About 15 years ago, I was diagnosed with hypothyroidism, and it completely shifted my perspective on health and wellness. At the time, I was an all-natural, no-meds-here holistic nutritionist. But as I began treatment, I realized there are moments when medication can be incredibly useful, even essential. Now, being diagnosed with thyroid problems led me to transition into becoming an integrative nutritionist, blending the best of holistic and conventional approaches to support health.
Hypothyroidism, or an underactive thyroid, occurs when the thyroid gland doesn’t produce enough hormones to support the body’s functions. This small, butterfly-shaped gland located in the neck beneath the throat plays a role in regulating key processes like heart rate, body temperature, weight, and blood pressure. When the thyroid isn’t working properly, it can disrupt the body’s balance and lead to various symptoms. While some people face the opposite problem, an overactive thyroid known as hyperthyroidism, this article will focus on hypothyroidism and its causes, effects on the body, and treatment options.
What are the symptoms of hypothyroidism?
Hypothyroidism can take years to show any signs, and it happens when the thyroid gland slows down, affecting the body’s metabolism. When symptoms do show up, they can be different for everyone and usually get worse as the thyroid slows down more.
Some symptoms are easy to notice on the outside, like:
- Gaining weight for no clear reason
- A swollen, pale face
- Hair and nails that break easily
- Hair thinning or falling out
- Dry, cool skin
- In some cases, the thyroid gland itself might get bigger, forming what’s called a goiter.
Some symptoms of hypothyroidism can affect how a person feels, such as:Â
- Feeling tired
- Struggling to stay warm
- Experiencing muscle aches
- Constipation
- Headaches
- Trouble focusing
- Feeling sad, unmotivated, or down
- Heavier or more irregular periods for women
- Difficulty getting pregnant
What causes hypothyroidism?
The most common reason people get hypothyroidism is because of a condition called Hashimoto’s disease. This is an autoimmune problem where the body’s immune system mistakenly attacks the thyroid gland.
There are other reasons someone might develop hypothyroidism too. These include having part or all of the thyroid removed through surgery, radiation treatments, or taking certain medications like lithium. It can also happen after treatments for an overactive thyroid. In some cases, it’s caused by not getting enough iodine in your diet or from genetic conditions. Sometimes, hypothyroidism is even linked to pregnancy. Thyroid conditions are more common in females than in males. 
When should I see my doctor?
If someone has symptoms of thyroid problems, they should see a doctor. Thyroid problems often go undiagnosed because the symptoms can look like other common health issues, making them tricky to figure out.
Patients should share all the details with their doctor, like any symptoms they’re experiencing, their family’s medical history, and any medications or supplements they’re currently using. They should also mention if someone in their family has had thyroid or autoimmune conditions in the past.
The doctor might check the neck to see if the thyroid is swollen or has any lumps. The doctor will also look for signs of an underactive thyroid, like a slow heartbeat.
To find out if someone has hypothyroidism, a doctor will order a blood test. This test checks thyroid hormone levels and looks for thyroid antibodies.
In some cases, the results may show a mild form of hypothyroidism, called subclinical hypothyroidism. The doctor will talk with the patient about the results and decide if any treatment is needed.
How is hypothyroidism treated?
When someone is diagnosed with hypothyroidism, they will usually need to take medicine such as Armour Thyroid or Synthyroid to replace the thyroid hormone their body isn’t making enough of. This medicine works like the hormone called thyroxine. Most people will need to take it for the rest of their lives. It’s usually taken once a day, at least 30 minutes before eating breakfast.
People on thyroid hormone replacement therapy need to keep taking their medicine, even if their hormone levels are normal and they feel fine. Once treatment begins, regular check-ups are usually needed so the doctor can adjust the dosage if necessary. It might take a little while to figure out the right amount of medicine for each person.
People being treated for hypothyroidism might end up with hyperthyroidism if their doctor doesn’t carefully check their medication doses.
What are the complications of hypothyroidism?
If left untreated, hypothyroidism can gradually get worse as the thyroid stops working properly. This condition can cause several health issues, such as high cholesterol, trouble having children, difficulty thinking clearly, depression, and even heart problems. In very rare cases, it can lead to a serious condition called myxedema coma. Myxedema coma is a rare, life-threatening condition that occurs due to severe, untreated hypothyroidism. It results in extreme slowing of bodily functions, including heart rate, breathing, and metabolism. Symptoms can include confusion, hypothermia, low blood pressure, and even unconsciousness. Immediate medical intervention is essential to manage this condition.
