Slow Thyroid – Separating Truth from Myth

by Patricia D. Cherasard PA-C, MBA
Chief Bariatric Surgical Physician Assistant
NYU Langone Long Island Surgical Associates, PC

You’ve been diagnosed with a Slow or Underactive Thyroid (aka hypothyroidism). What does that mean? It means your thyroid gland is not making enough thyroid hormones. Low Thyroid hormone levels can make you feel tired and weak. Untreated it can cause lasting effects to your whole body. Slow thyroid comes with many generalized symptoms that are often mistaken for other conditions such as aging and menopause. It typically affects middle-aged more than younger adults and women more than men.

What is a Thyroid Gland?

The Thyroid is a butterfly shaped gland located in the front of your neck. It makes hormones that control the way your body uses energy by secreting thyroid hormone into your blood. Thyroid hormone is largely responsible for metabolism and heart rate. Because the thyroid can affect so many parts of the body, it is always good to check for thyroid problems when you have unexplained or generalized symptoms like fatigue, tiredness or weight gain.

What to do next?

The good news is that accurate thyroid functions tests are available to diagnosis and treat an underactive thyroid. You will likely be referred to an endocrinologist who will be able to tailor a treatment plan to your particular circumstances by prescribing hormone treatments. When hypothyroidism isn’t treated, signs and symptoms can gradually become more severe. Constant stimulation of your thyroid gland to release more hormones may lead to an enlarged thyroid (known as a goiter).

What are the signs and symptoms of hypothyroidism?

Signs and symptoms can vary, depending on the severity of the hormone deficiency. The most common warning signs are:

• Fatigue
• Increased sensitivity to cold
• Constipation
• Dry skin
• Unexplained weight gain
• A puffy face
• Hoarseness
• Muscle weakness
• Elevated blood cholesterol
• Muscle aches, tenderness and stiffness
• Joint pain and swelling
• Irregular menstrual periods
• Thinning hair
• Slowed heart rate
• Depression
• Impaired memory

What are the causes of an underactive thyroid?

There can be a number of causes, including:

• Autoimmune disease, where the body begins to attack itself through the immune system. This is commonly known as Hashimoto’s thyroiditis and can be debilitating
• Congenital disease – some babies are born with an underactive or missing thyroid
• Pituitary disorder – the pituitary gland in the brain
• Pregnancy – postpartum hypothyroidism can be the result of the body producing
• Iodine deficiency – Iodine is an important nutrient in thyroid function
• Treatment of hyperthyroidism – if your body overreacts to the treatment of an OVERactive thyroid
• Radiation therapy, usually as a result of cancer treatment that can affect your sensitive thyroid gland
• Thyroid surgery which can reduce production of thyroid hormone
• Medications such as lithium, which is typically used to help treat psychiatric problems

What about weight gain/loss?

Many hypothyroid patients struggle with an inability to lose weight. If weight gain occurs with onset of symptoms, then with successful treatment the patient should experience some weight loss.

You are taking your meds regularly, but the weight doesn’t come off!

Slow thyroid may not be the only reason for your weight gain. Change in your metabolism, insulin resistance, and increased cortisol levels from stress can also be attributed to weight gain. Your medical team will be able to run test to determine if any other issues may be at play.

By taking proper hormone replacement medications, following a diet of healthy food choices, performing regular exercise and maintaining an overall healthy lifestyle, you can jumpstart a successful weight loss regimen.

The first step toward understanding what can be done about an underactive thyroid requires a consultation with a qualified specialist like the ones at NYU Langone Long Island Surgical Associates. Together with your doctor, you can make the decisions that are best for you individual condition.