Could Your Fatigue Be a Thyroid Problem?

Could your fatigue be a thyroid problem? It is possible. Hypothyroidism, or an underactive thyroid, is a common cause of tiredness, weight gain, feeling cold, dry skin, and low mood. The good news is that a simple blood test can check your thyroid, and hypothyroidism is usually very treatable with a daily medicine. At Urgent Care & Family Medicine in Conway, SC, our family medicine providers can evaluate your symptoms, order thyroid labs at our on-site lab, start treatment, and adjust your dose over time. Call to schedule a visit.

What Does the Thyroid Do?

The thyroid is a small, butterfly-shaped gland at the front of your neck. It makes hormones that help control your metabolism, which is how your body uses energy. Thyroid hormones affect your heart rate, body temperature, digestion, weight, mood, skin, hair, and menstrual cycle. When the thyroid does not make enough hormone, many body systems slow down.

What Are the Symptoms of Hypothyroidism?

Symptoms often develop slowly over months or years, so many people blame them on stress, aging, or being busy. Common symptoms include:

• Fatigue and low energy
• Feeling cold when others are comfortable
• Weight gain or difficulty losing weight
• Dry skin and brittle nails
• Thinning hair
• Constipation
• Muscle aches, stiffness, or weakness
• Low mood, trouble concentrating, or forgetfulness
• Heavier or irregular menstrual periods
• A puffy face or a hoarse voice
• A slow heart rate

These symptoms can also come from many other causes, including anemia, depression, poor sleep, vitamin deficiencies, and diabetes. That is why testing is important rather than guessing.

What Causes Hypothyroidism?

In the United States, the most common cause is Hashimoto’s thyroiditis, an autoimmune condition where the immune system attacks the thyroid. Other causes include:

• Thyroid surgery or radioactive iodine treatment
• Radiation treatment to the head or neck
• Certain medicines, such as lithium and amiodarone
• Inflammation of the thyroid after pregnancy
• Problems with the pituitary gland, which is less common

Hypothyroidism is more common in women and in people over 60, and it often runs in families.

How Is Hypothyroidism Diagnosed?

Diagnosis usually starts with a blood test called TSH, which stands for thyroid-stimulating hormone. TSH is made by the pituitary gland and tells the thyroid how much hormone to make. When the thyroid is underactive, TSH usually rises as the body tries to push the thyroid to work harder.

If your TSH is abnormal, your provider will usually check free T4, the main hormone the thyroid makes. Sometimes thyroid antibody tests are used to look for Hashimoto’s. Your provider may also check other labs, such as a blood count or vitamin levels, to look for other causes of fatigue. Our on-site lab makes it easy to get these tests done during your visit. For help reading your results, see our guide to blood test results.

How Is Hypothyroidism Treated?

The standard treatment is levothyroxine, a daily pill that replaces the thyroid hormone your body is not making. It is the same hormone your thyroid naturally produces, made in a lab. Most people take it for life.

Your provider will start with a dose based on your age, weight, heart health, and lab results, then recheck your TSH in about six to eight weeks. The dose is adjusted until your levels are in the target range and your symptoms improve. After that, many people need a blood test once or twice a year, or whenever their health changes, such as during pregnancy.

How Should You Take Thyroid Medicine?

How you take levothyroxine matters because food and some supplements can affect how well it is absorbed. Common advice includes:

• Take it at the same time every day, usually first thing in the morning on an empty stomach
• Take it with a full glass of water
• Wait 30 to 60 minutes before eating or drinking coffee
• Separate it by about four hours from calcium, iron, antacids, and some other supplements
• Try to stay on the same brand or formulation, and tell your provider if your pharmacy switches it

Follow the specific instructions your provider and pharmacist give you.

How Long Until You Feel Better?

Many people start to feel more energy within a few weeks of starting treatment, but it can take a few months to feel fully better as the dose is fine-tuned. If you still have symptoms once your labs are in range, talk with your provider. Something else, such as poor sleep, anemia, or depression, may also be contributing.

What Happens If Hypothyroidism Is Not Treated?

Untreated hypothyroidism can raise cholesterol, increase the risk of heart disease, worsen fatigue and depression, and cause problems with fertility and pregnancy. In rare, severe cases, it can lead to a dangerous condition that needs emergency care. Diagnosing and treating it early prevents most of these problems.

What About an Overactive Thyroid?

The thyroid can also make too much hormone, which is called hyperthyroidism. That can cause the opposite symptoms: a fast or pounding heartbeat, anxiety, shakiness, weight loss, feeling hot, and trouble sleeping. Too high a dose of thyroid medicine can cause similar symptoms. If you notice these, call us. Chest pain or a very rapid heartbeat with fainting needs emergency care.

Who Should Get Their Thyroid Checked?

Consider talking with your provider about thyroid testing if you have ongoing symptoms listed above, a family history of thyroid disease, another autoimmune condition such as type 1 diabetes, a history of neck radiation, or if you are pregnant or planning pregnancy. Thyroid testing is not always part of a routine checkup, so it is worth bringing up at your annual physical if you have concerns.

Why Choose Urgent Care & Family Medicine in Conway?

Our clinic at 235 Singleton Ridge Road is open Monday through Friday from 8:30 AM to 5:30 PM and Saturday from 9:00 AM to 1:00 PM. Our family medicine providers offer ongoing care for thyroid conditions, along with high blood pressure and diabetes, with labs drawn right here in our office. We accept most major insurance and offer clear self-pay rates.

What Is Subclinical Hypothyroidism?

Sometimes blood tests show a mildly high TSH with a normal free T4. This is called subclinical hypothyroidism. It is fairly common, especially in older adults, and it does not always need treatment. Your provider may simply recheck your labs in a few months, since mild changes sometimes return to normal on their own. Treatment may be recommended if your TSH is higher, if you have clear symptoms, if you have thyroid antibodies, or if you are pregnant or trying to become pregnant. This is a good example of why lab results are best interpreted alongside your symptoms and health history rather than on their own.

How Does the Thyroid Affect Pregnancy?

Thyroid hormone is important for a healthy pregnancy and for a baby’s brain development. Women with hypothyroidism often need a higher dose of levothyroxine during pregnancy, sometimes as soon as pregnancy is confirmed. If you take thyroid medicine and are planning a pregnancy or find out you are pregnant, contact your provider promptly so your levels can be checked and your dose adjusted. Thyroid levels are usually monitored more often throughout pregnancy and again after delivery.

What Should You Bring to Your Visit?

To make your visit as useful as possible, bring a list of your symptoms and when they started, all medicines and supplements you take, and any prior thyroid lab results. Biotin, a supplement often found in hair, skin, and nail products, can interfere with some thyroid tests, so let your provider know if you take it. You may be asked to stop it for a couple of days before your blood draw. Also share any family history of thyroid disease or other autoimmune conditions.

Frequently Asked Questions

What blood test checks for hypothyroidism?

The main screening test is TSH. If it is abnormal, your provider will usually check free T4 and sometimes thyroid antibodies.

Is hypothyroidism curable?

Most cases are lifelong, but they are very manageable. A daily thyroid hormone pill usually controls symptoms well.

Can hypothyroidism cause weight gain?

It can contribute to modest weight gain and make weight loss harder. Treatment often helps, though it is not a weight loss medicine.

How often do thyroid levels need to be checked?

Usually about six to eight weeks after starting or changing a dose, then once or twice a year when stable.

Can your clinic treat my thyroid condition?

Yes. Our family medicine providers can diagnose and manage hypothyroidism and will refer you to a specialist if needed.