For kids and teens, untreated hypothyroidism can also affect their growth and development.
During pregnancy, untreated thyroid problems can raise the chances of a miscarriage or other complications.
Can hypothyroidism be prevented?
Most cases of hypothyroidism can’t be avoided, but the symptoms can be managed. Hypothyroidism caused by iodine deficiency can be prevented by adding iodine to the diet. A simple way to do this is by using iodized salt when cooking or seasoning food, which can easily be found at grocery stores.
If someone’s hypothyroidism is caused by a medication they’re taking, they should talk to their doctor about switching to a different one. Medications should never be stopped without checking with a doctor first.
How common is hypothyroidism in men?
Research shows that in the US, about 4% of women aged 18–24 and 21% of women over 74 have hypothyroidism. For men, the rates are 3% and 16%, respectively. Hypothyroidism happens for similar reasons in both men and women, with Hashimoto’s being a leading cause.
Men and women often share similar symptoms, but some symptoms are unique to men, such as:
- Different problems with sexual health, such as low sex drive, trouble getting or keeping an erection, and taking a long time to finish during sex. Some men with this condition experience premature ejaculation, which is less common.
- Hypothyroidism can also impact semen quality, leading to lower sperm count, shape, and movement. These issues might make it harder for some men to have children.
- Low testosterone. When someone has hypothyroidism, it can cause testosterone levels in the blood to drop. It can also lower the amount of a protein called sex hormone-binding globulin, which helps move testosterone around the body. These changes can lead to symptoms of low testosterone in men.
How is hypothyroidism diagnosed?
Hypothyroidism is diagnosed the same way for both men and women. Doctors look at symptoms and use a blood test to see how well the thyroid is working. The test measures thyroid-stimulating hormone (TSH) and sometimes T3 and T4 levels, or thyroid autoantibodies if Hashimoto’s is suspected. TSH is made by the pituitary gland and helps control how much T4 the thyroid produces. If T4 levels are too low, the pituitary gland produces more TSH to try to boost T4. In people with hypothyroidism, TSH levels are high because the thyroid isn’t making enough T4.
TSH should be between 0.5 and 5 mIU/mL. Total T4 is usually in the range of 5 to 12 ug/dL. Total T3 normally falls between 80 and 220 ng/dL.
What does treatment of thyroid problems involve?
Hypothyroidism is usually treated with replacement thyroid hormones. This medicine is a man-made version of the thyroid hormone that the body naturally produces. It’s taken every day, and doctors adjust the dose based on how the patient feels and the results of blood tests. Once the right dose is found, blood levels are regularly checked to make sure everything stays on track. The pill is usually prescribed for life, but consistency can lead to living a perfectly normal life with the condition.
FAQs
What foods should I avoid in hypothyroidism?
Foods can impact thyroid function and how well thyroid replacement therapy works. Most people with hypothyroidism need hormone replacement therapy to manage the condition, but certain foods can affect how the body absorbs these medications. For example, soy can interfere with the absorption of thyroid hormones, so it’s best to avoid eating soy a few hours before or after taking the medication. Iodine is also essential for producing thyroid hormones, but eating large amounts of raw cruciferous vegetables, like broccoli or cabbage, can reduce the body’s ability to absorb iodine.
What do your hands look like if you have hypothyroidism?
Those with hypothyroidism might feel pain, numbness, or tingling in their hands and fingers. They could also see changes in the color or texture of their palms, along with problems affecting their nails and nail beds.
Is it possible to lose weight when you have hypothyroidism?
In hypothyroidism, the thyroid produces fewer hormones, slowing metabolism and leading to weight gain. This weight gain is partly due to fat and fluid buildup caused by the thyroid’s impact on kidney function. Taking prescribed thyroid medicine, like levothyroxine, can stabilize hormone levels and metabolism, making it easier to manage weight. However, losing already gained weight may require a healthy combination of diet and exercise.
Can stress cause hypothyroidism?
Stress doesn’t directly cause hypothyroidism, but it can affect how the thyroid works and make existing thyroid issues worse. Chronic stress raises cortisol levels, which can disrupt thyroid hormone production and conversion. High cortisol may lower TSH levels, reducing thyroid hormone output, and can also block the conversion of T4 into the active T3 hormone, leading to low active hormone levels. Stress may also weaken the immune system, which can trigger or worsen autoimmune thyroid diseases like Hashimoto’s thyroiditis, a common cause of hypothyroidism. It’s possible to manage stress with non-prescription OTC dietary supplements like the Stress Pack.
