Medical Column: Slow Metabolism?

By: Dr. Nathan Greene
Family Medicine Resident
Colquitt Regional Medical Center

What if one hormone in the body caused many potential problems such as fatigue, weight gain (being overweight), depression, constipation, and swelling?  What if there is an easy way to evaluate and treat this?

A low thyroid hormone level in the body is called hypothyroidism. Hypothyroidism is a common condition where the thyroid gland does not produce enough thyroid hormone to meet your body’s needs.

What are the symptoms of hypothyroidism? As mentioned earlier, these include weight gain, depression, fatigue, weakness, constipation, dry skin, and swelling, but can also include cold intolerance, shortness of breath on exertion, slow heart rate, heavy menstrual bleeding, joint stiffness, and muscle aches. Many of these symptoms progress slowly and it is quite common to overlook or ignore the symptoms. However, since this can be a serious medical condition with the potential for long term effects, it is best to tell your family physician about these symptoms so that he or she may do some simple labs to check your thyroid levels.

Who is at risk? Women are 5 to 8 times more likely to be affected by hypothyroidism than men, and the chance that you will develop hypothyroidism increases as you get older. In fact, 5-15% of women over the age of 65 will be diagnosed with hypothyroidism. Pregnant patients and people who have been diagnosed with an autoimmune disorder are also at higher risk.

What is to be done? The diagnosis of hypothyroidism is based primarily upon laboratory testing, so people with symptoms suggestive of hypothyroidism will often have a blood test such as TSH (thyroid stimulating hormone) ordered to check for the condition. In hypothyroidism, the TSH is elevated above the normal range, and this may prompt your physician to order an additional test such as an ultrasound of the thyroid gland, because the exact cause of hypothyroidism will need to be determined before appropriate treatment can begin.

By far, the most common cause of hypothyroidism is due to an autoimmune condition in which a person’s own immune system attacks the thyroid gland making it produce less thyroid hormone. When this is the case, the problem can be easily treated with medication. In some cases, hypothyroidism can be caused by certain medications or even some over the counter supplements, and in such situations, stopping the medication would be the first step toward correcting the problem. While there are much rarer causes of hypothyroidism, your physician will be able to help make the right diagnosis and get you started on the appropriate treatment.

Hypothyroidism is a common and easily diagnosed condition that if left untreated can be the cause of significant and potentially dangerous symptoms. If you or someone you know is experiencing symptoms similar to those described above, contact your Family Physician to get yourself tested as soon as possible. Treatment may be as simple as taking a thyroid supplement, and the difference you feel can be tremendous.