DRHOOK- Slow motion: Under-active thyroid applies the brakes

"Slow down, you move too fast. You've got to make the morning laaaaast." 

Simon and Garfunkel wrote some pretty amazing songs. But things are much more fast-paced now than they were back in their heyday. Don't believe me? If music videos flash so fast they can induce seizures– well, that's Usain Bolt fast to me.

What happens if your health forces you to slow down?

Well, if you're on Survivor, you will be voted off– unless you walk around naked on the beach.

For people with hypothyroidism, things slooow dooown. The thyroid is vital for metabolism and to keep the body going. However, about two percent of the population has hypothyroidism. Women are five to eight times more likely to be hypothyroid than men.

The symptoms of low thyroid, though, are pretty common in our Speedy Gonzales society: fatigue, weakness, and depression. So many people come to my office wondering if they are hypothyroid– only to be told they're not. (But it's worth checking their thyroid labs.)

Weight gain is prevalent, and of course we'd all like to think our weight gain is due to hypothyroidism, not to the extra bag of potato chips we ate lying on the couch last night. So when I do have newly diagnosed patients with hypothyroidism, and they ask me if they will lose weight on thyroid medicine, I respond, "If you're eating right and getting enough exercise, you'll lose weight. If you aren't, you won't."

(Pan camera to patient. Zoom in to their frowning face. That's a wrap!)

Aches and pains from low thyroid are due to muscle breakdown, and the joints just don't feel so good.

A lot of my female patients (and friends) have ice-cold hands: their greeting to me is always, "Brrrrr!" Feeling intolerant to cold is a symptom of hypothyroidism, but a lot of people with normal thyroids are cold as well, so that's not a sure-fire indicator of the problem.

Poor memory, poor thinking, and depressed mood can occur with hypothyroidism, as well as slow movement, slow speech, slow heart rate, Slovakia. 

You've heard of getting a lump in your throat? Well, a goiter is the real thing. It's an enlarged thyroid in front of the lower neck. If it gets too big, swallowing becomes difficult. And on the other end of the GI spectrum, constipation can be a real pain because of low thyroid function. 

Hypothyroidism can blow a person up: puffy eyes, puffy face, swollen legs, and even fluid accumulation in the abdomen, around the lungs and heart. This is interesting to me: the tongue can enlarge as well. "Cat got your tongue?" "No, it's my low thyroid."

The voice can become hoarse— a person with low thyroid function can sound like Kim Carnes.

Losing hair devastates most women. The scalp becomes thinner, and even the eyebrows can become thinner. The skin can become quite coarse and dryer than my sense of humor.

For women, menstrual cycles can be disturbed. In pregnant women, hypothyroidism can lead to mental retardation in the baby. Hypothyroidism can also cause the breasts to secrete milk– even in non-nursing women.

Those with autoimmune diseases are more at risk of developing hypothyroidism, such as folks with Type I Diabetes and with vitiligo (unpigmented skin, like Michael Jackson claims he has). 

Diagnosis is made by a simple blood test. Treatment is replacement of thyroid hormone.

I have a family history of hypothyroidism, so I wonder if I will develop it. Maybe if I talk and walk slower than The Flash, I will know my thyroid has burned out– or it could be because I drank some Sloe Gin.


Dr. Hook cracks a joke or two, but he's a renowned physician with a local practice. Email him with your questions.