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Hypothyroidism

One daily pill, one blood test every few months, and most people feel like themselves again.

Hypothyroidism means the thyroid gland produces too little thyroid hormone. Most cases are autoimmune (Hashimoto's). Symptoms are nonspecific but highly suggestive when combined. Treatment with levothyroxine is straightforward.

Causes & risk factors

  • Hashimoto's thyroiditis (most common)
  • Iodine deficiency
  • Post-radiation or post-thyroidectomy
  • Certain medications (lithium, amiodarone)
  • Congenital hypothyroidism

Symptoms

  • Fatigue
  • Weight gain
  • Cold intolerance
  • Dry skin and hair thinning
  • Constipation
  • Heavy periods
  • Low mood or brain fog

How it's diagnosed

  • TSH — the first and most sensitive test
  • Free T4 — confirms diagnosis
  • TPO antibodies — confirms autoimmune cause
  • Ultrasound if nodules palpable

Evidence-based treatment

  • Daily levothyroxine on empty stomach
  • Start low, titrate every 6-8 weeks
  • Retest TSH once stable
  • Separate from calcium, iron, and food by 30-60 minutes

Related symptoms

Hypothyroidism — FAQ

Is hypothyroidism lifelong?

Usually yes, especially with autoimmune cause. Temporary forms exist (post-viral thyroiditis, post-partum) and resolve within a year.

Do natural thyroid supplements work?

Synthetic levothyroxine is the standard of care and the only form reliably shown to normalise thyroid function. Desiccated thyroid has a small role in specific cases under specialist care.