Hypothyroidism: what to watch for and what to do

Feeling tired, cold, or unusually puffy? Those can be signs of hypothyroidism — a common condition where your thyroid doesn't make enough hormones. Most people do well once they get the right diagnosis and a simple daily pill. This page gives straight facts you can use: how doctors test for it, what treatments work, and quick tips to feel better every day.

Common signs and how it's diagnosed

Hypothyroidism often shows up slowly. Look for constant fatigue, weight gain without eating more, dry skin, thinning hair, constipation, increased sensitivity to cold, and heavy or irregular periods. Memory or concentration problems and a low mood also happen.

Diagnosis is a blood test. Doctors usually check TSH (thyroid-stimulating hormone) and free T4. A high TSH with a low free T4 points to underactive thyroid. Sometimes they also test antibodies to see if autoimmune thyroiditis (Hashimoto's) is the cause.

Treatment, monitoring, and simple daily rules

The standard treatment is levothyroxine — a synthetic thyroid hormone taken once a day. The goal is to normalize your TSH and relieve symptoms. New prescriptions often need dose checks every 6–8 weeks until levels are stable, then typically yearly checks.

Small but important habits make the pill work better: take levothyroxine on an empty stomach, 30–60 minutes before breakfast, or at bedtime 3–4 hours after your last meal. Avoid taking it at the same time as calcium, iron, certain antacids, and some supplements — these can block absorption. If you take any of those, space them at least four hours apart.

Expect gradual improvement. Energy, mood, and digestion often get better in a few weeks, but hair and cholesterol may take months. If symptoms persist after your labs look normal, tell your doctor — reasons vary and may need small adjustments or extra testing.

Special situations: pregnancy changes thyroid needs — dose often rises early on. If you're pregnant or planning to be, tell your clinician right away. Older adults and people with heart disease may need more careful dose increases.

Daily lifestyle tips: keep active with regular walks or strength work, follow a balanced diet (no need for extreme iodine unless recommended), manage stress and sleep, and check labels on new medicines for interactions. If you use herbal supplements, discuss them with your doctor.

When to get urgent help: severe weakness, fainting, very low body temperature, or confusion can signal a rare but serious condition called myxedema coma. Call emergency services if that happens.

Want to talk to someone from our team? Visit our contact page at Contact Us. For privacy questions, see our Data Protection & Privacy page. Browse related articles on our site to learn more about specific medicines, side effects, and practical tips for living well with hypothyroidism.