What is Hypothyroidism?

Hypothyroidism, also called low thyroid or underactive thyroid, is a condition in which your thyroid gland, a small butterfly-shaped gland at the base of your neck, doesn’t produce enough of its normal hormones. When it’s healthy, your thyroid produces two different hormones: triiodothyronine (T3) and thyroxine (T4). These are used by cells throughout your body, primarily to regulate metabolism. Not having enough of these hormones will slow down your body’s functioning.

Hypothyroidism Symptoms

Thyroid hormones affect every cell and organ of the body. That’s why hypothyroidism can have so many diverse symptoms.

Low thyroid can make you feel exhausted and sluggish, even if you’re sleeping more than usual. You can also feel mentally tired and unmotivated.

Unexplained weight gain

When thyroid levels are low, metabolism slows and your body tends to store more calories from your food as fat. This can make you gain weight even if your diet is good and you’re exercising.

Feeling cold

Burning calories creates your body heat. When your metabolism slows, you burn fewer calories and produce less heat.

Muscle weakness and aches

Low levels of thyroid hormone cause your body to break down tissues like muscle for energy. Muscle breakdown can make you weak and achy.

Hair loss

Hypothyroidism causes hair follicles to stop generating as quickly. Since these cells normally have a short lifespan and rapid turnover, your hair can thin.

Dry, itchy skin

Your skin cells typically turn over very quickly too. However, when they lose their growth signals from the thyroid, the outer layer isn’t replaced as quickly. Since this skin layer sticks around longer, it accumulates more environmental damage.


Slowing your metabolism slows down activity in your colon.


Scientists aren’t sure why this happens, but feeling sluggish and in poor health is likely to affect your mental outlook.

Other symptoms

Since thyroid hormones are used everywhere in the body, you may also experience decreased sweating, slowed heart rate, elevated blood cholesterol, menstrual problems, hoarseness, or other issues.

Causes of Hypothyroidism

You’re at most risk for hypothyroidism if you are a woman and over 60, but anyone can develop low thyroid. This is because it has many possible causes.
Autoimmune disease

When your immune system — normally an expert at telling friend from foe — mistakenly attacks your own healthy cells, you have an autoimmune disease. In one such disease, Hashimoto’s thyroiditis, your immune system attacks your thyroid gland. Hashimoto’s is more common in women than in men. After a while, there aren’t enough thyroid cells and enzymes left to make enough thyroid hormone. This can happen suddenly, or it can develop slowly over years.

Surgical removal or radiation treatment

Removal or irradiation of all or a significant portion of the thyroid will cause hypothyroidism. These treatments may be necessary for people who have thyroid nodules, thyroid cancer, or Grave’s disease (an autoimmune disease that causes the thyroid to overproduce hormones).


Thyroiditis is an inflammation of the thyroid gland, usually caused by an autoimmune attack or a viral infection.


Medicines such as amiodarone, lithium, interferon alpha, and interleukin-2, can affect the functioning of your thyroid. These drugs are most likely to trigger hypothyroidism in patients who have a genetic tendency to autoimmune thyroid disease.

Iodine deficiency

The trace mineral iodine — found primarily in seafood, seaweed, and iodized salt — is an essential ingredient in both of the hormones made by your thyroid. Too little iodine can lead to hypothyroidism, but the addition of iodine to table salt has virtually eliminated this problem in the United States. Balance is crucial though. If you eat too much iodine, you can actually worsen an existing hypothyroid problem.

Damage to the pituitary gland

The pituitary, a tiny pea-sized but critical gland at the base of the brain, tells your thyroid how much hormone to make. If it is damaged — for example, by a tumor — your pituitary may not make enough thyroid-stimulating hormone (TSH), and your thyroid may not produce enough hormones.

Pregnancy or birth defects

Although relatively rare, some women produce antibodies to their own thyroid gland during or after pregnancy and develop low thyroid. Also, babies can sometimes be born with no thyroid or a defective gland.


There are several steps in diagnosing hypothyroidism, although only a blood test is truly definitive. If you have symptoms and are concerned about whether or not you may have low thyroid, here are the steps to finding out:
1. Check the symptom list

The problem is that there are no definitive symptoms of hypothyroidism. In other words, there are no symptoms that you must have, and many of these symptoms are common to this disease as well as several others. However, if you see a symptom on the list that is new to you, that’s a signal to talk to your doctor. Any changes in your health are worth discussing.

2. Speak to your doctor

In addition to discussing any changes in your health, especially those that suggest your body is slowing down, review your medical and family history. Have you had thyroid surgery or radiation to that area? Do you have a family history of thyroid disease, or are you taking any medications that can cause hypothyroidism?

3. Get a physical exam

Your doctor will feel your thyroid and look for changes in your body, such as dry skin, swelling around the eyes and legs, slower reflexes, and a slower heart rate.

4. Take a blood test

Because the symptoms of low thyroid are so general, the only way to diagnose this condition for sure is through a blood test.

Several blood tests are used to diagnose hypothyroidism. A TSH (thyroid-stimulating hormone) test is the most important and sensitive one. It measures how much of the thyroid hormone T4 the pituitary gland is asking the thyroid gland to make. Abnormally high TSH is a signal of hypothyroidism: the thyroid gland is being asked to make more T4 because there isn’t enough T4 in the blood.

Your doctor may order a T4 test if your TSH test results are abnormal, to help determine what type of problem is affecting your thyroid. T3 testing is less helpful in diagnosis because it is the last test to become abnormal.

Hypothyroidism Treatment

Physicians treat hypothyroidism by replacing the hormones your body is not producing to bring your levels into the optimal range. This, in turn, reverses the symptoms caused by low thyroid. There’s no cure, but this disease can be managed to help you lead a normal and active life.

Treatment involves taking daily oral medication prescribed by your doctor and based on your needs. One oral option is a synthetic version of T4 or, if this does not relieve your symptoms, a combination of synthetic T4 and T3. Effective natural supplements containing both T4 and T3 can also be extracted from pig thyroid glands (porcine thyroid).

How Belmar Can Help

Belmar compounds T3 and T3/T4 tablets in a variety of strengths. We also dispense a range of commercial options. We’re focused on ensuring your doctor has the right medication available to fit your specific needs, so you can enjoy the best health and lifestyle possible.

If you’ve been diagnosed with hypothyroidism or are concerned about any of the symptoms on this page, contact us for more information and start a conversation with your doctor. Together, you can decide if a compounded prescription might be a good treatment for you.

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