Tired, slow and gaining weight: Hypothyroid?

Insights, answers and next steps from Ann Marie Paulsen, MD

Fatigue, unexplained weight gain, feeling sluggish and generally run down—these are some of the symptoms that lead many people to discover that their thyroid gland isn’t working right. An underactive, or “hypo,” thyroid is one of the most common conditions in the United States—so common, in fact, that the medication used to treat it, levothyroxine (Synthroid) is the most-prescribed drug in the country.

Despite its prevalence, however, most people don’t know much about hypothyroidism. Here’s some important information to bring you up to speed, including details about what it is, how to know if you’re at risk for it, how it affects your metabolism and what serious problems can develop if it goes untreated.

Why is an underactive thyroid a problem? 

The thyroid, a small gland in the front of your neck, produces several hormones that normally keep your metabolism humming along at a healthy pace. But if your thyroid starts having trouble releasing these hormones, your metabolism slows down. Most people know that slow metabolism makes it harder to burn calories—not a good thing if you’re trying to control your weight—but it goes much deeper than that. Metabolism refers to the way that every cell in your body converts food into energy to function and survive. When your metabolism slows down, everything else slows down with it.

What happens when you don’t get enough thyroid hormones? 

A slowing of metabolism can cause the following symptoms:

  • Fatigue
  • Slower movement and speech
  • Lower tolerance to cold
  • Constipation
  • Mild weight gain
  • Slowed heart rate

Other symptoms can develop too, as certain sugars build up in your tissues:

  • Dry skin, coarse hair or hair loss
  • Puffy face and shins
  • Enlargement of the tongue
  • Hoarse voice
  • Changes in women’s menstrual cycles
  • Changes in men’s libido, or erectile dysfunction
What raises your risk for hypothyroidism?

You’re more likely to become hypothyroid if:

  • You’re female: Women are up to eight times more likely to be hypothyroid
  • You are older than 60: It can develop at any age, but aging may be a factor
  • Hypothyroidism runs in your family
  • You have a goiter (enlarged thyroid)
  • You have a history of autoimmune disease
  • You’ve had radioactive iodine therapy or radiation to your head or neck
  • You use lithium or amiodarone (a drug used to treat abnormal heart rhythms)
  • You have an iodine deficiency (this is uncommon)
Where to go from here?

If you’ve had a few nagging symptoms for some time—especially if you have other risk factors for hypothyroidism—it makes sense to visit your primary care provider. A simple lab test can check your hormone levels and help decide what to do next. If your levels indicate hypothyroidism, treatment with medication is straightforward and very effective. If your levels are low, but not technically hypothyroid, we can monitor you and consider medication if your symptoms become too bothersome. In any case, don’t let symptoms go unchecked. Untreated hypothyroidism can lead to serious problems, including coronary artery disease, infertility, depression and cognitive decline. Any change in your body or health should always be discussed with your doctor.

Dr. Paulsen sees patients in our South office.