Thyroid Disorders: Symptoms and Treatment

In short: An underactive thyroid (hypothyroidism) is treated with Levothyroxine taken on an empty stomach first thing in the morning; an overactive thyroid (hyperthyroidism) with anti-thyroid medicines, radioactive iodine or surgery. Both are guided by TSH, T3 and T4 blood tests.

The thyroid is a small butterfly-shaped gland at the front of the neck, and despite its size it influences almost every system in the body. It produces hormones that regulate metabolism, heart rate, body temperature, energy levels and mood. Thyroid disorders are very common in India — particularly among women — and because the early symptoms are vague and easily blamed on stress or ageing, they often go undiagnosed for years.

The Two Main Thyroid Conditions

• Hypothyroidism (underactive thyroid) — The gland produces too little hormone, slowing the body down. It is the more common of the two and is usually treated with Levothyroxine (e.g., Thyronorm, Eltroxin), which replaces the hormone the body is not making.
• Hyperthyroidism (overactive thyroid) — The gland produces too much hormone, speeding the body up. Treatment may involve anti-thyroid medicines such as Carbimazole or Methimazole, radioactive iodine, or in some cases surgery, depending on the underlying cause.

Symptoms to Watch For

An underactive thyroid typically causes fatigue that does not improve with rest, unexplained weight gain, feeling cold when others do not, dry skin, hair fall, constipation, low mood and heavier or irregular periods. An overactive thyroid tends to cause the opposite: unintended weight loss despite a good appetite, a racing or irregular heartbeat, anxiety and irritability, tremor in the hands, excessive sweating, heat intolerance and difficulty sleeping. A visible swelling at the base of the neck, called a goitre, can occur with either condition. If several of these sound familiar, a simple blood test can confirm what is going on.

Taking Thyroid Medication Correctly

Levothyroxine is more sensitive to timing than most medicines, and taking it incorrectly is a common reason for reports that "the medicine is not working". It should be taken on an empty stomach, first thing in the morning, with plain water, and you should wait about 30 to 60 minutes before eating or drinking anything else — including tea and coffee.

Several everyday items interfere with absorption and should be separated by at least four hours: calcium supplements, iron tablets, multivitamins, antacids, and soy products. Take the tablet at the same time every day, and if you miss a dose take it as soon as you remember unless it is nearly time for the next one — never double up. Because different brands can differ slightly in absorption, it is generally best to stay on the same brand once your dose is stable.

Testing and Follow-Up

Thyroid treatment is guided by blood tests, most commonly TSH along with T3 and T4. After starting treatment or changing a dose, your doctor will usually recheck after six to eight weeks, then every six to twelve months once levels are stable. Thyroid requirements also change with pregnancy, significant weight change and age, so testing should not be skipped simply because you feel well. Dose adjustments are common and are not a sign that anything has gone wrong.

Get Your Thyroid Medicines at Discounted Prices

Gautam Chemist stocks Levothyroxine and other thyroid medicines in all commonly prescribed strengths, from every major brand, at discounts of up to 65%. Thyroid medication is usually lifelong, so the saving on each monthly refill is worth having. Our pharmacist is happy to explain the timing rules, which supplements to keep apart from your tablet, and how to keep your brand consistent between refills. Find us at SCO No. 195, Sector-16, Panchkula.

Please note: this article is general information from a pharmacy, not medical advice. Medicines, doses and timings must be decided by your doctor. Never start, stop or change a medicine on your own.