Diagnosis is based on symptoms and lab results. Most often lab results will display high TSH, low T3, T3. Symptoms  of thyroid disorders will include weight gain, fatigue, hair loss, brittle nails, muscle aches, slow heart rate, cold intolerance, constipation, brain fog, difficulty concentrating, depression, dry skin Thyroid panel blood work includes the following: TSH (normal 0.5-5 mIU/L) High TSH with low T3, T4 Hypothyroidism. The pituitary gland detects the amount of thyroid hormone is low and producing more TSH in an attempt to stimulate the thyroid to produce more T3 and T4. Normal TSH with low thyroid hormones (T3, T4) Pituitary gland dysfunction Free T4 (normal 0.8-2.4 ng/dl) Low T4 suggest hypothyroidism Other causes of low T4: low albumin (protein in the blood stream), pituitary gland disorder, hypothalamic failure T3 (normal 100-200 mIU/L) Decreased suggests hypothyroidism Thyroid Antibodies TPO Antibodies (0-34) Elevated suggests Hashimoto’s Testing for anti-Tg and anti- THO antibodies in the blood. Circulation antibodies to thyroperoxidase are the best markers for the detection of HT while the antibodies to thyroglobulin are less sensitive and less specific. The frequency of ‘Thyroid Panel’ Blood Work: New diagnosis: Most will have thyroid hormones tested every 3 months when first starting treatment and while hormone levels are reaching target level Change in medication dose: Once the dose is changed, levels should be checked in 3 months.

In a healthy thyroid , the pituitary signals the thyroid gland in response the amount of T3 and T4 circulating in the body. When thyroid hormone levels are high the pituitary will signal the thyroid to reduce the production of thyroid hormone and when levels are low the pituitary will signal to increase production. The steps for this process if listed below. Step 1: Pituitary gland located in the brain detects a dip in thyroid hormone circulating in the body and releases TSH (thyroid stimulating hormone) into the bloodstream Step 2: TSH travels to the thyroid where it signals the thyroid to release more T4 Step 3: T4 is released from the thyroid gland and either enters the tissues (free T4) or becomes inactive by attaching to proteins (bound T4). This is determined by how much thyroid is needed. Step 4: Some of the free T4 is converted into T3 in the liver and enters the bloodstream to reach tissue cells. T3 has a much more substantial impact on the tissues than T4 (For this reason, even if your T4 and TSH are normal, but your T3 conversion is low, you may still have hypothyroid symptoms ) Step 5: The body sends signals back to the pituitary gland.

Typical hypothyroid symptoms include the following: Fatigue Weight gain or difficulty losing weight Brain fog Difficulty concentrating Depression Sleep disorder (too much or too little sleep) Constipation Cold intolerance Fatigue Dry skin Brittle nails Hair loss or coarse hair Muscle aches Heavy periods Slowed heart rate Slowed reflexes Hypothyroidism crisis can develop in poorly controlled hypothyroid patients, patients who develop an unrelated acute illness, or in those unaware they have hypothyroidism . Hypothyroidism crisis is very dangerous and needs immediate medical need as it can result in coma. The hypothyroidism crisis is characterized by: Extreme intolerance to cold and shivering Slow labored breathing Slow heart rate Extreme lethargy Loss of consciousness

Treatment will depend on the type of hypothyroidism you are diagnosed with and will include medications, diet, and exercise plans. Most people with hypothyroidism (excluding iodine deficiency) will need lifelong thyroid hormone medication, and lifestyle choices are just as important. The foods we eat and exercises we perform will have a substantial impact on people with hypothyroidism. Pharmacological options for treating hypothyroidism include: Levothyroxine: It is a synthetic form of thyroid hormone provides T4 that will then need to be converted into T3 Typically given at doses of 1.6–1.8 μg per kg of body weight. Administration of levothyroxine must be controlled and regularly evaluated since excessive levels may have adverse effects. Synthroid: Is in synthetic form, provides T4 that will need to be converted into T3 Armour (natural option made from bovine cells) Sheild: Is a combination of T4 and T3. This medication is often considered the best option for those who have either the inability to convert T4 into T3 or who have a lower conversion range Many people will start on one medication, feel better for a while and then start to feel worse again. Others may not feel better at all. Reasons, why this occurs are very individual, but nutrition deficiencies, protein imbalance, insufficient iodine, low T4 to T3 conversion rates, or food sensitivities all play a role.

Diet plays an important role in the maintenance of thyroid function. Hypothyroid patients need to pay attention to what they consume because there are foods that have been proven to hinder thyroid function such as estrogenic and goitrous and foods that improve it such as selenium rich. In addition, patients with hypothyroidism are at risk for weight gain so making proper food choices are essential for maintaining healthy BMI. Nutritive deficiencies such as low B-12 are common among patients in this group and can lead to co-morbid conditions such as anemia, so foods high in nutrients should be chosen over empty calorie foods. How often to eat : Studies have shown that hypothyroid patients have more energy when eating 5-6 small meals per day in comparison to 3 large meals per day. Hypothyroidism Dietary Recommendations: Proteins : It is recommended that hypothyroid patients have one serving of protein at every meal lean meats: chicken, turkey, lamb, pork fish beans Vegetables : 5-6 serving per day. Using plate method, vegetables should make up half your plate. High fiber foods: Hypothyroid patients often suffer from constipation. High-fiber foods not only keep patients regular but also keep them full which promotes weight loss. Iodine rich foods and its right balance:  Studies are contradictory when it comes to iodine.