Thursday, 5 April 2012

The basics

Hypothyroidism is often undiagnosed, misunderstood and treated lightly. This is despite the fact it can lead to other health issues such as diabetes, cancer and heart failure if left untreated.

The thyroid is a gland situated at the base of the neck. It controls energy and metabolism. It produces the hormones T4 (80%) and T3 (20%). Most of the T4 is converted to T3 because T3 is the active, stronger hormone. The hormones are used by every single cell in the body. So if the thyroid produces too little or too many of these hormones, you really, really notice! It affects every single aspect of your health.

When someone is hypothyroid they have an underactive thyroid, which means not enough hormones are being produced. The leading cause is Hashimoto's thyroiditis. Hashimoto's is an autoimmune disease which attacks the thyroid, eventually causing its total destruction. During the attacking stage of the disease, it's not uncommon for a person's condition to cycle between hypothyroidism and hyperthyroidism (overactive thyroid). The disease can be triggered by hormonal changes like those associated with menopause, childbirth and puberty. Environmental triggers like BPA and cigarette smoke can also set the disease off. The disease tends to run in families.

The most common early symptoms people have when they are hypothyroid are fatigue, hair loss and depression. Your body feels like a car trying to run on empty. A doctor will do a TSH test to evaluate thyroid function. TSH is a hormone produced by the pituitary gland to stimulate the thyroid into producing correct amounts of hormone by 'knocking' on the thyroid's door. In hypothyroidism, the TSH will knock and knock and the blood test must show a sufficiently high result in order to be diagnosed.

Standard treatment is with thyroxine. This is a synthetic T4 hormone medication and is taken daily in tablet form. The dose is normally adjusted every 4-6 weeks until blood results indicate the hormones (or more often, just the TSH...) are within normal range. Ideally, free T4 and free T3 levels should be tested along with the TSH. Most people report feeling their best when their TSH is between 0-1 and the T4 and T3 are in the upper quarter of their ranges.

The medication is taken for life and should control symptoms. Many people do fine on the standard treatment but for a significant number, standard treatment doesn't work, only partially works or stops working. They still have hypothyroid symptoms despite 'normal' lab results. Or their original TSH test will be 'normal' despite them having hypothyroid symptoms. This is where things get tricky and patients find themselves battling a tide of medical ignorance...


  1. bravo for starting this blog Jess, I like "the basics" it's a good place to start with your story. And thank you for visiting mine and commenting on my latest post, it's so great to connect with other thyroid patients, together we will make a difference, for ourselves and others in similar situations!!

  2. Hi Jess~ So happy to connect with you and share experiences with you! This is a great post - it would really be a wonderful way to explain to someone what hypothyroidism is. I am looking forward to reading more. By the way, your blog design is really cute!

  3. Hello Jess,
    Thank you so much for visiting my blog. You have put a lot of great information in this post. I think it's important that we all understand what is happening to us. It really irritates me that the known "standard" way to treat Hashimoto's, Graves, Hypo or Hyperthyroidism is not helping a number of people and the medical field is isn't doing anything to improve. I look forward to reading more of your post.

  4. Hi

    I am so glad that there is some help for us. I have an under active thyroid caused by autoimmune disease. Is this Hashimoto's? I feel awful at the moment and have been told my TSH is normal at 2.76. Am going for more blood tests on Wednesday have no idea what he is testing me for. He made a comment of informing me that I was just depressed that's why I am so tired. Living in the dark ages here it seems!

    I have lived with this for 6 years and when I challenge the Doctor he makes me feel like an idiot. Any advice please.


  5. Hey Vicky, yes it sounds like you have Hashimoto's. A TSH of 2.76 is not normal! It should ideally be between 0-1. I've had doctors offer me anti-depressants too but they won't solve the underlying issues! Don't let anyone make you feel small - you know your own body best. Please email me; I'd love to have a chat - jess-s(at)


  6. Good work on the blog, I have a rollercoaster up and down TSH, currently at TSH 6.6, and working towards nailing down the right amount to get it down, good points about the range, some forms show a range of .3-5.5 which I find way too broad in spectrum, also working on finding perfect time to take it, not take vitamins or anything when I first take the synthroid, obtain the name brand and not random generics. Will know more in about 5 weeks. Do you take it same time every day, what dose are you on, do you think UK and US practices are similar in treatment methods, they seem to be pill pushing in US as well.

  7. Very nice post, impressive. its quite different from other posts. Thanks for sharing.

    Toshiba PVT-375BT

  8. Nice message with lots of information included in the posting.Please find our link
    if you may be interested in ,please refer to
    Hematologist Mailing list & Email list