If you present to your doctor with symptoms like weight gain, cold sensitivity, dry skin, or unbearable fatigue, they might test you for hypothyroidism - an underactive thyroid gland.
Many labs look only at thyroid-stimulating hormone (TSH) to assess thyroid health. We believe it's critical to also measure free triiodothyronine (fT3), free thyroxine (fT4), and TPO antibodies.
Once you've received a diagnosis, you can focus on treating your condition and managing your symptoms. Borrow this list of questions to guide your consultation and make the most of the time with your doctor:
Questions to ask your doctor about hypothyroidism
1. What caused my hypothyroidism?
There are several possible causes for hypothyroidism:
- Previous thyroid disease that involved surgery or radiation to your thyroid gland
- Autoimmune disease like Hashimoto's disease — a condition in which your immune system attacks your thyroid gland
- Certain medicines can contribute to hypothyroidism
- Failure of the pituitary gland is an infrequent cause of hypothyroidism
- Some women develop hypothyroidism during or after pregnancy due to the metabolic demands of pregnancy
- Nutritional deficiencies can impact thyroid hormone production
Ask your doctor to help you determine your root cause.
2. What treatment do I need?
Doctors typically treat hypothyroidism with a human-made thyroid hormone replacement. Often, treatment for thyroid replacement starts with T4-only formulations, assuming that the body can successfully convert T4 to T3 on its own.
If your body struggles with the conversion, or you take interfering medication, standard T4 medicines may not be sufficient for you, and the addition of human-made T3 may be of benefit.
Those who are interested in a more natural approach may prefer combination therapies. There are two main types of combination thyroid medications - desiccated and compounded.
When choosing thyroid medication, remember that there is no one-size-fits-all treatment, and it's essential to work with your doctor to find a treatment plan that's right for you.
3. How will you figure out my dose?
Each of us is unique with individual sensitivities, so our bodies will not all react that same way to a specific medication or dosage. Your doctor will determine your medication dosage based on your weight, age, symptoms, and any other conditions you have.
Finding the right treatment and dosage can be tricky, so work with your doctor until you find what's best for you.
When you begin a new medication, you should test your thyroid every four to six weeks and adjust as needed until your levels are stable. Once your levels are stable and you feel good, you should test your thyroid every four to six months to make sure you're still on the right dose.
4. How often will I need to take this medication?
Most people take their thyroid hormone replacement daily for the rest of their lives. Dosage may change over time. Work with your doctor for specific recommendations.
Find out which Paloma thyroid doctor is right for you:
5. How do I take my medication?
Your doctor will likely suggest that you take your medication at the same time each day. It's usually recommended to take your medication four hours before or after taking any medicines, food, or supplements that can interfere with the absorption of the thyroid hormone.
Swallow your pill with any liquid other than soy milk, grapefruit juice, or coffee. Most T4 formulations, except Tirosint, can be crushed and dissolved in water for administration.
6. So, which drugs or food might interact with my medication?
Some foods or medicines may prevent your body from fully absorbing your thyroid medication. Talk to you doctor to learn how long you should wait to take any of the following after you've administered your daily thyroid medicine:
- Vitamins or supplements containing iron or calcium
- Soy foods
- Antacids containing aluminum hydroxide
- Birth control pills
- Antiseizure drugs or antidepressants
- Cholesterol-lowering drugs
- Cholestyramine
7. What if I miss a dose?
Life happens! If you miss a dose, take it as soon as you remember. If it's nearly time for your next dose, skip the missed dose and go back to your regular schedule. If you miss more than a few doses, talk to your doctor.
8. Can I switch to a different medication?
Several different brand names and generic version of thyroid hormone replacement are available. If you do switch medications, under the supervision of your doctor, it's important to retest your thyroid every four to six weeks and adjust your dosage, again, under the supervision of your doctor, as needed, until your levels are stable.
9. What side effects might I experience?
When taking thyroid hormone in the recommended dose, you shouldn't experience many side effects. In more significant amounts, you may experience:
- Difficulty sleeping
- Pounding heart
- Shakiness
- Increased appetite
Ask your doctor which side effects are severe enough to schedule a consultation. You can use Paloma's in-app chat feature to talk directly with your doctor.
10. What changes should I make to my lifestyle?
The more dietary stress you put on yourself, the more likely you are to experience inflammation that can interfere with your thyroid function. Work with your care team to identify dietary triggers and reverse nutritional deficiencies.
11. What health problems can hypothyroidism cause?
Untreated thyroid disease puts you at risk for other ailments, such as heart diseases, osteoporosis, and infertility.
12. What kind of exercise can I do?
Some symptoms of hypothyroidism may make exercise feel uncomfortable. However, when practiced safely, many forms of exercise can benefit thyroid health. Talk to your doctor about a movement plan that feels good for you.
