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How to Treat Hypothyroidism

writtenByWritten by: Sofie Wise
Sofie Wise

Sofie Wise

Sofie hopes to create a more sustainable healthcare system by empowering people to make conscious health decisions. Her interests include cooking, reading, being outdoors and painting.

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reviewBy Reviewed by: Leann Poston, M.D.
Reviewer

Leann Poston, M.D.

Leann Poston, M.D. earned her medical degree from the Wright State University Boonshoft School of Medicine. She completed an MBA from Raj Soin College of Business, focusing on healthcare. She is a full-time medical communication writer and educator.

May 26, 2021 Read Time - 14 minutes

What Is Hypothyroidism?

Hypothyroidism, also known as underactive thyroid syndrome, is a condition in which the thyroid gland fails to produce enough thyroid hormones to meet the body’s needs.

Treatment for hypothyroidism is notoriously difficult, but there are many steps one can take to alleviate symptoms.

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What Is the Thyroid?

The thyroid is a small, butterfly-shaped gland that sits at the base of the front of the neck, just below the Adam’s apple. It is responsible for producing hormones that regulate the body’s metabolism, which is how the body uses energy.

The thyroid gland produces two thyroid hormones, triiodothyronine (T3) and thyroxine (T4). If the thyroid hormones are too low or too high, it affects how the body’s energy is being used and, in turn, can slow down or speed up many of the body’s functions, resulting in several different symptoms.

T3 and T4 influence the rate at which your body processes fats and carbohydrates, body temperature, heart rate, and the regulation of protein production.

Hypothyroidism means that there is not enough thyroid hormone produced in the thyroid gland and released to the body. The imbalance rarely causes symptoms in the early stages, but if left untreated, can cause a number of different health problems, including:

  • Obesity
  • Fatigue
  • Depression
  • Heart disease

Thankfully, modern medicine allows us to accurately test for thyroid issues so that doctors can diagnose hypothyroidism and treat it accordingly.

Treatment for hypothyroidism requires the patient to take a synthetic thyroid hormone. Once you and your doctor determine the right synthetic hormone dosage, it is a simple and easy process to get treatment for hypothyroidism.

Hypothyroidism Symptoms

Symptoms of hypothyroidism vary quite a bit based on the severity of the thyroid hormone deficiency. Problems caused by hypothyroidism often take years to reveal themselves, so you might not notice the symptoms of your thyroid issue right away.

And, to make it even more unclear, the initial symptoms of hypothyroidism are fatigue and weight gain, which can easily be attributed to growing older or other lifestyle habits. “Because the symptoms are so variable and nonspecific, the only way to know for sure whether you have hypothyroidism is with a simple blood test for TSH,” according to the American Thyroid Association.

Hypothyroidism symptoms may include:

  • Fatigue
  • Weight gain
  • Increased sensitivity to cold
  • Dry skin
  • Puffy face
  • Elevated blood cholesterol level
  • Muscle aches, tenderness, and stiffness
  • Joint pain, stiffness or swelling
  • Hoarseness
  • Thinning hair
  • Irregular periods
  • Slowed heart rate
  • Depression
  • Impaired memory

If left untreated, signs and symptoms might become more severe over time. When the thyroid gland is not producing enough hormones, the brain is still trying to signal the gland to do so. This constant stimulation of your thyroid gland can lead to an enlarged thyroid.

It can also cause forgetfulness, slower thought processes, and, in some cases, depression.

In extremely rare cases, an untreated case of hypothyroidism can result in “advanced hypothyroidism,” or myxedema.

Myxedema can be life-threatening. Its symptoms include low blood pressure, decreased breathing, decreased body temperature, unresponsiveness, and sometimes even coma. It is rare, but can be fatal if left untreated or misdiagnosed.

Signs of Hypothyroidism in Infants, Children, and Teens

Though most common in middle-aged and older women, anyone can develop hypothyroidism.

Signs of Hypothyroidism in Infants

Infants that are born without a thyroid gland or with a gland that does not function properly may have different signs and symptoms than adults. Newborns that have a thyroid issue may demonstrate:

  • Jaundice, or yellowing of the skin and whites of the eyes
  • Frequent choking
  • An enlarged, protruding tongue
  • Puffy face

If the disease progresses, infants may have trouble feeding and, consequently, have developmental issues. They may also experience:

  • Constipation
  • Excessive sleepiness
  • Poor muscle development

When hypothyroidism in infants is left untreated, it leaves the infant vulnerable to severe physical and intellectual disabilities.

