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An underactive thyroid gland slows down many of the body's functions. The metabolism slows down, heart may beat slowly, muscles may weaken, cholesterol level may rise and there may be difficulty in thinking and remembering. Commonly hypothyroidism may present clinically as follows :

The signs and symptoms of hypothyroidism are often subtle and non-specific; hence overlooked or easily mistaken for other illnesses. All complaints need not be present in a given individual. If any of the manifestations are present, consult your doctor. Hypothyroidism can also occur in new born babies. This should be diagnosed as early as possible. If treatment is not started in time, development of brain of the child may be permanently affected and, may lead to mental retardation. Growth of the child is also hampered.

The simple, easy diagnostic test for hypothyroidism is estimation of TSH levels in the blood. If the TSH level is higher than the normal, it is likely to be hypothyroidism. The TSH test is the most valuable method of diagnosing hypothyroidism. Your doctor may also order tests like T3, T4, etc., if necessary.

• The treatment for hypothyroidism is with thyroid hormone replacement therapy.
• Treatment has to be continued life long. (Except a few cases where hypothyroidism is temporary e.g. after certain drugs or after infection or delivery).
• Your doctor may prescribe a synthetic thyroid hormone called thyroxine sodium. Treatment for hypothyroidism with thyroxine sodium should be individualised for each patient. It may take a few months to adjust the thyroxine dose.
• The dose of thyroxine sodium prescribed by your doctor must be taken daily in the morning on empty stomach preferably 30 minutes before breakfast (or otherwise, if specifically suggested by your doctor) because food interferes with the absorption of these tablets.
• Treatment should never be stopped or discontinued without medical advice.

Not taking the prescribed dose of thyroxine sodium regularly, can have adverse effects on various parts of the body, like heart, skin and hair, brain, muscles, reproductive organs. Hence it is important to take your medicine regularly.
Similarly, over treatment (too much of thyroid hormone) may cause irritability, weaker bones, heart problems (like increased heart beat)

If you take your medication correctly everyday, you should obtain relief from your symptoms within a matter of weeks. If symptoms persist, please consult your doctor, who may need to adjust your dose. Don't stop taking your medication because you feel better. If you stop taking it, you may initially feel fine, but then your symptoms are likely to recur.

Treatment of hypothyroidism with thyroxine sodium is safe and relatively simple. As long as you are alert to changes in your health, visit your doctor regularly, and most importantly, take your medication everyday without fail, you can keep hypothyroidism under control and lead a normal active life.

Please do not initiate treatment for hypothyroidism on your own. Consult your doctor, who will prescribe appropriate treatment and provide necessary advice. Should you have any queries regarding hypothyroidism and its treatment, or encounter any problem during therapy, seek medical advice.

1. Is hypothyroidism a lifelong disorder?
   In the majority of cases, hypothyroidism is indeed lifelong. It may be temporary in a few conditions (e.g. ingestion of certain drugs, delivery)
2. How is hypothyroidism treated?
   Treatment of hypothyroidism is replacement treatment i.e. the deficient thyroid hormone (thyroxine sodium) is replaced externally in tablet form.
3. Does the treatment have any side effect?
   Treatment replaces the natural hormone which is deficient in the body and is safe, if you take the right dose as advised by your doctor. Under treatment will cause inadequate replacement of the deficient thyroid hormone and hence symptoms persist. On the other hand, over treatment may cause irritability, tremors, fast and irregular heart beats . It is important to take the adequate dose of thyroid hormone regularly.
4. How soon after starting treatment will symptoms disappear?
   Certain symptoms like puffiness and weight generally improve in a couple of weeks. Thereafter, improvement in appetite and constipation occur. Some symptoms like hoarseness of voice, changes in hair and skin may require several months to disappear.
5. Does the diet have to be changed?
   Diet need not be changed. On the other hand, if you are suffering from some other diseases like diabetes or high blood pressure, appropriate modification of diet may be needed.
6. Can hypothyroid patients lead a normal married life?
   Hypothyroid patients who are properly treated can lead a normal sex life. In particular, hypothyroid women who are properly treated can have regular menstrual cycles, normal conception, pregnancy and delivery. There is no excessive risk of defects in newborn. The offsprings of hypothyroid individuals need not necessarily have thyroid disorders.
7. What happens if a hypothyroid patient becomes pregnant?
   The dose of thyroxine has to be adjusted during the period of pregnancy. Many patients may need an increasing dose. However the dosage adjustment should only be done by your doctor. As soon as you miss menstrual cycle get the pregnancy confirmed and contact your doctor as early as possible.
8. What if I am on other medication?
   If you are already taking any medication for some other disease, please inform your doctor about the same and he or she will give the necessary advice.