Hypothyroidism
Hypothyroidism occurs when the thyroid gland does not produce enough thyroid hormone, slowing down many of the body's functions. It causes fatigue, weight gain, cold intolerance, and low mood. It is very common — particularly in women — and is easily managed with daily thyroid hormone replacement.
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This page provides general health information only and is not a substitute for professional medical advice.
What is hypothyroidism?
The thyroid gland produces hormones that regulate metabolism — the rate at which the body uses energy. When thyroid hormone levels are too low, every system in the body slows down. Hypothyroidism affects approximately one in twenty women and one in one hundred men, becoming increasingly common with age.
The condition develops gradually — symptoms often appear so slowly that they are attributed to ageing, stress, or depression for months or years before the diagnosis is made. A simple blood test measuring TSH (thyroid stimulating hormone) confirms the diagnosis.
Symptoms
- Persistent fatigue and low energy despite adequate sleep
- Weight gain or difficulty losing weight despite diet and exercise
- Feeling cold — particularly cold hands and feet — even in warm weather
- Low mood, depression, and slowed thinking
- Dry skin, brittle nails, and hair thinning or loss
- Constipation
- Muscle aches, weakness, or cramps
- Slow heart rate and puffy face
- Heavy or irregular periods in women
- Raised cholesterol — hypothyroidism is a common secondary cause of dyslipidaemia
Many symptoms of hypothyroidism are vague and overlap with depression, chronic fatigue, and normal ageing. A TSH blood test is the only reliable way to confirm the diagnosis — and treatment produces dramatic improvement in most people.
Causes
- Hashimoto's thyroiditis — an autoimmune condition and the most common cause in developed countries; the immune system gradually destroys thyroid tissue
- Previous thyroid surgery or radioiodine treatment
- Iodine deficiency — rare in Europe but common globally
- Certain medications including lithium and amiodarone
- Congenital hypothyroidism — present from birth
When to see a doctor
See a doctor if you have persistent, unexplained fatigue, weight gain, or low mood — particularly if you are a woman over 40. Thyroid function is often not tested routinely, so it is worth specifically requesting a TSH test if you have symptoms. People already on levothyroxine should have their thyroid function reviewed at least annually.
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Treatment options
Hypothyroidism is treated with levothyroxine — a synthetic form of thyroid hormone taken as a once-daily tablet. Treatment is safe, effective, and lifelong in most cases. With the correct dose, thyroid hormone levels normalise and symptoms resolve completely.
- Levothyroxine — standard treatment; dose is adjusted based on regular TSH blood tests
- Combined T4/T3 therapy — considered for patients who do not feel fully well on levothyroxine alone
- Regular monitoring — TSH testing every 6–12 months to ensure the dose remains optimal
- Dose adjustment — requirements may change with age, weight changes, pregnancy, and other medications
How eMedClinic can help
Our endocrinologists diagnose hypothyroidism, arrange and review blood tests, prescribe levothyroxine, and provide ongoing dose monitoring. We are particularly well placed to support expats who have moved abroad and need to continue their thyroid treatment without disruption — including prescription renewals and annual reviews entirely online.
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