Underactive Thyroid

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An underactive thyroid, also known as hypothyroidism, is when your thyroid gland doesn’t produce enough hormones. This can cause a range of symptoms including tiredness, depression, and weight gain. 

The most common treatment for an underactive thyroid is Levothyroxine. This replaces the hormones that your thyroid gland isn’t producing and helps to improve your symptoms.

Levothyroxine is available to order from our UK registered online doctor and pharmacy service. You will need to complete a medical assessment as part of your order. Please note, this service is only available to people who are currently prescribed Levothyroxine on repeat by their GP.

Visit the British Thyroid Foundation website or the NHS page on hypothyroidism for more information.

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Underactive Thyroid

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Overview

What is an Underactive Thyroid?

The thyroid gland is a small gland located in the neck. It releases hormones called triiodothyronine (T3) and thyroxine (T4). These hormones are important for the body to function normally.  

An underactive thyroid is when the thyroid gland doesn’t produce enough of these hormones and a person experiences symptoms as a result. The medical name for an underactive thyroid is hypothyroidism.

An underactive thyroid can be diagnosed with a blood test called a thyroid function test. This measures the levels of T4 in your blood and another hormone called thyroid-stimulating hormone (TSH). A high TSH level and a low level of T4 means you may have an underactive thyroid.

 

Content Reviewed: 15/02/21

Causes

Underactive Thyroid Causes

A large majority of cases are due to the thyroid gland being unable to produce enough hormones due to an abnormality with the gland or an iodine deficiency. Sometimes it can be caused by treatments for thyroid cancer or an overactive thyroid. Congenital hypothyroidism occurs when a baby is born with a thyroid gland that isn’t fully developed.


For more information, see the NHS page on hypothyroidism causes.

Treatments

Underactive Thyroid Treatment

An underactive thyroid has a good prognosis and most people can have their symptoms resolved by taking the medicine Levothyroxine. This is the most common underactive thyroid treatment.  

Levothyroxine is taken daily and the dose varies from person to person. When your doctor first prescribes you Levothyroxine, they will start with a low dose and give you regular blood tests. 

The test results help your doctor find the right dose for you. When you and your doctor find the dose that works for you, the blood tests will become less regular. Most people on a stable dose have a blood test every year to check their thyroid levels.

Levothyroxine should be taken once daily on an empty stomach. Ideally, it should be taken in the morning around 30 minutes before any other medication.

Most of the side effects people can experience with Levothyroxine happen because the dose is too high. This can cause symptoms of an overactive thyroid (hyperthyroidism) such as irritability, tremors, palpitations, and difficulty sleeping. If you notice any of these side effects from Levothyroxine, let your doctor know and they may adjust your dose.

Sometimes people are prescribed combination therapy for an underactive thyroid. This involves treatment with Levothyroxine and T3 together. However, this is not usually prescribed in the UK because there is not enough data to suggest it is better than Levothyroxine alone.

Symptoms

Underactive Thyroid Symptoms

An underactive thyroid can cause a range of symptoms. Some of these symptoms are similar to those of other conditions, making it easy to confuse with other health problems. Some symptoms can develop slowly and people may not realise for a long time that they have symptoms.

Common hypothyroidism symptoms include fatigue, weight gain, sensitivity to cold, constipation, impaired concentration and memory, reduced libido, and muscle aches. It can also cause brittle nails and hair, and dry and scaly skin.

FAQ

How does an underactive thyroid affect you?
An underactive thyroid means that your thyroid gland is not producing enough thyroid hormones. These hormones are crucial for regulating bodily functions like metabolism. An underactive thyroid can cause many side effects such as weight gain, depression, and fatigue.

Can you tell if you have hypothyroidism by looking at your hands?
One of the symptoms of hypothyroidism can be ridged, brittle nails that may be slow-growing. This is why sometimes people link checking your hands and nails with checking for hypothyroidism. However, the only way to diagnose hypothyroidism is with a blood test. 
Nail changes may be a sign of hypothyroidism, other diseases, or nail infections. Nails also tend to change as you get older.

 

What are the early warning signs of thyroid problems?
If thyroid problems are not treated, it can cause later symptoms of an underactive thyroid. This includes a low voice, hearing loss, and thin eyebrows. However, a number of symptoms are seen early on with an underactive thyroid. This includes fatigue, weight gain, depression, muscle aches, and memory problems.

 

What are the long term problems if an underactive thyroid is left untreated?
If an underactive thyroid is left untreated over a long time, it can cause high cholesterol which can then lead to cardiovascular disease and heart problems. Speak to your doctor if you have an underactive thyroid and experience chest pain.
Another complication is a goitre. This is when the thyroid gland swells and causes a lump in the throat. A goitre can also be a symptom of an overactive thyroid.

 

How do you treat an underactive thyroid?
In the majority of cases, an underactive thyroid is treated by taking a daily dose of Levothyroxine. This replaces the thyroxine that the thyroid gland isn’t producing. Treatment will usually be lifelong and the dose of Levothyroxine may need to be changed occasionally, depending on the results of a thyroid blood test. 
The side effects of Levothyroxine usually happen if the prescribed dose is too high. This causes side effects that are similar to the symptoms of an overactive thyroid such as a fast heartbeat, irritability, anxiety, and mood swings. If you notice any side effects with treatment, speak to your doctor to see if you need to have your dose adjusted.

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