Diabetes & Endocrinology
Weight change, fatigue, hair fall, irregular periods and low mood are all attributed to stress and lifestyle. In a substantial number of people, a single blood test explains all of them.
The thyroid is a small butterfly-shaped gland at the front of the neck that sets the body's metabolic rate. Too little hormone and everything slows — heart rate, digestion, thought, temperature regulation. Too much and everything accelerates.
Because the gland influences nearly every organ, its symptoms are vague and easily attributed to something else. That is why thyroid disease is both common and commonly missed.
A TSH test is the screening investigation, with free T4 and free T3 added when TSH is abnormal. Fasting is not required, though testing in the morning gives the most consistent results. Certain supplements, particularly high-dose biotin, interfere with the assay and should be stopped a few days before.
Testing is worthwhile if you have the symptoms above, a family history of thyroid disease, another autoimmune condition, unexplained infertility or recurrent miscarriage, or a neck swelling. All pregnant women should be tested, since untreated hypothyroidism in early pregnancy affects the baby's brain development.
Hypothyroidism is treated with a daily thyroid hormone tablet, taken on an empty stomach with water, at least thirty to sixty minutes before food, and separated by four hours from calcium and iron supplements. The dose is adjusted based on TSH, checked six to eight weeks after any change and then annually once stable.
Treatment is usually lifelong, and it works well. Once the dose is correct, symptoms resolve and there is no restriction on diet, exercise, pregnancy or anything else. Hyperthyroidism has more options — medication, radioactive iodine or surgery — chosen according to the cause.
Do not change brands of thyroid tablets casually, and do not stop the tablet when you feel better. Both cause the level to drift, and it takes weeks to notice.
This article is general health education written and reviewed by the Department of General Medicine at SIMS. It is not a substitute for an examination, a diagnosis or the advice of your own treating doctor, and it cannot account for your history, medicines or reports. If a symptom is sudden or severe — chest pain, stroke symptoms, breathing difficulty, serious injury, seizures or heavy bleeding — call 9281862028 or come straight to the emergency department instead of reading further.
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