How to recognise hypothyroidism
Taken individually, the symptoms are all non-specific – together, however, they form a recognisable pattern:
- persistent tiredness and lack of drive, even after enough sleep
- feeling cold where others find it comfortably warm
- dry, cool skin, brittle nails, dull hair and even hair loss
- weight gain without any change in eating or exercise
- constipation
- problems with concentration and memory, low mood
- heavier, longer or irregular periods
- difficulty conceiving
Take notice if several of these points come together and persist for weeks. A single blood test usually brings clarity quickly.
At a glance
- Typical: tiredness, feeling cold, dry skin, hair loss, constipation, poor concentration
- Most common cause: Hashimoto's thyroiditis
- Diagnosis: TSH and fT4, supplemented by TPO antibodies and ultrasound
- Treatment: levothyroxine, in the morning on an empty stomach, thirty minutes before breakfast
- First check-up: six to eight weeks after starting treatment
- Appointments: book online or call +43 1 5333 654
Why it takes so long for someone to look
“You are just stressed.” “It is your age.” “Everyone is tired after having a baby.” Women with hypothyroidism often hear these sentences for years before anyone measures the thyroid. The reason: exhaustion fits many things.
We take the opposite approach. If you come to us with this pattern of symptoms, the thyroid is not checked at the end of a long list of exclusions but at the beginning – because the test is simple, quick and informative.
Causes
- Hashimoto's thyroiditis: by far the most common cause in Austria. Read more on the page Hashimoto's thyroiditis.
- after surgery or radioiodine therapy: when thyroid tissue has been removed or shut down
- medicines: such as amiodarone, lithium or certain cancer treatments
- iodine deficiency: now rare in Austria thanks to iodised table salt
- temporarily after an inflammation or after childbirth
Subclinical hypothyroidism
We often find a slightly raised TSH with a still normal fT4. This is called latent or subclinical hypothyroidism. It is not an emergency and does not have to be treated in every case.
In favour of treatment: marked symptoms, a strongly raised TSH, detectable TPO antibodies, a wish to conceive or a pregnancy. Against it: a slightly raised value without symptoms in an otherwise healthy woman – here we re-check first.
The treatment: levothyroxine
Levothyroxine replaces exactly the hormone that is missing. It is not a chemical foreign to the body but the synthetic form of the body's own T4. Correctly dosed, it has no side effects, because the body simply works at its normal level again.
The tablet is taken in the morning on an empty stomach, about thirty minutes before breakfast and with water – not with coffee. We start with a cautious dose and work our way towards the right level for you through check-ups.
From diagnosis to stable treatment
Diagnosis
TSH, fT4, antibodies, ultrasound
Start
low starting dose of levothyroxine
Check-up
after six to eight weeks, adjust the dose
Stable
then usually a yearly check-up
Frequently asked questions
Will I have to take levothyroxine for life?
For hypothyroidism caused by Hashimoto's or resulting from surgery, as a rule yes, because the missing hormone has to be replaced permanently. For temporary hypothyroidism – for instance after an inflammation or after childbirth – treatment can be stopped again after a few months. We decide this together on the basis of your follow-up values.
I forgot my tablet – what now?
No need to worry. Levothyroxine has a long half-life, so one forgotten tablet hardly matters. Take the next one as usual. Double doses are not necessary.
Will I lose weight with levothyroxine?
Only the water retained because of the hypothyroidism – usually one to three kilograms. Levothyroxine is not a slimming aid, and overdosing to lose weight is dangerous for the heart and bones. Read more on the page Thyroid, weight and menopause.
Can I change my diet instead of taking tablets?
A balanced diet with enough iodine and selenium supports the thyroid but cannot replace missing hormones. With Hashimoto's we expressly advise against high-dose iodine supplements.