid function. It reads in the opposite direction to intuition — a high TSH means an underactive thyroid.
- MetabolismMetabolic rateMetabolism is the whole set of chemical reactions a body uses to turn food into energy, build tissue and clear waste. It runs constantly, and most of it happens whether a person is active or asleep.
- OedemaEdema, Fluid retentionOedema is swelling caused by fluid collecting in the tissues, most often seen in the ankles and legs. It is a sign rather than a diagnosis, and what matters is the reason behind it.