Impairment of thyroid function affects about 2% of adult women and about 0.1% to 0.2% of adult men in North America.

As many as 25% of patients with hypothyroidism have normal levels of T3.
Symptoms of thyroid dysfunction can have a significant impact on behavior such as mental confusion and memory problems.

Hypothyroidism can be associated with depression and its symptoms:

  • decreased interest in daily activities  
  • concentration difficulties
  • sleep disturbances
  • reduced sexual interest
  • fatigue
  • weight gain
  • intolerance to cold
  • dry skin
  • constipation
  • mental slowing
  • menorrhagia (heavy periods)
  • amenorrhea (skipped periods)
  • galactorrhea (breast discharge)
  • lab tests will show: high TSH and low free T4

Hypothyroidism can be associated with certain heart problems and mild high blood pressure.

Even mild thyroid failure can have harmful effects.

What is Hypothyroidism?
The thyroid is a small, butterfly-shaped gland located in the front of the neck, which produces thyroid hormones, or "chemical messengers," that signal cells throughout the body to increase oxygen use. The two key thyroid hormones are L-triiodothyronine (T3) -the more biologically active thyroid hormone - and thyroxine (T

Hypothyroidism occurs when there is an inadequate secretion of thyroid hormones, resulting in a slowing down of the body's metabolism. While low production of these hormones results in hypothyroidism, (an underactive thyroid) high production of these hormones results in hyperthyroidism, (an overactive thyroid).

Hyperthyroidism can be associated with:

·        nervousness

·        irritability

·        palpitations

·        tachycardia

·        weight loss

·        tremor

·        decreased menstrual flow

·        vision changes

·        lab tests will show: low TSH and high free T4.

Thyroid Disease in Pregnancy

Maternal thyroid disease is associated with adverse pregnancy outcomes and may negatively impact a child's neurocognitive development; for these reasons, the ATA stresses, screening is particularly important in women of childbearing age.

A mild, transient hyperthyroidism of pregnancy can occur during the first trimester, as increasing levels of human gonadotropin stimulate the thyroid. However, true hyperthyroidism during pregnancy is dangerous for both the woman and her fetus. The relative risk of prematurity can increase 16 times if hyperthyroidism isn't controlled. There is a ninefold increase in the risk of low birth weight and a fivefold increase in the risk of severe preeclampsia in these patients.

Postpartum thyroiditis will occur in 10% of women. The transient hyperthyroidism usually clears within 6-8 weeks, but transient hypothyroidism may follow and last up to 6 months. Beta-blockers can manage the hyper-metabolic symptoms. During the hypothyroid phase, thyroid hormone should be administered.


The goals of thyroid hormone replacement therapy are to normalize thyroid hormone levels and to provide symptomatic relief. Although there are several types of thyroid hormone replacement available, not any one type is optimal therapy for everyone. As a result, treatment options may vary from person to person.

How Does a Doctor Determine You Need Thyroid Hormones?

After you have discussed your symptoms with your doctor and hypothyroidism is suspected, a TSH (thyroid stimulating hormone) test, and possibly others, may be ordered. When a physician receives a laboratory report, the report slip will state normal ranges for TSH and possibly for other specific hormones. The TSH measurement is of fundamental importance since it reflects the sufficiency of the brain's supply of thyroid hormone. A normal range TSH indicates that the hypothalamus senses a normal amount of thyroid hormone and is stimulating the thyroid to continue making and releasing thyroid hormone at the same rate. An elevated TSH level signals the central nervous system's insufficiency of thyroid hormone, while a reduced TSH level indicates that the central nervous system senses increased amounts of thyroid hormone.

Blood Tests
If you take thyroid supplement medication on the day of your blood test, you should wait until after the blood has been drawn so as to avoid any test interference. Once the blood has been drawn, you may take that day's dose and return to your regular dosing schedule.

There are many blood tests used to diagnose and monitor patients with thyroid conditions. No single lab test is considered 100% accurate in determining thyroid disease, but a combination of two or more tests may help to determine if there is a problem with the thyroid gland or the pituitary gland. The Thyroid Stimulating Hormone (TSH) and Free Thyroxine Index (FT4I) are the two blood tests most commonly used to diagnose patients with hypothyroidism and to monitor their progress while using a thyroid medication.1



Normal Value

Results in

Results in

Thyroid Stimulating Hormone (TSH)

0.3 - 5.0µU/mL or
0.3 - 5.0 mU/L



Total T4 Immunoassay

5 - 11µg/dL or
64 - 142 nmol/L



Free T4 Index

6.5 - 12.5



Total T3 Immunoassay

95 - 190 ng/dL or
1.5 - 2.9 nmol/L

Normal or Low


Free T3 Index

20 - 63

Normal or Low



Wide Range of Variation
Within the range of normal for thyroid hormone concentration, there is a rather wide degree of variation from individual to individual.

When a patient has symptoms suggestive of hypothyroidism but is shown to have lower normal values of thyroid hormone, a physician may start a trial of thyroid hormone therapy, hoping to increase these lower normal thyroid hormone values to upper normal values. If there is a sustained favorable response without any evidence of clinical hyperthyroidism, long-term replacement therapy may be justified.

Hypothyroidism is traditionally treated with thyroid hormone replacement therapy (either synthetic or natural). Thyroid replacement therapy could include taking levothyroxine (T4), liothyronine (T3), or a combination product that contains both T4 and T3. All of these treatments work in the body like thyroxine, the human hormone that is normally produced by the thyroid gland, and subsequently converted to T3, the active hormone.

Armour Thyroid is the leading combination therapy (T4/T3 ) product available for the treatment of hypothyroidism.  It is a natural preparation derived from porcine thyroid glands.

Levothroid is a synthetic treatment containing the hormone levothyroxine (T4). It is both gluten-free and lactose-free.  It treats hypothyroidism by replacing or supplementing the T4 that is normally produced by the thyroid.

Thyrolar is the only synthetic product combining L-triiodothyronine (T3) and levothyroxine sodium (T4 ) indicated for the treatment of hypothyroidism. This product is for patients who seek combination therapy in a synthetic form.


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