Hypothyroidism: Symptoms in Women, Causes and Treatment

You are tired all the time, even after a full night of sleep. You feel cold when everyone else is comfortable, your hair is thinning, and the weighing scale keeps creeping up although you have not changed what you eat. Many women hear “it is just stress” for years before someone orders a simple thyroid test. Hypothyroidism is common, easy to diagnose and very treatable.

What is hypothyroidism?

The thyroid is a small butterfly-shaped gland at the front of the neck. It makes hormones that set the speed of your metabolism. In hypothyroidism the gland makes too little, so the whole body slows down. It is far more common in women than in men, and the risk rises after 30 and after pregnancy.

Hypothyroidism symptoms

Symptoms come on slowly and are easy to blame on something else:

• Constant tiredness and sluggishness
• Weight gain or difficulty losing weight
• Feeling cold more than other people
• Dry skin, brittle nails and hair thinning
• Constipation
• Puffy face, hoarse voice or swelling at the front of the neck (goitre)
• Heavy or irregular periods, and trouble conceiving
• Muscle aches, low mood and poor concentration
• A slow heartbeat

Not everyone has all of these, and many of them overlap with iron deficiency and vitamin D deficiency, which is why a blood test matters.

What causes an underactive thyroid?

• Hashimoto’s thyroiditis: an autoimmune condition where the body attacks the thyroid. This is the most common cause.
• Iodine deficiency, which was once very common in northern Pakistan and is now less so because of iodised salt, but still matters
• Thyroid surgery or radioactive iodine treatment
• Some medicines, such as lithium and amiodarone
• Thyroid problems after pregnancy
• Babies can be born with an underactive thyroid, which is why newborn screening exists

Tests for hypothyroidism

The main test is TSH, a pituitary hormone that rises when the thyroid is underactive. Most labs list a normal range of roughly 0.4 to 4.0 mIU/L, though ranges differ slightly. Your doctor may also check free T4 and anti-TPO antibodies, which point to Hashimoto’s. A tip worth knowing: high-dose biotin supplements, often taken for hair and nails, can interfere with thyroid test results, so tell your doctor and stop them a few days before testing if advised.

Treatment: levothyroxine

Hypothyroidism is treated with levothyroxine, a replacement for the hormone your body is missing. Most people need it for life. Doctors adjust the dose by repeating the TSH test, usually 6 to 8 weeks after starting or after any change. Some practical points make a big difference:

• Take it at the same time every day on an empty stomach with water, usually 30 to 60 minutes before breakfast.
• Keep iron, calcium, multivitamins and antacids at least 4 hours away from the tablet, because they stop it being absorbed.
• Tea and coffee also reduce absorption, so leave a gap after the tablet.
• Try to stay on the same brand, since small differences between brands can change your TSH.
• Do not stop when you feel better. Feeling better means the tablet is working.
• Never raise or lower the dose yourself. Too much levothyroxine causes palpitations, anxiety and bone loss.

Thyroid and pregnancy

If you have hypothyroidism and are planning a pregnancy or have just found out you are pregnant, tell your doctor straight away. The dose often needs to be increased early in pregnancy, and untreated hypothyroidism can affect the baby’s development.

Diet myths

You do not need to give up cabbage, cauliflower or soy products in normal food amounts. A balanced diet with some iodised salt, eggs, milk and fish is enough for most people. Selenium and other supplements are not routinely needed. No food or herbal remedy replaces levothyroxine.

When to see a doctor urgently

Severe, untreated hypothyroidism can rarely lead to a medical emergency with extreme drowsiness, confusion, a very slow heartbeat and a very low body temperature. Get help immediately if this happens.

Key takeaways

• Tiredness, weight gain, feeling cold and hair thinning together are worth a TSH test.
• Hashimoto’s thyroiditis is the commonest cause, especially in women.
• Levothyroxine, taken properly and monitored with TSH, controls the condition.
• Keep calcium and iron tablets at least 4 hours apart from it.

Related medicines on Medimart

The standard medicine used to treat an underactive thyroid:

• Levothyroxine: thyroid hormone replacement, taken daily as prescribed

Prescription medicines are supplied only against a valid prescription. Please take them only as advised by your doctor.

Browse thyroid medicines on Medimart with delivery across Pakistan. Prescription medicines are supplied only against a valid prescription.

This guide is for general information and does not replace advice from a doctor. If you have these symptoms, please get your thyroid checked.