Hypothyroidism is an underactive thyroid gland that does not produce enough thyroid hormone. It affects millions of Indians, with women three times more likely to develop it than men.
Symptoms
Fatigue, weight gain, cold intolerance, dry skin, hair loss, constipation, depression, and slow heart rate. Many symptoms are subtle and often dismissed as aging or stress.
Causes
The most common cause globally is Hashimoto thyroiditis, an autoimmune condition where the immune system attacks the thyroid. Iodine deficiency was common historically but is now rare in India due to iodized salt.
Diagnosis and monitoring
A TSH test is the primary diagnostic tool. A TSH above 4.0 mIU/L with low Free T4 confirms overt hypothyroidism. Subclinical hypothyroidism (TSH 4-10 with normal T4) is common and may or may not require treatment depending on symptoms and other factors.
Treatment
Levothyroxine is the standard treatment, taken daily on empty stomach. Dose is titrated based on TSH levels, with testing every 6-8 weeks after adjustments. Most patients require lifelong treatment.