Is It Your Thyroid?

Hypothyroidism refers to a condition where the thyroid gland cannot produce thyroid hormone. The most common cause of hypothyroidism is Hashimoto’s thyroiditis. Hashimoto’s is  an autoimmune disease that leads to inflammation and eventual destruction of the thyroid gland. Patients with underactive thyroid often complain of fatigue, brain fog, intolerance to cold, constipation and weight gain.

 At first glance, treatment of hypothyroidism appears straightforward. You are low on thyroid hormone, so we give thyroid hormone back. Normal, healthy thyroid makes 2 hormones, a lot of T4, a little of T3, and then T4 will convert to T3. Typically, we give patients synthetic T4, the generic drug, levothyroxine. For many patients, this is a simple and effective treatment.

 Unfortunately, studies show that at least 15% of patients with Hashimoto’s have persistent symptoms despite being on therapy. So what is going on? There are several possibilities. Sometimes, the numbers are technically normal, but not optimized, and a small tweak can have a surprising amount of benefit on symptoms. Other times, patients benefit from a change to brand name therapy for better dosing consistency. Others find improved energy and clarity by adding on liothyronine (T3).

If none of these changes help, just a reminder, it may not be your thyroid! At the end of the day, symptoms of hypothyroidism are nonspecific, fatigue, brain fog, weight gain can have many causes. If you find that you are making numerous changes in your thyroid medications without any improvement in your symptoms, it is worth exploring other causes for what you are feeling.

Find a doctor that will listen and take the time to formulate a treatment plan that will help you feel better.