Hypothyroidism

Hypothyroidism, also called an underactive thyroid, happens when levels of thyroid hormone in your blood are too low. The hormones are released by your thyroid gland and control how cells in your body use energy. When you don’t have enough of the hormones, you’ll experience symptoms like fatigue and weight gain. Medication can help you manage the condition. 

Penn Medicine endocrinology, diabetes, and metabolism experts routinely care for people with hypothyroidism. Our experts in endocrinology and thyroid care are highly experienced in diagnosing and treating an underactive thyroid. We work with you to restore your hormone levels and resolve your symptoms, and we coordinate with other specialists to help you manage weight gain and other related conditions. Your care team gives you complete care to effectively treat the disease. 

Symptoms of hypothyroidism often develop slowly, sometimes over years, and can be subtle at first. Early signs and symptoms of hypothyroidism include: 

• Weight gain 
• Constipation 
• Fatigue, weakness, and sensitivity to cold 
• Irregular menstruation, including heavy periods 
• Joint or muscle pain 
• Dry or pale skin 
• Depression 
• Brittle hair and nails 

Over time, you might develop these later symptoms of hypothyroidism; 

• Puffiness in the face, hands, and feet 
• A hoarse voice 
• Reduced smell and taste 
• Thickening of the skin 
• Thinning of eyebrows 
• A slowed heart rate 
• Decreased body temperature 
• Speech that’s slower than usual 

If hypothyroidism goes untreated, it can cause female infertility, male infertility, peripheral neuropathy, heart problems, an enlarged thyroid gland (simple goiter), and other conditions. 

Hypothyroidism is commonly caused by inflammation that damages cells in the thyroid gland, known as thyroiditis. The thyroid gland can become inflamed due to an autoimmune reaction, because of a viral or respiratory infection, or after pregnancy (postpartum thyroiditis). Other causes of an underactive thyroid include radiation therapy, certain medications like lithium, birth defects, a pituitary tumor, pituitary surgery, and a condition during pregnancy called Sheehan syndrome. If you’re being treated for an overactive thyroid (hyperthyroidism), taking too much of your medication can also cause your hormone level to become too low. 

The disorder is more common in people assigned female at birth and in people over age 50. 

Medication can replace the thyroid hormone you’re missing. It’s often taken as a pill at the lowest dose possible to normalize your thyroid hormone levels and manage your symptoms, but you may need to try different dosages to find what’s most effective. If you have severe hypothyroidism, you may need to go to the hospital to be given medication intravenously. 

Penn Medicine is home to specialized experts in endocrinology and thyroid care. In addition to providing a complete evaluation for hypothyroidism, we work with you to find the right dosage of hormone replacement to successfully treat the disease. As an academic medical center, we also research thyroid disorders, giving us deeper insights that directly inform the care we provide. 

Managing hypothyroidism is something you’ll need to do for the rest of your life, and we’re here to support you with advanced treatments, regular follow-up visits, and expert care. Hypothyroidism doesn’t have to slow you down. We’re your partners in managing it for the long term.