Signs of Hypothyroidism in Children and Teens

Children and teenagers generally experience the same symptoms of hypothyroidism that adults do. However, they may also experience:

  • Slower growth resulting in a shorter stature
  • Delayed puberty
  • Delayed development of adult teeth
  • Slower mental development

Hypothyroidism Causes

When the thyroid does not produce enough hormones the balance of chemical reactions in the body can be upset. There are a number of possible causes that might lead to this imbalance, including autoimmune diseases, radiation therapy, thyroid surgery, hyperthyroidism treatment, and certain medications.

Hypothyroidism is a result of the thyroid gland failing to produce enough hormones. This failure to produce hormones may be a product of several different factors, including:

  • Autoimmune disease – Autoimmune disorders occur when the body’s immune system produces antibodies that attack its own tissues. Scientists aren’t sure why the body produces these antibodies and why it attacks itself. Some think a virus or bacterium might trigger this, while others believe genetic factors cause autoimmune disorders. It is likely a combination of the two factors. When the immune system attacks the body cells, it often targets the thyroid. One example is Hashimoto’s disease which limits the thyroid’s ability to produce hormones and results in hypothyroidism. Hashimoto’s disease is the most common autoimmune cause of hypothyroidism. 

Other hypothyroidism causes may include:

  • Medications – Some medications can contribute to hypothyroidism. Medicines such as lithium, amiodarone, interleukin-2, and interferon alpha can prevent the thyroid gland from producing its hormones normally. These medicines are most likely to affect the thyroid’s functionality in patients who have a genetic susceptibility to autoimmune thyroid disease.
  • Treatment for hyperthyroidism – Hyperthyroidism is the opposite of hypothyroidism; it is a condition in which the thyroid gland overproduces thyroid hormones, thus causing a hormone imbalance in the body. Hyperthyroidism can be treated with radioactive iodine and/or antithyroid medications, both of which are meant to reduce and normalize the thyroid function. In some cases, these treatments can cause permanent hypothyroidism if too much medication is administered.
  • Thyroid surgery – Thyroid surgery may be performed if a patient is experiencing hyperthyroidism, goiters, thyroid nodules, or thyroid cancer. Thyroid surgery involves removing either all of the thyroid or a large portion of the thyroid gland, both of which diminish and/or halt thyroid hormone production. In this case, hypothyroidism will be a lifelong condition, and the patient will need to take a supplemental thyroid hormone for the rest of their life.
  • Radiation therapy – Radiation therapy used to treat head and neck cancers, Hodgkin’s disease, and other lymphomas can affect the thyroid gland and possibly lead to hypothyroidism. Radioactive iodine therapy is also sometimes used to treat hyperthyroidism and can lead to hypothyroidism as well.
  • Thyroiditis – Thyroiditis is the inflammation of the thyroid gland, typically caused by a viral infection or autoimmune attack. When thyroiditis occurs, it causes the thyroid to empty its entire supply of stored thyroid hormone into the bloodstream at once, causing brief hyperthyroidism (excessive thyroid production) followed by hypothyroidism.
  • Congenital hypothyroidism – Congenital hypothyroidism means that a baby is born with the condition. This occurs when a baby is born without a thyroid or with only a partially formed one. Sometimes, the baby will have part or all of the thyroid in the wrong place in the body (called ectopic thyroid). In some babies, the thyroid cells or their hormones do not work correctly. All of these issues lead to lifelong hypothyroidism.
  • Damage to the pituitary gland – The pituitary, or “master gland,” signals to the thyroid how much hormone it should produce. If the pituitary gland is damaged by radiation, surgery, or a tumor, it might not be able to give the thyroid proper instructions anymore. This can stop thyroid hormone production or alter it in other harmful ways.
  • Thyroid infiltrating disorders (rare) – In rare occasions, diseases can deposit abnormal substances in the thyroid that hinder its ability to function. An example of this is amyloidosis, which often causes the deposit of amyloid proteins into the thyroid and prevents the gland from working normally.

Risk Factors of Hypothyroidism

The two main contributing factors to hypothyroidism are age and sex. Your chances of developing hypothyroidism increase with age and are naturally higher for if you are a woman (women are 5–8-times more likely to develop the condition than men).

The population most at risk for hypothyroidism is women over the age of 60.

