Hypothyroidism occurs when your body doesn’t produce enough thyroid hormones. The thyroid is a small, butterfly-shaped gland that sits at the front of your neck. It releases hormones to help your body regulate and use energy.

Your thyroid is responsible for providing energy to nearly every organ in your body. It controls functions such as how your heart beats and how your digestive system works. Without the right amount of thyroid hormones, your body’s natural functions begin to slow down.

Symptoms of an underactive thyroid, or hypothyroidism, are a long list. At the top of the list is fatigue, feeling tired. Not uncommonly, patients start to feel cold. They’re more sensitive to the cold and would tend to be the first person in the house to turn the heat up. They can gain weight. Their hair can start to fall out. Dry skin. Constipation. With women, they may notice that their periods are becoming heavier or, in fact, irregular. Men can notice, sometimes, difficulty in erectile function.

There’s also an effect with psychological or psychiatric change. Mild thyroid deficiency can look a whole lot like depression. People become not motivated to do things, depressive in mood. It’s often a very difficult thing to tell apart mild depression from an underactive thyroid. Not just for patients, but for physicians as well.

If you have any further questions on the diagnosis or treatment of thyroid deficiency, do check with your primary care practitioner.

Presenter: Dr. Richard Bebb, Endocrinologist, Victoria, BC

Now Health Network Local Practitioners: Endocrinologist

The treatment of an underactive thyroid depends a bit on the cause. There are some causes which will actually solve themselves. Most of the time, however, it requires taking replacement thyroid hormone.

Some of the causes, for example, that may result in underactive thyroid can be a drug side effect, or a result of having inflammation in your thyroid, and the thyroid will pass through a phase of low levels. It won’t be able to produce its required amount, but eventually will rally – heal itself – and you won’t require long-term thyroid replacement.

But for most patients, when their thyroid is underactive spontaneously, it’s due to a disease called Hashimoto’s thyroiditis. Hashimoto’s thyroiditis is an autoimmune disease. Your immune system gets a bit confused, and instead of fighting off bacteria or viruses, it turns on your thyroid and actually causes damage.

And we don’t have an accepted way to stop that inflammation, and we’re left just replacing your thyroid hormone to restore normal physiology and restore normal health and make you feel normal.

To diagnose low thyroid, or hypothyroidism, first is to suspect it from the symptoms, because some of the symptoms are really not very specific; fatigue – everything causes fatigue. But once you have a clinical suspicion of it, the test to do is a TSH test (thyroid stimulating hormone test).

And while not a perfect test, it’s very good in most circumstances, to diagnose an underactive thyroid. When your thyroid level is low, your TSH level goes up. And it can be used both to diagnose thyroid disease, and it’s also one of our key measures that we use when we start treating thyroid deficiency, to know that we have put you on an appropriate physiological dose of thyroid hormone.

If you have any further questions on the diagnosis or treatment of thyroid deficiency, do check with your primary care practitioner.

Presenter: Dr. Richard Bebb, Endocrinologist, Victoria, BC

Now Health Network Local Practitioners: Endocrinologist