How to Tell if You Have an Underactive Thyroid

Given its size, the thyroid—a small butterfly-shaped gland located in the neck—wields a lot of power over how well your body functions and you feel.

According to Dr. Ibitoro Osakwe, Chief and fellowship program director of the Division of Endocrinology and Diabetes at Baystate Medical Center, the thyroid produces thyroid hormone T4 and T3 that regulate the body’s metabolism—the rate at which the body produces energy from nutrients and oxygen. Thyroid hormone affects critical body functions, such as heart rate, cholesterol levels, mood, bone density, and body weight. Every cell, tissue, and organ in the body is impacted by how much thyroid hormone is or isn’t produced.”

One of the most common thyroid problems, says Osakwe, is an underactive thyroid, also called hypothyroidism or hypothyroid disease.

Who is at risk of hypothyroidism?

Hypothyroidism can affect anyone — men, women, infants, teens, and the elderly. You may be born with it, or it can develop as you age. While anyone can have hypothyroidism, it most often occurs in women, often after menopause.

Other factors that put you at higher risk of developing a thyroid disease include:

• A family history of thyroid disease
• Certain medical conditions including Type 1 diabetes, rheumatoid arthritis, pernicious anemia, and autoimmune diseases including lupus and Hashimoto’s Disease
• Use of medication high in iodine
• Being over age 60, especially so for women
• Previous history of a thyroid condition or cancer

Hypothyroid symptoms

Without enough TSH, every system in the body slows down leading to a variety of potential symptoms. Because symptoms may develop over months or even year, they’re easy to overlook. While symptoms vary from person to person, common ones include:

• Feeling tired
• Weight gain
• Muscle weakness
• A puffy face
• Forgetfulness
• Feeling cold or intolerant of the cold
• Irritability
• Constipation
• Dry skin
• Elevated cholesterol levels
• Thinning hair
• Hoarseness
• Slowed heart rate
• Heavy or irregular menstrual cycles
• An enlarged thyroid (goiter)

Osakwe says, “If you’re experiencing two or more of these symptoms, you should schedule a visit with your doctor.”

Testing for hypothyroidism

Hypothyroidism is diagnosed through a simple blood test to check your TSH levels.

In some cases, imaging tests such as ultrasound, may be necessary if your thyroid is large, to look for nodules or lumps in your thyroid.

How is hypothyroidism treated?

“Treatment for hypothyroidism consists of a daily-use synthetic thyroid hormone levothyroxine in the form of a pill,” says Osakwe. “This oral medication works to restore adequate hormone levels and reduce symptoms. When a patient first starts taking the medication, we re-test them 6-8 weeks from the first dose to check where their TSH levels are. Depending on what we see, we may increase or lower the dosage to get the levels in the right range for the individual. Sometimes it takes a few adjustments to get the levels right.”

If taken according to instructions, medication will work to relieve symptoms and help your bodily systems function properly.

Osakwe notes, “For most patients, hypothyroidism medication will need to be taken for the rest of their life to keep the disease under control. Your doctor will check your TSH levels annually and make adjustments based on the findings.”

Learn more about Baystate Health's Thyroid Clinic.