Medication best treatment for hypothyroidism

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Q: I was just diagnosed with hypothyroidism. How is it treated?

A: Hypothyroidism is a fairly common disorder in which the thyroid does not produce enough hormones to regulate metabolism.

About 2 to 10 percent of the population have it, with women five to eight times more likely than men to be diagnosed.

It seems to be genetically related. Even more prevalent is subclinical hypothyroidism, a type of hypothyroidism that has no symptoms.

Hypothyroidism is usually treated with thyroid replacement medication, which your primary care provider can prescribe.

Symptoms related to hypothyroidism are, unfortunately, vague and non-specific.

For example, most patients with hypothyroidism will complain of fatigue, constipation and weight gain.

Some more specific symptoms could be hair loss, menstrual irregularities, and very dry skin, but these symptoms could be related to other issues.

A serious consequence of not being treated for hypothyroidism is that it could turn into a syndrome called myxedema coma. It can leave you in a coma and affect your heart and respiratory system.

Other potential consequences include elevated blood pressure or elevated cholesterol, an enlarged heart resulting in heart failure, damage to nerves, depression and infertility.

To diagnose hypothyroidism, your doctor will order a blood test that checks your levels of thyroid stimulating hormone (TSH) and the free thyroxine (free T4).

If the TSH is high and the free T4 is low, despite any symptoms, the diagnosis of hypothyroidism is confirmed.

If the TSH is slightly elevated with normal free T4, this could indicate subclinical hypothyroidism, which might become overt hypothyroidism in the future.

If the diagnosis is questionable, a thyroid antibody might be ordered. A positive result would require treatment for hypothyroidism.

Often, hypothyroidism occurs as an autoimmune attack on the thyroid. The thyroid antibody test is helpful is diagnosing Hashimoto's thyroiditis, the most common cause of hypothyroidism.

Treatment of hypothyroidism is simple: thyroid replacement medication. Typically, your provider will prescribe daily synthetic thyroxine, known as generic levothyroxine, or Synthroid.

Another option is porcine (pig) thyroid, or Armour Thyroid.

Levothyroxine is usually easier to regulate than Armour Thyroid, but some patients might respond better to one drug versus the other.

Treatment for true overt hypothyroidism is absolutely necessary.

Universally screening for hypothyroidism is controvestial, so discuss with your physician whether or not you should be screened.

Dr. William E. Kyle is an internal medicine physician at Memorial Health University Physicians - Legacy Center in Okatie.

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