Q: I have been diagnosed with hypothyroidism for approximately 20 years. I take generic Synthroid. My numbers are always within normal limits but I still have the symptoms of hypothyroidism. As a matter of fact, I feel like they are getting worse. My biggest complaint is hair loss but I am also experiencing cold hands and feet, constipation, and tiredness. I go to the doctor to check my levels twice a year and my prescription has not changed. What do you think?
A: The thyroid is a butterfly-shaped gland located at the base of the neck in the front. The hormones produced by the gland are triodothyronine, better known as T3, and thyroxine, better known as T4. Hypothyroidism (an under-active thyroid) is a condition in which they thyroid gland fails to produce sufficient specific hormones which disrupts the normal balance of chemical reactions within the body. Left untreated, it can cause obesity, heart disease, joint pain and infertility. As you have discovered, at least until recently, treatment with synthetic thyroid hormone such as the Synthroid you are taking, is commonly an easy fix.
When left untreated, the gland can enlarge and is referred to as a goiter. A goiter can interfere with the acts of breathing and swallowing. There is an increased risk of developing cardiac issues because high LDL cholesterol levels can occur in those with an under-active thyroid. Damage to the peripheral nerves can cause peripheral neuropathy that causes a tingling sensation and pain in the area affected by nerve damage. Long-term untreated hypothyroidism can result in a condition referred to as myxedema that can advance to lethargy, extreme intolerance to cold, and more.
While anyone of any age can develop hypothyroidism, those at increased risk include having an autoimmune disorder such as Hashimoto’s thyroiditis, being female over the age of 60, having been treated with radioactive iodine or anti-thyroid drugs, and having received radiation to the neck and upper chest areas, and more. Symptoms are generally slow starting and occur over time; however as metabolism slows, a person with hypothyroidism may experienced an unexplained weight gain, muscle weakness and pain, stiff joints, constipation, an increased sensitivity to cold, thinning hair, memory loss, depression, and more. Diagnosis can be made through laboratory testing that includes a T3, T4 and TSH. If abnormalities are detected, a physician can diagnose the condition, prescribe medication, and have an individual on the road to recovery. Medication taken orally will restore hormone levels and reverse any symptoms.
Levothyroxine, the active ingredient in the Synthroid you are taking, is generally well-tolerated. However, it can cause unwanted effects that may include extreme fatigue, chest pain, labored breathing, sweating, nausea, fever, chest tightness, and more. Less commonly, hair loss can result. So, you can be losing your hair from your hypothyroidism and it can be exacerbated by the very medication you are taking to stabilize your hypothyroidism.
Because your medication doesn’t appear to be controlling your symptoms, I recommend you return to your prescribing physician and share your concerns. Perhaps an adjustment in your medication, a brief respite from it, or conversion to another brand may be appropriate. Another option is to request a second opinion with an endocrimologist.
Readers who would like related information can order Dr. Gott’s Health Report “Thyroid Disorders” by sending a self-addressed, stamped number 10 envelope and a $2 US check or money order to Peter H. Gott, MD Health Reports, PO Box 433, Lakeville, CT 06039. Be sure to mention the title or print an order form from www.AskDrGottMD.com.
