Hypothyroidism: When to See an Endocrinologist?

The thyroid gland is an endocrine gland located at the base of your neck and is responsible for producing thyroid hormone (TH). TH plays a significant role in bodily functions. An imbalance can affect your metabolism, energy level, weight, heart rate, mood, bowel movements, cholesterol levels, bone density, menstrual cycle, and many more.

Hypothyroidism is when your thyroid gland fails to produce the required amount of thyroid hormone. Over 60% with thyroid conditions are not even aware of having it. This is because most of the symptoms associated with hypothyroidism are similar to any common health issues you usually face daily.

So, how would you know whether you are suffering from hypothyroidism?

Signs of Hypothyroidism

Here are some of the symptoms of hypothyroidism that require an immediate visit to an Endocrinologist −

Your Weight has Gone up Dramatically

A significant and unexplained increase in weight could be a clear sign of an underactive thyroid or hyperthyroidism. In this condition, your thyroid gland cannot produce adequate thyroxine, causing your metabolism to slow down drastically, leading to unexpected weight gain.

Meanwhile, in hyperthyroidism or an overactive thyroid, your body produces more than the required amount of thyroxine. This puts your metabolism in overdrive, causing massive weight loss in a small timeframe.

Your skin and Hair have Become Dry, Coarse, and Scaly

In hypothyroidism, your skin tends to get dry, scaly, and pale because of dermal water content and mucopolysaccharides. It also increases your dermal carotene, resulting in prominent yellowing on the soles, palms, and nasolabial folds.

Excessive dry skin, especially on your hands, elbows, and feet, could signify hypothyroidism. It causes can also cause coarseness and brittleness in your hair. Hyperthyroidism, on the other hand, can make your skin appear moist and smooth. Your skin will quickly get flushed and red or have a bronzed appearance on the skin or cheeks.

Your Face Will Look Puffy 

A puffy face, including dry eyes, hair loss in eyebrows, and swelling around the eyes, could be linked to severe hypothyroidism, also known as myxoedema.

Hypothyroidism often progresses slowly, and it may take months or even years for patients to notice any symptoms. Facial puffiness often appears at the advanced stages of the condition or could arise when the patients stop taking their thyroid medication.

A puffy face in hypothyroidism often comes with other symptoms such as dry skin, hair thinning, fatigue, loss of energy, memory problems, depression, weight gain, extreme sensitivity to cold, muscle cramps, heavy or irregular menstruation, and depression.

Your Periods are Heavy, Absent, or Irregular

Hypothyroidism can cause anovulation, a condition where you may get heavy periods as it puts a brake on ovulation. The bleeding is caused due to disordered growth and shedding on the uterine lining, resulting in unexpected bouts and uterine bleeding.

The thinning of the uterine lining is caused due to a change in prolactin level, which arises when your pituitary glands change the way they are used to control the ovaries, which could also put a total brake on your period.

Women in their reproductive age may experience heavy, irregular, and absent periods due to hypothyroidism. 

You are Having Difficulty Conceive

Hypothyroidism can negatively affect your fertility and prevent ovaries from releasing the egg. All menstruating women release an egg from their ovaries each month. However, women with hypothyroidism release egg less frequently or no egg at all.

This is because the condition can interfere with embryo development, thereby increasing the chances of miscarriage. Pregnant women with untreated hypothyroidism need to get their condition treated. It could cause premature birth or cause congenital disabilities such as lower weight during delivery or lowered mental dexterity.

You Feel Too Much Cold

Under average thyroxine production, your cells produce 65% energy and 35% heat. The change in hormone levels confuses your body to have either too much energy or insufficient energy. This is why people with hypothyroidism struggle too much to stay warm, while with hyperthyroidism, one may experience excessive sensitivity to heat or sweat.


You are Always Tired

Hypothyroidism can make you restless, depressed, and tired by severely hampering your regular sleep pattern. This is because an underactive thyroid can change your body temperature drop, causing joint pain and muscle pain, which makes it harder for you to fall asleep. Hence, lack of proper sleep makes you tired and exhausted during the daytime.

Hypothyroidism: Causes

Hypothyroidism is primarily caused due to an inflammation of the thyroid gland. However, it can also be caused due to specific medical treatments, iodine deficiency, and many other factors.

Inflammation of the Thyroid Gland (Thyroiditis)

An inflammation in the thyroid gland can damage or destroy a large portion of the cells, making it impossible for them to produce enough hormones. The common cause of thyroid inflammation is caused by autoimmune thyroiditis, aka Hashimoto thyroiditis or Hashimoto's disease. This is a form of autoimmune disease where your immune system attacks your thyroid gland's healthy cells, causing inflammation.

Medical Treatments

Sometimes hypothyroidism occurs as a side-effect of taking certain medications or treatments. Some of these treatments address other thyroid disorders that induce hypothyroidism.

For instance, it can be caused when the patient is treated for thyroid conditions such as hyperthyroidism, thyroid cancer, or surgical removal of a nodule from the thyroid gland. A hyperthyroid treatment may drastically lower the thyroid hormone-producing cells, leading to an underactive thyroid.

Radioactive iodine treatment can also induce hypothyroidism, which is common while treating an overactive thyroid and goiters. The treatment aims to kill a specific section of the thyroid, preventing goiter growth. People with this treatment often end up with hypothyroidism within a year or two. 

Problem with the pituitary gland

You may experience hypothyroidism if the pituitary gland in your brain does not produce adequate thyroid stimulating hormone (TSH), which hinders the signals from your brain to the thyroid gland to make the hormone. 

Iodine Deficiency

Iodine is an essential element required to produce thyroid hormone, and since your body does not make iodine, you need to have it through your diet. Iodine deficiency can cause thyroid gland enlargement, hypothyroidism, and cause intellectual disabilities in infants and children.

Hypothyroidism due to iodine deficiency is not an issue in most countries. This is because iodine is readily available in most food contents and salts. However, many other parts of the world don't have enough iodine in their diet. Around thirty percent of the world's population is at risk of developing iodine deficiency.

Congenital Hypothyroidism

It is a condition where a person is born with abnormally low thyroid function. The condition resolves on its own in children (around 50%), while others must take lifelong treatment.

Hypothyroidism: Treatment

Treating hypothyroidism includes thyroid hormone medicine such as Levothyroxine (Levo-T, Synthroid, etc.) daily, taken by mouth. It helps return your hormone levels to their healthy range, allowing you to live a quality life.

You will start to feel better within 1-2 weeks of treatment. During the first 6 to 8 weeks, your endocrinologist will check your TSH levels to adjust the dosage. Then you may be asked for another TSH six months later.

Under the proper dosage, levothyroxine doesn't cause any side effects, but too much of it may cause tiredness, increased appetite, sleep issues, heart palpitations, and shakiness. If you experience any of these symptoms following the treatment, it indicates an overproduction of the hormone. That means you need to readjust your dosage.

Note − It is a lifelong treatment, and your endocrinologist will check your TSH levels yearly to adjust your dosage accordingly.

Updated on: 14-Feb-2023


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