Hypothyroidism is often undiagnosed, misunderstood and treated lightly. This is despite the fact it can lead to other health issues such as diabetes, cancer and heart failure if left untreated.
The thyroid is a gland situated at the base of the neck. It controls energy and metabolism. It produces the hormones T4 (80%) and T3 (20%). Most of the T4 is converted to T3 because T3 is the active, stronger hormone. The hormones are used by every single cell in the body. So if the thyroid produces too little or too many of these hormones, you really, really notice! It affects every single aspect of your health.
When someone is hypothyroid they have an underactive thyroid, which means not enough hormones are being produced. The leading cause is Hashimoto's thyroiditis. Hashimoto's is an autoimmune disease which attacks the thyroid, eventually causing its total destruction. During the attacking stage of the disease, it's not uncommon for a person's condition to cycle between hypothyroidism and hyperthyroidism (overactive thyroid). The disease can be triggered by hormonal changes like those associated with menopause, childbirth and puberty. Environmental triggers like BPA and cigarette smoke can also set the disease off. The disease tends to run in families.
The most common early symptoms people have when they are hypothyroid are fatigue, hair loss and depression. Your body feels like a car trying to run on empty. A doctor will do a TSH test to evaluate thyroid function. TSH is a hormone produced by the pituitary gland to stimulate the thyroid into producing correct amounts of hormone by 'knocking' on the thyroid's door. In hypothyroidism, the TSH will knock and knock and the blood test must show a sufficiently high result in order to be diagnosed.
Standard treatment is with thyroxine. This is a synthetic T4 hormone medication and is taken daily in tablet form. The dose is normally adjusted every 4-6 weeks until blood results indicate the hormones (or more often, just the TSH...) are within normal range. Ideally, free T4 and free T3 levels should be tested along with the TSH. Most people report feeling their best when their TSH is between 0-1 and the T4 and T3 are in the upper quarter of their ranges.
The medication is taken for life and should control symptoms. Many people do fine on the standard treatment but for a significant number, standard treatment doesn't work, only partially works or stops working. They still have hypothyroid symptoms despite 'normal' lab results. Or their original TSH test will be 'normal' despite them having hypothyroid symptoms. This is where things get tricky and patients find themselves battling a tide of medical ignorance...