Hypothyroidism (or an underactive thyroid) is caused by not enough of the thyroid hormones secreted by the thyroid. Diagnosis of hypothyroidism is almost exclusively based upon the levels of the hormone in the bloodstream. There are normal ranges and if our level drops below this expected range it is consistent with hypothyroidism. These tests are routine and nothing to be concerned about as they are incredibly accurate. Your doctor will order a thyroid function panel; this panel measures the level of the key hormones that the thyroid should be secreting:
T4 and TSH (thyroid-stimulating hormone). In a patient with an underactive thyroid gland, the T4 level will be low but the TSH will be high. This is because the body is aware that not enough T4 is being made and so it makes an excess of TSH to try and kickstart the production. Blood levels have normal ranges but there are other factors to consider, such as the presence or absence of other symptoms, for example, depression is often associated with this condition, as is anaemia. This, as any disease has different levels of severity. Some people will experience very mild deviations and be asymptomatic, whereas others will suffer greatly.
The degree of thyroid problems often but not always correlates with the degree of symptoms. Your doctor should place more emphasis on making you feel better than trying to force your levels into the normal range.
Hypothyroidism is usually easy to treat. The most effective treatment is thyroid medication. You are given a pill which contains a synthetic form of the hormone that your body needs. It supplements your bodies production of T4 and it comes in multiple strengths, so there is a dosage to suit every patient. There should be a re-evaluation at regular intervals to ensure that the proper level needed for the patient can be established. This medication is often a lifelong decision, so annual checks of your level will be necessary. This is the most common approach, but it does not work for everyone as it can be difficult to find the correct dosage. Some patients simply prefer other options.
Symptoms can begin to dissipate in as little as one to two weeks on the right medication; however, the full metabolic response to the thyroid therapy can take a month or two. Too low a dose can cause fatigue and too high can cause nervousness, palpitations or even insomnia. The dosage is even more critical in patients with heart conditions as an excess can increase the risk of heart attacks or worsen angina. After taking the medication or therapy for a month, hormone levels are measured to establish whether the dose is appropriate. Once under control, hypothyroidism should not have much effect on your daily lives. It is only in the initial stages before diagnosis when the symptoms run rampant that you will notice it.