Hypothyroidism

Hypothyroidism: Frequently Asked Questions

Here are some frequently asked questions related to hypothyroidism.

Q: A neighbor of ours was recently diagnosed with hypothyroidism. She went to the doctor with the same kinds of problems I have: getting tired more easily, forgetting little things, feeling cold a lot of the time. Now, my granddaughter thinks I should go, too. I don’t feel sick, I’m just getting older. What should I do?

A: It makes sense to ask your doctor if you might have hypothyroidism. The testing is simple: just a sample of blood from your arm. The treatment is simple: a daily dose of thyroid hormone in tablet form to replace what the thyroid gland isn’t making anymore. The results can be huge: improvement or disappearance of a number of distressing symptoms including fatigue, difficulty with memory, and inability to tolerate cold.

Q: I was confused when I asked my doctor about my thyroid hormone level and she talked about T3 and T4. What do these have to do with thyroid hormone?

A: Two slightly different forms of thyroid hormone are found in the blood. One is abbreviated as T3 (thyroid hormone with 3 attached iodines) and the other as T4 (thyroid hormone with 4 attached iodines). Both are considered thyroid hormone. The form of thyroid hormone found in replacement tablets is T4.

Q: The doctor said my hypothyroidism isn’t due to a problem in my thyroid gland, but instead something wrong in another gland, one in my head. Does that make sense?

A: Although the vast majority of cases of hypothyroidism result from a problem in the thyroid gland, up to about 5% of cases are due to a problem in the pituitary gland, the tiny endocrine gland located under brain tissue that produces and releases TSH. In your case, your thyroid gland isn’t making enough thyroid hormone because it isn’t receiving enough TSH to stimulate it to do so. Treatment is the same as for any other case of hypothyroidism: replacement of the missing thyroid hormone with synthetic hormone taken in tablet form.

Q: My sister’s doctor retired, and she went to a new one. He did some tests and told her she has hypothyroidism from a condition called Hashimoto’s thyroiditis. She said he told her to tell me so I could be tested. I remember that my aunt had problems like my sister’s, but no one went to a doctor back then just for tiredness and forgetting things. My aunt died years ago, and my sister lives over a thousand miles away. How could I be affected?

A: There is a genetic factor in developing Hashimoto’s thyroiditis, and there is often a familial tendency toward it and other autoimmune disorders. Because Hashimoto’s thyroiditis is more common in older women, both you and your sister might be at higher risk for developing it, particularly if there is a positive family history (as there might be if your aunt was affected, too). Discuss it with your doctor.

Q: We tried to conceive for several years, and now I’m finally pregnant. My obstetrician did some blood work when I went to see her, and she says I’m at risk for thyroid trouble after the baby comes. I don’t recall any doctor talking about my thyroid before. What does she mean?

A: Postpartum thyroiditis (an inflammatory condition of the thyroid that develops after delivery) affects about 5% to 9% of mothers. About 80% to 90% of women who develop postpartum thyroiditis had antibodies directed against their thyroid gland in their blood during their pregnancies. Ask your doctor what she found in your blood test results – do you have antithyroid antibodies in your blood? A consultation with an endocrinologist may be helpful.

Q: My husband had bypass surgery three years ago. He was recently diagnosed with hypothyroidism, and the doctor asked him a number of questions about how he was feeling, if he was having any attacks of angina, getting short of breath on stairs, etc. Is his hypothyroidism making his heart disease worse?

A: Actually, the decreased metabolic activity associated with hypothyroidism decreases the workload on the heart. Your husband’s doctor may have been concerned because the increased metabolic activity associated with starting thyroid hormone treatment will increase the workload on the heart somewhat. The best thing for your husband to do is talk with his doctor about how he feels, any concerns he has about possible strain on his heart while starting thyroid hormone treatment, and what steps can be taken to minimize stress on his heart.

Q: I’ve gotten routine physicals for years, and my blood work was always fine. Now my cholesterol level is high, and the doctor wants to test for hypothyroidism. What is the connection between cholesterol and the thyroid gland?

A: The decreased metabolic activity associated with hypothyroidism leads to an increase in blood cholesterol levels. Because you haven’t had high cholesterol in the past, your doctor may feel your current cholesterol level represents undiagnosed hypothyroidism. A simple blood test can check your thyroid gland function. If you have hypothyroidism, a daily dose of thyroid hormone will correct your hormone level, restore proper body metabolic activity, and bring your cholesterol level back to its previous, normal level.