Diagnosing and Treating Hypothyroidism


If you suspect you have hypothyroidism, see if your symptoms match any on the list below. Then talk over the following action plan with your doctor.

If you feel . . .

  • Fatigued or exhausted
  • Lethargic
  • Depressed or anxious
  • Moody or irritable
  • Uninterested in sex
  • Constipated
  • Forgetful
  • Cold even when others dont
  • Achy or crampy
  • Nauseous or queasy

Or if you have . . .

Next Page: Try this action plan

[ pagebreak ]. . . Try this action plan
1. List your symptoms.
Write down that you cant get through the day without a nap, or that youve gained 20 pounds despite walking five times a week and doing the South Beach Diet.

2. Ask about your family.
Hypothyroidism tends to run in families. Talk to siblings, parents, aunts, uncles, cousins, and grandparents. They might have been told they had a “glandular disorder.” Ask if theyve ever taken a supplemental thyroid hormone.

3. Ask your primary-care doctor for a TSH test.
Its an inexpensive blood test (covered by insurers) that checks for levels of thyroid stimulating hormone (TSH); high levels indicate low thyroid. Find out your exact level, not just whether its in the “normal” range. Some experts, including groups like the American Association of Clinical Endocrinologists, now say a normal score is between 0.3 and 3. That means a TSH above 3 would indicate hypothyroidism. But many labs havent adopted the new guidelines, so a result of 4 or even 5 wont necessarily be flagged as high.

4. Get retested in 3 months.
You might also ask for a low-dose trial of thyroid medication to see if it helps before being tested again. Some doctors are amenable to doing that.

5. Ask for the Anti-TPO thyroid antibody test.
If your TSH test is normal but you dont feel right, the antibody test can help determine whether you have hypothyroidism.

6. Ask for additional hormone tests.
Doctors can also screen levels of T3, T4, Free T3, and Free T4 hormones, which can provide a more accurate picture of how your thyroid is functioning. If the results are out of whack, you may need treatment.