But getting a diagnosis of hypothyroidism and the right target levels for thyroid hormone can be tricky.
Are you frequently tired? Do your muscles hurt? Are you in a fog?
Millions of Americans may have an under-diagnosed thyroid problem called hypothyroidism.
Because the early symptoms of the disease are diverse and could have many causes, you may not even mention them to your doctor. Too little thyroid hormone flowing in your blood means your cells miss a “get going” signal — and you feel sluggish. You might think you don’t have the energy to exercise, when in fact, exercise would give you more pep. If you’re tired or sleepy even after getting enough sleep, you may worry that you’re depressed.
Another sign of a thyroid problem is a slow metabolism. Many people struggle to lose weight as it is. If you have a thyroid issue you may be holding onto salt and water, and you’ll also gain weight on fewer calories.
It may seem ordinary to become forgetful when you’re tired. A thyroid hormone deficiency will slow down your brain along with the rest of your body.
Other indicators are high blood cholesterol levels and a lower-than-usual libido. Too little thyroid hormone can cause your body to suppress your testosterone, the desire pump. Of course, weight gain, forgetfulness, and fatigue aren’t likely to make you feel attractive and amorous, either.
Your skin may feel dry and itchy, since your skin may be getting less blood flow, and you may not be sweating often enough. If your thyroid is sluggish, you may see an increase in hair loss and brittle nails, and any wounds may be slower to heal. Your digestive track may slow down as well, and make you constipated.
Finally, you may have trouble staying warm, and your muscles may be constantly sore. If you’re constantly longing for a hot bath, even on days you don’t work out, tell your doctor.
There’s a simple blood test for thyroid function. If you have low thyroxine, a thyroid hormone, your body will produce high levels of TSH, which stands for thyroid stimulating hormone. Elevated TS test results, along with your symptoms, will prompt your doctor to investigate possible causes.
Many doctors, including Pamela Smith, MD, author of “What You Must Know About Thyroid Disorders & What to Do About Them,” point out that “normal” may not be optimal for you. A standard test may look just at TSH and “free T4,” which is thyroxine. Smith suggests a “thyroid panel” that includes five measurements, of TSH, free T3, free T4 (a “go” signal), reverse T3 (a “stop” signal), and thyroid antibodies. She also suggests getting tested for iodine levels.
You may find that you feel best with a TSH as low as 1 and T3 and T4 in the optimal range.
Smith’s advice: try smaller changes before asking for medication. If you have low iodine levels, you can take a supplement or use iodized salt. But don’t take iodine unnecessarily, since too much can increase your risk of developing Hashimoto’s thyroiditis, a kind of ¬hypothyroidism, or thyroid cancer.
Eat foods high in selenium, a mineral which helps your body make thyroid hormones effective. A few Brazil nuts a day will do it, Smith says. She also advises eating breakfast, ideally mixing protein with carbohydrates and trying the Mediterranean diet, which emphasizes olive oil, fish, and vegetables.
If you decide to try hormones, which can be very effective at treating hypothyroidism, your doctor may prescribe levothyroxine (Synthroid) or levothyroxine sodium (Levothroid).
April 01, 2020
Christopher Nystuen, MD, MBA