Some other contributing risk factors for hypothyroidism are:

  • Family history of thyroid disease or autoimmune disease – People with a close relative (i.e., parent or grandparent) who suffer from an autoimmune disease or thyroid disease are more likely to experience hypothyroidism.
  • Radioactive iodine therapy – Anyone who has been treated with radioactive iodine therapy, particularly in the neck and upper chest area, has an increased risk of hypothyroidism.
  • Autoimmune disease – Those who already have an immune condition are at increased risk for hypothyroidism. Examples of autoimmune diseases are celiac disease, rheumatoid arthritis, type 1 diabetes, pernicious anemia, vitiligo, multiple sclerosis, and Addison’s disease.
  • Turner Syndrome – Turner Syndrome is a condition in which women have more than two X chromosomes. Girls and women experiencing Turner Syndrome are at greater risk of developing hypothyroidism.
  • Postpartum women – Women who have delivered a baby within the past 6 months should be routinely screened for hypothyroidism. Those with an underactive thyroid are particularly at risk, but all postpartum women have an increased risk of hypothyroidism.
  • Race – Asian and white individuals experience higher rates of hypothyroidism than other races.
  • Medications – Some medications cause hypothyroidism as a side effect. Taking medications such as lithium, amiodarone, and interferon can increase your risk of hypothyroidism. Check with your doctor to make sure that you can manage this risk accordingly.
  • Book on our free mobile app or website.

    Our doctors operate in all 50 states and same day appointments are available every 15 minutes.

  • See a doctor, get treatment and a prescription at your local pharmacy.

  • Use your health insurance just like you normally would to see your doctor.

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Complications of Hypothyroidism

When left untreated, hypothyroidism can lead to several potential health problems:

  • Heart problems – Hypothyroidism may be associated with increased risk of heart disease, mainly because high levels of low-density lipoprotein cholesterol (“bad” cholesterol) may occur in people who have an underactive thyroid. Even mild or early-stage hypothyroidism that does not present symptoms can cause an increase in total cholesterol levels and over time diminish the heart’s ability to pump blood.
  • Goiter – Goiter is a condition in which a gland is larger than it should be. This occurs in the thyroid gland when the gland is being overstimulated because it is receiving constant signals to produce more hormones. Hashimoto’s thyroiditis is one of the more common causes of goiter. It may not be uncomfortable, but a large goiter can affect appearances and interfere with swallowing or breathing if left untreated.
  • Peripheral neuropathy – Long-term untreated hypothyroidism can cause damage to the peripheral nerves—the nerves that transmit information from the brain and spinal cord to the rest of the body. Signs and symptoms of peripheral neuropathy might include numbness and tingling or pain in the affected area. Peripheral neuropathy can also cause weakness of the muscles and loss of muscle control.
  • Infertility – Low levels of thyroid hormones may interfere with ovulation and consequently impair fertility. Some causes of hypothyroidism (i.e., autoimmune diseases) can also hinder fertility.
  • Myxedema – Myxedema is a rare life-threatening condition that results from long-term undiagnosed hypothyroidism. The symptoms of myxedema include intense cold intolerance and drowsiness followed by extreme lethargy and/or unconsciousness.
  • Mental health issues – Depression can occur in the early stages of hypothyroidism and may become more severe over time. Hypothyroidism can also slow mental functioning.

How to Diagnose Hypothyroidism

Diagnosis of hypothyroidism depends on a number of factors. Some of the main factors that contribute to diagnosing hypothyroidism include:

  • Symptoms – Hypothyroidism does not have any unique characteristic symptoms—all of its symptoms could potentially present as symptoms of a different illness. One way to differentiate whether your symptoms are a product of hypothyroidism is to consider whether you’ve always had the symptoms (in which case hypothyroidism is unlikely) or whether the symptom is a departure from the way you used to feel (which means hypothyroidism is more likely).
  • Medical and family history – Medical history and familial history both contribute to the diagnosis of hypothyroidism. It is important to inform your doctor whether you have ever had thyroid surgery or radiation therapy in the neck area. You should also tell your doctor all current medications you are taking and whether any of your family members have had thyroid disease.
  • Physical exam – The doctor may examine the thyroid gland to check for swelling, dry skin, slower reflexes, and/or a slower heart rate.
  • Blood tests – There are two blood tests that allow a doctor to be certain of his or her diagnosis of hypothyroidism.
    • TSH test, which measures how much of the thyroid hormone thyroxine (T4) the thyroid is being directed to make. An unusually high TSH indicates the presence of hypothyroidism because it demonstrates that the thyroid gland is being asked to make extra T4 because there isn’t enough T4 in the bloodstream, but it is unable to meet the demand.
    • T4 tests measure how much unattached T4 is in the blood and available for cells to uptake. If there is not enough T4, hypothyroidism is likely.

