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Do you have a thyroid problem?

Here's how to tell and what you can do.

By Dr. Mark Borchelt

Feeling tired, gaining or losing weight inexplicably or experiencing muscle weakness? There may be something wrong with your thyroid. 

The thyroid gland is a butterfly-shaped endocrine gland in the lower front of the neck. It makes thyroid hormone and secretes it into the bloodstream, where it is carried to all tissues of the body. Thyroid hormone is necessary for life and helps keep the body warm, in addition to many other functions. Other organs need it to work properly. 

If the thyroid starts to fail, symptoms often gradually appear, thus they are sometimes hard to recognize — especially early on. Other symptoms that many indicate something may be wrong with your thyroid include the development of increased sensitivity to cold temperatures, hoarseness of the voice, constipation, dry skin and/or depression. Prolonged signs should trigger an evaluation for hypothyroidism. 

Hashimoto’s disease, otherwise known as lymphocytic thyroiditis, is the most common cause of an underactive thyroid (hypothyroidism) in the United States. It is an autoimmune disease, meaning the body’s own immune system attacks the thyroid, causing it to eventually fail to make thyroid hormone. The tendency to develop an autoimmune disease is inherited, but something (perhaps a virus) activates the genes that cause the disease. 

As with other autoimmune diseases, Hashimoto’s disease is six to eight times more common in women than in men. Typically, it occurs in middle-aged women, but it can occur in children and in men, too. Often there is a family history of thyroid disease or other autoimmune disease. 

Other autoimmune diseases include pernicious anemia, type 1 diabetes, adrenal insufficiency, premature ovarian failure/ menopause, vitiligo and others. There are no symptoms unique to Hashimoto’s disease. Commonly, an enlargement of the thyroid gland, sometimes referred to as a goiter, will be noted. 

The diagnosis usually is made with blood samples sent to the lab. A pituitary hormone known as TSH (thyroid-stimulating hormone) usually will be elevated, and the thyroid hormone (free T4) will be low. There is really no need to check a free T3 level (another thyroid hormone usually best for evaluating an overactive thyroid). Similarly, a reverse T3 level is not helpful. A thyroid peroxidase level (TPO) is a diagnostic of Hashimoto’s disease. 

Thyroid hormone replacement is the only treatment for Hashimoto’s disease, but it is not always necessary. There are several different types of thyroid hormone replacement therapies available, and your endocrinologist can help you choose what is best for you. The condition also can be monitored with blood work, including a Thyroid Stimulating Hormone (TSH). This should be done six weeks after starting thyroid hormone or after each dose adjustment. In addition, surgery is not necessary for Hashimoto’s disease. 

Your thyroid is a vital hormone gland and plays a major role in your metabolism. Do not hesitate to take control of your health and partner with your doctor so you can feel better faster.


  • Fatigue
  • Gaining or losing weight inexplicably
  • Muscle weakness
  • Increased sensitivity to cold
  • Hoarseness of the voice
  • Constipation
  • Dry skin
  • Depression 

Mark D. Borchelt is a Memorial Physician Clinic endocrinologist. Call (228) 867-5000 for an appointment or visit for a physician directory.