Dr. M.J. Bazos, Patient Handout
HYPOTHYROIDISM

About Your Diagnosis
Hypothyroidism is the lack of normal thyroid hormone production. It may occur at any age and is screened for in all newborns. Hypothyroidism may be caused by birth defects, viruses, or autoimmune diseases. Often hypothyroidism results from the treatment of hyperthyroidism after the abnormal thyroid gland is removed by surgery, or after it is treated with radioactive iodine (especially for Graves’ disease). It is not contagious but may affect an unborn child if the pregnant mother does not produce adequate thyroid hormone. It is very easily treated by the use of synthetic thyroid tablets, and the effectiveness of these tablets can be easily checked by blood tests.

Living With Your Diagnosis
Because thyroid hormone controls the energy use and general activity of all the body’s organs, low thyroid has many signs and symptoms. Patients may feel tired, sluggish, depressed, weak, and gain weight. They may retain fluid, have slowed heartbeats, and even slowing of the bowel movements. Skin and hair may be coarse. In infancy and childhood, slow growth and poor mental development occur. Prolonged hypothyroidism can result in heart failure, poor growth, mental retardation (in infants), and severe swelling of the hands and feet. All of these symptoms can be prevented and treated if proper thyroid replacement therapy is used.

Treatment
The best, and only, treatment for hypothyroidism is replacement of thyroid hormone. Many years ago, animal thyroid was used for this purpose; however, synthetic thyroid hormone is now available. It is inexpensive, very effective, and available in a wide range of doses to allow accurate dosing for each patient. The dose should be taken daily because the body needs a new supply each day. Your doctor can test your blood to determine the right dose for you. With the proper dosage, there are no side effects from synthetic thyroid hormone. At doses that are too high, you may have palpitations, nervousness, shakiness, bone loss, and increased bowel movements. These symptoms should prompt blood tests to check the need for a change in dose.
The DOs
• Take your medication daily because it is used and removed from the bloodstream daily.
• Follow a low-fat, low-cholesterol diet with close attention to maintaining a reasonable weight. One complication of hypothyroidism is increased cholesterol in the blood. In some cases, this may be completely corrected with the proper diet and an adequate thyroid replacement dose. Your doctor will check a fasting cholesterol level periodically to monitor your need for other cholesterol therapy.
• See your doctor as recommended. Remember, if you have Graves’ disease, you will still need to see your ophthalmologist (eye doctor) on a regular basis, even though your thyroid has been controlled.
• Exercise daily; 20–30 minutes per day of moderate exercise, if approved by your doctor, will help to control your weight and your cholesterol levels. If you have not previously exercised, your doctor may have you undergo a stress treadmill test first, to see how much exercise you can safely undertake.

The DON’Ts
• Don’t skip your thyroid medicine because you feel well. Serious, life-threatening complications such as heart failure may begin slowly and without warning.
• Don’t increase your dose unless told to by your doctor, because you may cause bone loss, heart rhythm disturbances, or other side effects.
• Don’t forget to have your thyroid hormone levels checked periodically, even if you are feeling fine. Your needs may change over time with changes in weight and age, and your doctor will change your thyroid dose accordingly.

When to Call Your Doctor
• You gain weight, retain fluid, or feel depressed.
• You have palpitations, tremor, or nervousness.
• Your vision is blurred or you have eye pain.
• You are short of breath.