How to Get Treatment for Hypothyroidism

There is no cure for hypothyroidism, but proper medication will allow patients to keep the disease completely under control.

One treatment option is to see an endocrinologist, or “hormone doctor.” Endocrinologists are internal medicine doctors that are specially trained to diagnose and treat all hormone production-related issues.

Seeing an endocrinologist is a great way to get treatment for hypothyroidism or any other thyroid issue you might be experiencing.

A specialist is not necessarily required to treat thyroid issues. Much of the treatment process can be done with your primary care physician or with an online physician.

Hypothyroidism Treatment

Treatment for hypothyroidism is a hormone replacement regimen.

Because hypothyroidism means that your thyroid is not producing enough of its hormones, taking the synthetic hormone levothyroxine (levoxyl, levothroid, synthroid, and others) to replace what is missing will alleviate the thyroid issue and reverse any symptoms you might be experiencing.

After 1–2 weeks of treatment, you should notice that you feel less fatigued. The medication will also lower your cholesterol levels and reverse any thyroid-related weight gain over time.

Determining the proper levothyroxine dosage might take time. It will require initial blood tests every 2–3 months so that you and your doctor can find a dosage that’s right for you. In the meantime, there are some possible side effects of ingesting too much hormone medication, including:

  • Insomnia
  • Increased Appetite
  • Shakiness
  • Heart palpitations

Once you and your doctor find an appropriate dosage, you should not experience side effects from the levothyroxine.

Hypothyroidism Medication

levothyroxine-for-hypothyroid

Levothyroxine sodium is the primary medication used to treat hypothyroidism. There are several different brand options for levothyroxine.

Some of the most common brand name levothyroxine medications are as follows:

  • Synthroid
  • Levoxyl
  • Tirosint
  • L Thyroxine
  • Levo T
  • Levothroid
  • Levothyroxine T4
  • Levoxine
  • Tirosint
  • Unithroid

“If you take your medicine according to the instructions, you usually should be able to control the hypothyroidism,” according to MedlinePlus. ”You should never stop taking your medicine without talking with your health care provider first.”

  • Book on our free mobile app or website.

    Our doctors operate in all 50 states and same day appointments are available every 15 minutes.

  • See a doctor, get treatment and a prescription at your local pharmacy.

  • Use your health insurance just like you normally would to see your doctor.

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Getting Thyroid Treatment Through PlushCare

Getting thyroid treatment through an online physician is a simple and easy way to maintain treatment for your hypothyroid condition.

PlushCare employs only doctors from top 50 medical institutions without exception. This means that you can recieve top-quality care without stepping outside of your front door.

We started PlushCare because we wanted to improve access to affordable healthcare. We want to ensure that you can get your medications as quickly and easily as possible.

Yes, your online physician can write a prescription!

How To Get Hypothyroid Treatment:

  • To begin your treatment for hypothyroidism, click here and book an appointment with a physician. Our physicians will discuss your symptoms with you and go over the process of getting treatment for hypothyroidism.
  • If you decide that you want to start treatment, your doctor will order lab tests for you to have completed at a lab in your area. We work with national lab companies to ensure that everyone has access to a lab near them. The lab tests will confirm whether you are experiencing a hormonal imbalance that indicates hypothyroidism.
  • Upon reviewing the labs, the doctor will send a prescription for thyroid medication to the pharmacy of your choosing.

Read More About Hypothyroidism


Sources:

PlushCare is dedicated to providing you with accurate and trustworthy health information.

American Thyroid Association. Hypothyroidism. Accessed on May 20, 2021 at https://www.thyroid.org/hypothyroidism/

MedlinePlus. Hypothyroidism. Accessed on May 20, 2021 at https://medlineplus.gov/hypothyroidism.html

Harvard Medical School. Treating hypothyroidism. Accessed on May 20, 2021 at https://www.health.harvard.edu/newsletter_article/treating-hypothyroidism

Most PlushCare articles are reviewed by M.D.s, Ph.Ds, N.P.s, nutritionists and other healthcare professionals. Click here to learn more and meet some of the professionals behind our blog. The PlushCare blog, or any linked materials are not intended and should not be construed as medical advice, nor is the information a substitute for professional medical expertise or treatment. For more information click here.

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