This is usually an autoimmune process. Autoimmunity is the failure of an organism to recognize its own constituent parts as self, which allows an immune response against its own cells and tissues. Any disease that results from such an immune response is termed an autoimmune disease.
Here body produces antibody which reacts with the thyroid cells. The cells can not produce thyroid hormone and body becomes deficient in it. This is like type 1 Diabetes where the antibody is directed to the Insulin producing cells in the Pancreas and the person becomes dependent on Insulin.
History with clinical examination can diagnose underactive thyroid. Then we do blood test for thyroid function like TSH and free T4, usually we do not need anymore tests.
Treatment of Underactive thyroid is reasonably easy. We can prepare in the laboratory same thyroid hormone (thyroxine) that is produced by our thyroid gland, so the chance of reaction or not tolerating and side-effects are nil. You need to take the tablet regularly. The dose will be decided by your Doctor.
Remember iron and calcium tablet do not allow thyroid tablet to get absorbed from the stomach. So, if you are on iron/calcium tablet, there should be a gap of four hours between thyroid tab and iron/calcium.
It is very Important to take the Thyroxine tablet in empty stomach as food interferes with its’ absorption, we suggest not to eat or drink anything (other than water) for at least half an hour.
While you are on treatment with thyroid hormone, it is not possible to tell how much of the thyroid hormone in blood is coming from the tablet and how much from the gland because the thyroid hormone we give now is exactly the same in chemical structure as that of the body’s own thyroid hormone.
The only way is to stop your tablet for six weeks and repeat the blood test. If you are genuinely underactive, your symptoms will come back and you should understand that your own thyroid gland is unable to give you normal amount of thyroid hormone and you need to supplement from outside.
This type of trial of stopping and watching can be tried once 12 to 18 months after starting treatment in doubtful cases.
Once we know the exact dose of thyroid hormone for treating underactive thyroid, test need not be done for more than once in six to nine months. The good practice is to repeat the test at least once a year to make sure that you are not under- or over-treated. Your Doctor will be the best person to tell you the time for the next test.
Thyroid hormone dose not vary much with food, then also our standard suggestion is to get the test done in the morning before taking the tablet in the fasting state and then to continue taking the same dose till your Doctor has seen the report and advice you about the dose.
6 Thyroid Medication Mistakes You Don’t Want to Make
1. You expect to feel better instantly.
2. You take your meds at the wrong time
3. You switched from a brand-name to generic levothyroxine.
4. You store your levothyroxine tablets in the wrong place.
5. You think adding T3 will help.
6. You take “natural” thyroid medications and supplements.
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