Disease of the thyroid gland - hypothyroidism: a primer for patients   

Thyroid related diseases are common problems and matter of concern for many of our patients. Let’s deal with some queries you might have related to it .

1) What is a 'thyroid' related problem?

Thyroid gland is an endocrine gland, having two lobes, located on either side of your Adam's apple on the front of your neck. Normally, it produces a hormone called thyroxin required for growth and development as well as day to day metabolism inside our body. Although there a variety of ways thyroid gland can be affected ,e.g: decreased hormone (thyroxin) production or over-production of the same hormone , sometimes some visible swellings in the gland or pain over the gland , etc , we commonly have decreased hormone production as the most common problem . This problem is known as primary hypothyroidism  (just a fancy term used by doctors for better communication).  

2) What are the symptoms of hypothyroidism?

Although many patients have no symptoms, some tend to have increased lethargy (weakness), some weight gain, increased sleep, irregular menstruation or even a mildly swollen thyroid region in the neck among a list of many problems. A thing to keep in mind is that although these symptoms would require a thyroid function test, they do not necessarily mean that they (symptoms) can be caused by lack of thyroid hormone (hypothyroidism) only. Many other disorders have one or more of similar symptoms so the ultimate decision to test your thyroid function at a given time should rest on your doctor.

3) Taking the thyroxin tablet, what are my do’s and don'ts?

Once you are diagnosed hypothyroidism, your doctor may decide to put you on a thyroxin tablet to be taken once daily, usually before breakfast (Tablets usually in multiples of 25 ug ie 25, 50, 75,100,125 etc). Here are a few important points to take care when you are on thyroxin tablet:

1. Take the tablet at least 40 minutes before breakfast or any other medicine including any medicine for your gastritis
2. If you are on iron or calcium tablets too, take the iron/ calcium tablet after lunch or dinner , at least 4 hours away from the thyroid tablet
3. Just in case you forget a day’s dose,  you may take both the missed dose and next day’s dose  on the next morning
4. There is no restriction for water intake with thyroxin tablet but other liquids including tea should not be taken for upto 40 minutes after taking the tablet
5. Take the same brand of thyroxin as far as possible
6. Do not store the thyroxin tablet near hot utensils or stove , especially  if you have kept it in kitchen

4) Do I need to take the thyroxin tablet lifelong?

Well, first of all, lets understand that in hypothyroidism , once you are on proper dose of thyroxine tablet, you are completely normal . Taking the tablet lifelong , if required , is not going to harm  you if taken as per the advice of your doctor and thyroid function test is done periodically as per the doctor’s suggestion.  It is just a replacement just like the food you take is a replenishing of your energy stores in the body. Coming on to the question proper, hypothyroidism is lifelong is about 85% of the cases. The other 15% cases are either subclinical hypothyroidism in pregnancy or transient hypothyroidism after an episode of something called a thyroiditis . You doctor will be able to tell this at the outset or at least after 3-6 months of thyroxin use. 

5) How often do I need to do the thyroid function test done ?

It depends on various factors. Usually we get them repeated in 3-6 months’ time if you are on a stable dose across few visits. Sometimes , esp in pregnancy , we might want to repeat it in 1-2 months too .  Most often only a TSH level is required for patients on follow up.