If you have a mildly underactive thyroid called subclinical hypothyroidism , you may not need any treatment. If you develop symptoms, your GP may suggest that you start having treatment. Your doctor may prescribe you a hormone replacement medicine called levothyroxine thyroxine. You take this once a day as a tablet. Usually, you start by taking a small amount of levothyroxine and this is gradually increased until your level of thyroid-stimulating hormone returns to normal.
Your GP will take a blood sample every four to six weeks and then change the amount, depending on the results.
It can take a while for your hormone levels to get back to normal, so it may be a few months until you start to feel better. In the UK, the most common cause of an underactive thyroid is autoimmune thyroiditis, which is known as Hashimoto's thyroiditis. This is when your immune system attacks your thyroid gland, damaging it and stopping it producing enough thyroid hormone. Radiotherapy for thyroid cancer can also lead to an underactive thyroid. The symptoms of an underactive thyroid, such as physical and mental tiredness and lack of energy, can have a serious effect on your day-to-day life. You may find that your quality of life suffers and it affects things like your work life, relationships and social life, for example.
It can also lead to miscarriage. You may worry about gaining weight, as this can happen with an underactive thyroid, but speak to your doctor about this. You can also find out more about weight after treatment in our frequently asked question FAQ below: Will I lose weight when I start treatment? Treatment for underactive thyroid raises the levels of thyroid hormone in your body. Most people make a full recovery and feel completely better once their hormone levels get back to normal. Around one in every 20 people with an underactive thyroid will still have some symptoms, even though their hormone levels are normal.
If this happens, your GP may arrange for you to have further tests to see whether something else is causing your symptoms. Later on in your pregnancy, low thyroid hormone levels can cause complications such as pre-eclampsia and heart problems. Your doctor may need to increase the amount of levothyroxine you take. After your baby is born, the amount you need to take should go down again. One of the main symptoms of an underactive thyroid is that you put on weight, even though you may feel less like eating.
There are only a small number of research studies that have looked at weight in people who have an underactive thyroid. See Related information for tips and advice on healthy eating and exercise. If your weight changes a lot, see your doctor. They may need to change the amount of levothyroxine you take. Doctors usually call this subclinical hypothyroidism. As many as one in 10 people have borderline underactive thyroid, and the likelihood of developing it goes up as you get older.
This is because you may be more likely to develop an underactive thyroid that needs treatment in the future. Whether you have treatment or not, your doctor will do regular blood tests to check your thyroid hormone levels. At Bupa we produce a wealth of free health information for you and your family. We believe that trustworthy information is essential in helping you make better decisions about your health and care. Look out for the quality marks on our pages below. If you have an overactive thyroid hyperthyroidism , it means your thyroid gland is making too much thyroid hormone.
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And if there's a question you want to ask that hasn't been answered here, please submit it to us. This information was published by Bupa's Health Content Team and is based on reputable sources of medical evidence. It has been reviewed by appropriate medical or clinical professionals. Photos are only for illustrative purposes and do not reflect every presentation of a condition.
The information contained on this page and in any third party websites referred to on this page is not intended nor implied to be a substitute for professional medical advice nor is it intended to be for medical diagnosis or treatment. Third party websites are not owned or controlled by Bupa and any individual may be able to access and post messages on them.
Underactive thyroid (hypothyroidism)
Bupa is not responsible for the content or availability of these third party websites. We do not accept advertising on this page. For more details on how we produce our content and its sources, visit the 'About our health information' section. Back to top Menu. About underactive thyroid Your thyroid gland is in your neck, in front of your windpipe. Symptoms of underactive thyroid Symptoms of an underactive thyroid can develop slowly and gradually.
If you do get underactive thyroid symptoms, the main ones include: putting on weight less of an appetite to eat feeling the cold dry skin feeling weak and tired and having no energy a puffy face stiff muscles losing your hair — this is usually all of your hair rather than patches and usually goes away once you get treatment for an underactive thyroid slowing down, mentally and physically a hoarse voice constipation a feeling of something being stuck in your throat a slow heart beat in women, irregular periods Having an underactive thyroid can affect your mental health too.
If you have any of these symptoms, see your GP. Need a GP appointment?
Underactive thyroid (hypothyroidism) | Health Information | Bupa UK
Diagnosis of underactive thyroid Your GP will ask about your symptoms and examine you. The main hormones measured in blood tests are: TSH — thyroid-stimulating hormone — a normal reading is in the range of 0. It may be discovered as a result of blood tests for another autoimmune disorder or because there is a history of thyroid disorders in the family.
A blood test result showing a slightly raised TSH level with a normal FT4 level indicates that you may have mild thyroid failure, also known as subclinical hypothyroidism, and that you may have an increased risk of eventually developing hypothyroidism.
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You should have a regular thyroid function test and consult your doctor if you notice any symptoms, as you may benefit from treatment. Your doctor will prescribe levothyroxine, a synthetic version of the thyroxine produced by the thyroid gland. Levothyroxine is very pure, and has negligible side-effects when taken in the correct dose. Most patients require between and mcg a day, but the dose can be lower than 75mcg or up to mcg a day, depending on your needs. If you have severe hypothyroidism or are at risk of heart problems you can expect your doctor to start cautiously and increase the dose gradually.
Patience is needed as it can take several months before you feel better and for the thyroid function tests to return to normal or be judged satisfactory by your doctor. During this period you will have regular thyroid function tests, usually every six to eight weeks, and your dose may need to be adjusted according to the results of the tests. Levothyroxine is best taken in the morning, with water, on an empty stomach, at least half an hour before eating and drinking anything.
It is also best taken at least four hours apart from calcium, iron, cholesterol-lowering drugs cholestyramine, colestipol , and multivitamin tablets, as these too can decrease absorption. Grapefruit on the other hand is known to increase the absorption of levothyroxine as it increases acidity in the stomach. There are a number of other drugs that interact with levothyroxine.
Always check with your doctor or pharmacy if you are on any other prescription or over the counter medication. It is easy to miss a levothyroxine tablet, but because your body has a big reservoir of thyroxine, you will not notice a difference. However, it is important to take the tablets consistently every day as this can affect your blood test results and your health. Try and devise a system to help you take them every day.
Once the correct dose has been established it is unlikely to vary, although it is still important to have a blood test each year just to make sure. Too much levothyroxine will cause symptoms of an overactive thyroid and too little levothyroxine will not completely resolve symptoms of an underactive thyroid.
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The correct dose of levothyroxine is one that restores good health. In most patients this will be associated with a thyroid-stimulating hormone TSH reading in the lower part of the reference range and a level of thyroxine T4 in the blood towards the upper part or even slightly above the reference range. Some patients treated with levothyroxine have persistent complaints despite serum TSH readings in the reference range.
Combination therapy of levothyroxine and tri-iodothyronine LT4 and LT3 may be considered as an experimental approach under the supervision of an accredited endocrinologist but LT3 is not always available on the NHS. Levothyroxine is produced by several manufacturers and your pharmacy may not always give you the same brand; most people will not be aware of any difference between brands.
Very rarely people may feel less well with certain brands of levothyroxine. The reason for this is not clear but might relate to differences in fillers and bulking agents between the various brands of tablets. If this is the case, you should discuss this with your doctor, as some may agree to prescribe a consistent brand of levothyroxine. If you are planning a pregnancy you should let your doctor know and ideally have a blood test before you conceive.
As soon as you know you are pregnant, and if you are already taking levothyroxine, it is recommended that the dosage is increased immediately by mcg daily. You should then arrange to have a thyroid function test as soon as possible.