Thyroid underactive living patient overview

Overview

An underactive thyroid (hypothyroidism) means your thyroid gland does not make enough thyroid hormone. This hormone helps control your body's energy use, temperature, and many other functions.

Yes, it is one of the most common thyroid disorders, especially in women and people over 60.

It can affect anyone, but it is more common in women, people over 60, those with a family history, and people with certain autoimmune diseases (like type 1 diabetes).

Symptoms

Common symptoms

• Tiredness and lack of energy
• Weight gain (even with normal eating)
• Feeling cold more than usual
• Dry skin and hair
• Constipation
• Muscle aches and stiffness
• Depression or low mood
• Poor memory or trouble concentrating

Symptoms in children

• Slower growth and delayed puberty
• Poor school performance and trouble learning
• Tiredness and low energy

Symptoms in older adults

• Memory problems and confusion (can be mistaken for dementia)
• Falls and balance trouble
• Depression and withdrawal from activities

Causes

Main causes

• Autoimmune disease (Hashimoto's disease) – the body attacks the thyroid
• Previous treatment for an overactive thyroid (radioactive iodine or surgery)
• Thyroiditis (inflammation of the thyroid)
• Certain medications (like lithium)
• Iodine deficiency (rare in developed countries)

Risk factors

• Being female
• Age over 60
• Family history of thyroid problems
• Having another autoimmune condition (like type 1 diabetes or celiac disease)
• Previous thyroid surgery or radiation to the neck

When to see a doctor

See a doctor urgently if:

• If you have chest pain, trouble breathing, or severe confusion

Book a routine appointment if:

• If you have mild symptoms like tiredness, weight gain, feeling cold, or dry skin
• If you have a family history of thyroid problems and are feeling unwell

Diagnosis

Your doctor will ask about your symptoms and order a simple blood test to check your thyroid hormone levels.

Tests that may be done

• Blood test for TSH (thyroid-stimulating hormone)
• Blood test for thyroid hormone (T4)
• Sometimes an antibody test to check for an autoimmune cause

What to expect at your appointment

The blood test is quick and usually done at a local clinic or hospital. Your doctor will explain the results and work with you to decide the best treatment if needed.

Treatment

The main treatment is taking a daily synthetic thyroid hormone tablet to replace what your body is missing. Your doctor will start you on a low dose and adjust it based on your blood tests.

Self-care at home

• Take your medication at the same time every day, usually in the morning on an empty stomach
• Do not skip doses – set a reminder if needed
• Have regular blood tests as your doctor advises
• Tell your doctor if you start any new medications (they can affect thyroid hormone levels)

Medical treatments

Your doctor will prescribe a thyroid hormone replacement tablet. The dose is tailored to you and adjusted slowly based on blood test results. Regular monitoring (usually every few months at first, then yearly) helps keep your levels in the normal range.

When is surgery considered?

Surgery is not used to treat an underactive thyroid. If you have had thyroid surgery for another reason, you may already be taking hormone replacement.

Living with this condition

Most people with an underactive thyroid lead normal, active lives. It may take a few weeks to get the right dose of medication. You will have regular check-ups to monitor your levels and adjust treatment as needed.

Lifestyle tips

• Take your medication every day as prescribed
• Eat a balanced diet with plenty of fruits, vegetables, and whole grains
• Exercise regularly to help manage weight and boost energy
• Avoid taking your medication with high-fibre foods or soy products – wait at least 30 minutes before eating

Diet and exercise

A healthy diet and regular physical activity are important for overall health. They can help manage weight, improve energy, and reduce the risk of heart disease. Talk to your doctor before starting a new exercise routine.

Mental health and emotional wellbeing

An underactive thyroid can cause low mood, depression, or anxiety. These feelings often improve once treatment starts and levels are normal. If you continue to feel down, talk to your doctor – support is available.

Prevention

In most cases, underactive thyroid cannot be prevented because it is caused by your immune system. However, if you are at risk (e.g., family history), regular blood tests can catch it early.

Complications

If left untreated

• High cholesterol and increased risk of heart disease
• Infertility or problems during pregnancy
• Peripheral neuropathy (nerve damage causing tingling or pain)
• Rarely, myxedema coma – a dangerous condition with severe confusion and low body temperature

Long-term outlook

With proper treatment, most people with an underactive thyroid feel much better and can manage the condition well. Regular blood tests and medication adjustments help keep your levels normal and prevent complications. Most people live a full, healthy life.

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