Hypothyroidism Tests and Diagnosis

Renu Bhuwalka from Mumbai has lived with hypothyroidism for the over 3 decades. She shares her lived experience from early symptoms to diagnosis and how she managed it well to ensure an active lifestyle.  Please tell us a bit about your condition? I have had hypothyroidism for the last 36 years. I was diagnosed in 1986, when I was 28 years old. What were the early symptoms? What made you go to a doctor? I had over a few months become very lethargic and I thought it was just…

Tips for managing Hypothyroidism Take your daily medication on time. It will reduce your symptoms and keep the thyroid hormones in balance. There is no specific diet but do ensure adequate intake of iodine. Iodine rich foods include eggs, dairy products, meat etc. Lose excess weight. Weight gain is due to slowed metabolism and can lead to other issues. Note that the maximum weight gain due to thyroid issues is 4-5Kg.   Stay fit and be active. This will improve stamina/ energy levels…

There is no clear way to prevent hypothyroidism but you can reduce your risk by doing the following: Quit smoking. Use a neck collar when going in for head and neck X-ray. Have adequate iodine intake. This is especially true in many under-developed countries, where salt is now iodised to reduce this deficiency. Avoid exposure to radioactive iodine. Join our No Smoking Community to learn more  

The goal of treatment is to bring the person back to an euthyroid state (state of having normal thyroid gland function), hence necessitating lifelong thyroid hormone replacement therapy.  Levothyroxine which is a synthetic T4 hormone is the preferred choice of treatment. It is usually prescribed once a day.  L-triiodothyronine which is synthetic T3 is used less frequently due to a shorter half-life.  Combination of the two synthetic hormones is available but with no significant…

Diagnosis of hypothyroidism will be based on a full clinical history, physical examination and blood tests. In some cases, ultrasound of the neck may also be prescribed. Blood test of serum TSH and free T4 levels is the more definitive diagnostic tool. Based on the results, the type of hypothyroidism can be identified. TYPE SERUM TSH  FREE T4 Primary Hypothyroidism High Low Secondary Hypothyroidism Low or normal Low Subclinical Hypothyroidism High (on…

The following are the types of hypothyroidism -  Primary hypothyroidism is the most common type of hypothyroidism. It occurs when the dysfunction is in the thyroid gland itself. Central hypothyroidism  Secondary hypothyroidism occurs when there is dysfunction in the pituitary gland. Tertiary hypothyroidism results from hypothalamus disorders. Subclinical or Underactive Thyroid is the early form of thyroid failure when T4 levels are still normal. It is seen in 3-8% of the…

Symptoms of hypothyroidism are often vague and non-specific, commonly confused  as signs of aging, menopause, depression, vitamin deficiencies, diabetes etc.  This often leads to missed or delayed diagnosis.  Common symptoms of hypothyroidism are listed in the table below: Symptoms of primary hypothyroidism General Fatigue, Hoarse Voice Cardiac Bradycardia, Diastolic Hypertension, Pericardial effusion Gastrointestinal Weight gain, Decreased appetite,…

There are a few causes of hypothyroidism. The most common cause of hypothyroidism is Autoimmune thyroid disease. Other causes include: Type Underlying causative factor Autoimmune Atrophic autoimmune thyroiditis, Hashimoto’s thyroiditis Iodine deficiency Poor intake of dietary iodine Iatrogenic Radioiodine therapy, Removal of thyroid glands Medication side-effect Amiodarone, Interferon, Rifampicin, Lithium, Methimazole, Propylthiouracil, Thalidomide, Sunitinib…

What is Hypothyroidism The thyroid is an endocrine gland situated at the base of the neck. It is a vital gland that produces three major hormones : T3 (Triiodothyronine), T4 (Thyroxine) and Calcitonin. These hormones play a major role in the growth, metabolism and development of the human body. (Image captured from https://www.hormones-australia.org.au/the-endocrine-system/thyroid/ ) When there is an insufficient secretion of the T3 and T4 hormones, it leads to a condition termed…