Hypothyroidism

What is a T4 test?
1. T4 is a hormone that plays a role in several body functions, including
growth and metabolism.
2. There are two kinds of T4 tests: a total T4 test and a free T4 test.
3. A number of drugs can interfere with your T4 levels, so tell your doctor
what medications youre taking before a T4 test.

Your thyroid produces a hormone called thyroxine, which is known as T4. This
hormone plays a role in several of your bodys functions, including growth and
metabolism.

Some of your T4 is called free T4. This means that it hasnt bonded to protein in
your blood. Most of the T4 in your body does bond with protein.

There are two kinds of T4 tests: a total T4 test and a free T4 test. A total T4 test
measures the T4 that has bonded to protein and the free T4. A free T4 test
measures only the free T4 in your blood.

Why do doctors perform a T4 test?

Your doctor may order a T4 test if a thyroid-stimulating hormone (TSH) test
has come back with abnormal results. A T4 test will help your doctor determine
what is wrong with your thyroid.

Some thyroid disorders include:

hyperthyroidism (overactive thyroid)

hypothyroidism (underactive thyroid)
hypopituitarism (underactive pituitary gland)
thyrotoxic periodic paralysis (occasional muscle weakness caused by high
levels of thyroid hormone)
 Your doctor may suspect that one of these thyroid conditions is present if you
have symptoms such as:

eye issues, such as dryness, irritation, puffiness, and bulging

skin dryness or puffiness
hair loss
hand tremors
increased heart rate

You may also experience more general symptoms such as:

weight changes
difficulty sleeping or insomnia
anxiety
fatigue and weakness
intolerance to cold
sensitivity to light
menstrual irregularity
Sometimes, your doctor may also order a test for T3 and/or TSH. The
TSH, or thyroid-stimulating hormone, stimulates your thyroid to release
both T3 and T4. Performing one or both of these other tests may help
your doctor gain a better understanding of your thyroid problem.
In some cases, your doctor may perform one or more of these tests to
help assess whether a known thyroid issue is improving.

What do abnormal T4 test results

mean?
An abnormal result on the T4 test may not give your doctor enough information
to fully understand or diagnose your condition. They may also need to consider
the results of tests for T3 and TSH levels.

Pregnancy can affect your T4 levels. If your T4 levels are abnormal but youre
pregnant, your doctor may order further testing. For example, the levels of T3 in
your blood may help your doctor understand your situation.

Elevated T4 levels may indicate hyperthyroidism. They may also indicate other
thyroid problems, such as thyroiditis or toxic multinodular goiter.
 Other abnormal results may indicate:

high levels of protein in the blood

too much iodine
too much thyroid replacement medication
trophoblastic disease, a group of rare pregnancy-related tumors
germ cell tumors

Too much iodine can raise your T4 levels. Because X-ray dye includes iodine, a
recent X-ray involving dye may also raise your T4 test results.

Abnormally low levels of T4 may indicate:

dietary issues, such as fasting, malnutrition, or an iodine deficiency

medications that affect protein levels
hypothyroidism
illness

What is primary hypothyroidism?

Your thyroid gland controls the metabolism of your body. To stimulate
your thyroid, your pituitary gland releases a hormone known as thyroid-
stimulating hormone (TSH). Your thyroid then releases two hormones,
T3 and T4. These hormones control your metabolism.
In hypothyroidism, your thyroid doesnt produce enough of these
hormones. This is also known as an underactive thyroid.
There are three types of hypothyroidism: primary, secondary, and
tertiary.
In primary hypothyroidism, your thyroid is being stimulated properly.
However, it isnt able to produce enough thyroid hormones for your
body to function properly. This means that your thyroid itself is the
source of the problem.
In secondary hypothyroidism, your pituitary gland isnt stimulating your
thyroid to produce enough hormones. In other words, the problem isnt
with your thyroid. The same is true with tertiary hypothyroidism.

What causes primary hypothyroidism?

 The most common cause of primary hypothyroidism is Hashimotos disease.
This is an autoimmune disease that causes your immune system to mistakenly
attack your thyroid.

You might also develop primary hypothyroidism for a number of other reasons.

If you had hyperthyroidism (or overactive thyroid), your treatment may have
left you with hypothyroidism. A common treatment for hyperthyroidism is
radioactive iodine. This treatment destroys the thyroid. A less common
treatment for hyperthyroidism involves the surgical removal of part or all of the
thyroid. Both can result in hypothyroidism.

If you had thyroid cancer, your doctor would have surgically removed your
thyroid, or part of it, to treat the cancer.

Other possible causes of hypothyroidism include:

insufficient dietary iodine

a congenital disease
certain drugs
viral thyroiditis

In some cases, a woman might develop hypothyroidism after giving birth.

According to the National Institutes of Health, the disease is most common in
women and people over 60 years old.

What are the symptoms of primary

hypothyroidism?
The symptoms of hypothyroidism vary widely from person to person.
Symptoms typically develop slowly, and depend on the severity of the disease.

At first, you may notice general symptoms including:

fatigue
lethargy
 sensitivity to cold
depression
muscle weakness

Because the thyroid hormones control the metabolism of all your cells, you
might also gain weight.

Other possible symptoms include:

pain in your joints or muscles

constipation
brittle hair or nails
voice hoarseness
puffiness in your face

As the disease progresses, these symptoms gradually become more severe.

If your hypothyroidism is extremely severe, you might fall into a coma, known
as a myxedema coma. This is a life-threatening condition.

How is primary hypothyroidism

diagnosed?
If you show physical symptoms of hypothyroidism, your doctor might decide to
do tests to check whether you have this condition.

Your doctor will generally use a blood test to check your T4 and TSH levels. If
your thyroid is malfunctioning, your pituitary gland will produce more TSH in
an attempt to get your thyroid to produce more T3 and T4. An elevated TSH
level can indicate to your doctor that you have a thyroid problem.

How is primary hypothyroidism

treated?
Treatment for hypothyroidism involves taking medication to replace the missing
thyroid hormones. Your doctor will typically start you on a low dose and
 increase it gradually. The goal is for your levels of thyroid hormones to return
to within the normal range.

Youll continue to take your thyroid medication throughout your life. Your
medication replaces the thyroid hormones that your thyroid is unable to
produce. It does not correct your thyroid disease. This means that if you stop
taking it, your symptoms will return.

Some medications and foods can interfere with your medications. Make sure to
tell your doctor about all medications that you take, including over-the-counter
drugs. Some vitamins and supplements, especially those for iron and calcium,
can also interfere with your treatment. You should talk with your doctor about
any supplements youre taking. You may also need to cut back on eating
anything made from soy and some high-fiber foods.

Hypothyroidism Diet Plan

Hypothyroidism occurs when levels of the two thyroid hormones,
triiodothyronine (T3) and thyroxine (T4), are too low. Although changing your
diet alone isnt enough to restore normal thyroid hormone levels, avoiding some
foods and eating more of others can help improve your bodys absorption of the
hormones.

Foods to Avoid

Many common foods and supplements contain compounds that interfere with
thyroid functions. In general, its best to avoid the following foods and
supplements:

Soy: Studies suggest that phytoestrogens in soybeans and soy-rich foods may
inhibit the activity of an enzyme that makes the thyroid hormones. One study
found that women who consumed soy supplements were three times more likely
to develop hypothyroidism.
Iodine-rich foods: Some forms of hypothyroidism are caused by a lack of
sufficient iodine. In such cases, using iodized salt or iodine-enriched foods can
be beneficial. But eating too much iodine can have the opposite effect and
 suppress thyroid gland activity. Check with your doctor before taking
supplements.
Iron and calcium supplements: Taking iron or calcium supplements can also
change the effectiveness of many thyroid medications.
High-fiber foods: Although a high-fiber diet is usually recommended, too
much fiber may interfere with the absorption of thyroid medicines.
Certain vegetables: Cruciferous vegetables that are rich in fiber like broccoli,
cabbage, spinach, kale, and Brussels sprouts can inhibit thyroid drug absorption.
Reducing the amounts of such produce in your diet may help.

Caffeine, tobacco, and alcohol can also influence the effectiveness of thyroid
medicine. Ask your doctor for tips on how to regulate or reduce your
consumption.

Foods to Eat

Nutrient-rich foods that improve your health may also benefit your thyroid
gland, including:

Antioxidant-rich fruits and vegetables:Blueberries, tomatoes, bell peppers,

and other foods rich in antioxidants can improve overall health and benefit the
thyroid gland. Eating foods high in B vitamins, like whole grains, may also
help.
Selenium: Tiny amounts of selenium are needed for enzymes that make thyroid
hormones to work properly. Eating selenium-rich foods, such as sunflower
seeds or Brazil nuts, can be beneficial.
Tyrosine: This amino acid is used by the thyroid gland to produce T3 and T4.

Diet Plans and Herbal Supplements

Hypothyroidism doesnt prevent or limit you from following a certain

health lifestyle. People with hypothyroidism can choose to be
vegetarian, eat protein-rich foods, or avoid allergy-causing ingredients.
You may also decide to use alternative medicines. Some plant extracts,
like ashwagandha (Withania somnifera), coleus (Coleus forskohlii),
gotu kola (Centella asiatica), and guggul (Commiphora mukul) have
been suggested to benefit some symptoms of hypothyroidism. But
evidence to support these claims are limited. Always speak with your
doctor before making any big changes to your eating habits or before
taking any supplements.
 T4 and TSH Results
The T4 test and the TSH test are the two most common thyroid function
tests. Theyre usually ordered together.
The T4 test is known as the thyroxine test. A high level of T4 indicates
an overactive thyroid (hyperthyroidism). Symptoms include anxiety,
unplanned weight loss, tremors, and diarrhea.
The TSH test measures the level of thyroid-stimulating hormone in your
blood. The TSH has a normal test range between 0.4 and 4.0 milli-
international units of hormone per liter of blood (mIU/L).
If you show signs of hypothyroidism and have a TSH reading above 2.0
mIU/L, youre at risk for progressing to hypothyroidism. Symptoms
include weight gain, fatigue, depression, and brittle hair and fingernails.
Your doctor will likely want to perform thyroid function tests at least
every other year going forward. Your doctor may also decide to begin
treating you with medications, such as levothyroxine, to ease your
symptoms.