Quiz: Is hypothyroidism difficult to diagnose?

Our clinician-designed quiz helps you understand whether or not your symptoms are consistent with hypothyroidism. If they are, we'll guide you towards next steps and make sure you have everything you need to pursue a diagnosis.

What is hypothyroidism?

Hypothyroidism is a medical condition characterized by an underactive thyroid gland, which fails to produce an adequate amount of thyroid hormones. The thyroid hormones play a crucial role in regulating various bodily functions, including metabolism, growth, and development. The most common cause of hypothyroidism is an autoimmune condition called Hashimoto's thyroiditis, where the body's immune system mistakenly attacks the thyroid gland. Other causes include surgical removal of the thyroid gland, radiation therapy, certain medications, and congenital thyroid disorders.

The primary thyroid hormones affected in hypothyroidism are thyroxine (T4) and triiodothyronine (T3). These hormones are responsible for maintaining the body's metabolic rate and energy levels. When the production of thyroid hormones decreases, it leads to a slowdown in various bodily functions, resulting in a wide range of symptoms.

It is essential to diagnose hypothyroidism accurately through comprehensive clinical evaluation, including a physical exam, medical history, and laboratory tests such as thyroid stimulating hormone (TSH) and free T4 levels. Treatment typically involves hormone replacement therapy with synthetic thyroid hormones, such as levothyroxine, to restore normal thyroid hormone levels in the body.

What are the symptoms for hypothyroidism?

Hypothyroidism can manifest in a wide range of symptoms, which may vary in severity among individuals. The symptoms often develop slowly and can be subtle, leading to challenges in diagnosis. Common signs and symptoms of hypothyroidism include:

  1. Fatigue and weakness: Individuals with hypothyroidism may experience persistent fatigue and weakness, even with adequate rest.
  2. Weight gain: Unintentional weight gain is a common symptom of hypothyroidism. However, it is important to note that weight gain is not the sole indicator of the condition and can vary among individuals.
  3. Cold intolerance: Hypothyroidism can result in feeling excessively cold, even in mildly cool temperatures.
  4. Constipation: Sluggish bowel movements and constipation are frequently reported symptoms in individuals with hypothyroidism.
  5. Dry skin and hair: Insufficient thyroid hormone levels can lead to dry and itchy skin, as well as brittle and thinning hair.
  6. Depression and cognitive issues: Hypothyroidism can contribute to feelings of depression, difficulty concentrating, and memory problems.
  7. Menstrual irregularities: Those who menstruate may experience changes in their menstrual cycle, including heavier or prolonged periods, or even irregular menstruation.

These symptoms should prompt individuals to seek medical evaluation if they persist or worsen over time. Early detection and treatment are crucial to managing hypothyroidism effectively and minimizing potential complications.

Iconic can help you find a doctor with hypothyroidism expertise →

How does medical fatphobia show up in hypothyroid diagnosis and treatment?

Medical fatphobia refers to the systemic bias and discrimination against individuals based on their body size, particularly larger bodies. Unfortunately, medical fatphobia often influences the diagnosis and treatment of hypothyroidism. Research suggests that healthcare providers may overlook or misinterpret symptoms of hypothyroidism in individuals with higher body mass index (BMI), assuming that their symptoms are solely related to their weight.

One study found that larger-bodied individuals with hypothyroidism were more likely to have their thyroid function undertreated, resulting in persistent symptoms and poorer health outcomes. This bias can lead to delays in diagnosis, inadequate medication dosage, and a lack of appropriate follow-up care.

Another aspect of medical fatphobia is the focus on weight loss as a primary treatment goal for individuals with hypothyroidism. While weight loss may be a desirable outcome for some individuals, it should not be the sole focus of treatment. In fact, excessive emphasis on weight loss can perpetuate stigma and harm patients' mental and physical health.

It is crucial to recognize and address these issues to ensure equitable and effective healthcare for all individuals, regardless of their body size.

Size-inclusive care for hypothyroidism

Size-inclusive care for hypothyroidism involves a patient-centered approach that prioritizes health outcomes rather than weight-focused interventions. It acknowledges that health and well-being can be achieved and maintained at various body sizes and focuses on supporting individuals in optimizing their overall health. Here are some key principles for size-inclusive care for hypothyroidism:

  1. Whole-person approach: Shifting the focus from weight to overall health and well-being is critical. Recognize that health is a multifaceted concept that encompasses various factors beyond body weight, such as physical, mental, and emotional well-being.
  2. Individualized treatment: Recognizing that each person with hypothyroidism is unique, and individualized treatment plans should be developed. This approach considers the individual's specific symptoms, medical history, preferences, and goals. It is important to tailor treatment to the person's needs rather than applying a one-size-fits-all approach.
  3. Focus on symptom management: Hypothyroidism is characterized by a range of symptoms, such as fatigue, weight changes, mood alterations, and cognitive impairment. In size-inclusive care, the emphasis is placed on managing these symptoms effectively rather than solely focusing on weight loss. Treatment strategies should address symptom relief, optimize thyroid hormone levels, and enhance overall well-being.
  4. Addressing mental health: Size-inclusive practitioners understand the potential impact of hypothyroidism on mental health, including depression and anxiety. They offer appropriate support and resources to address these mental health concerns, including referrals to therapy, counseling, or support groups.

Implementing size-inclusive care for hypothyroidism can improve patient outcomes, increase patient satisfaction, and reduce the harmful effects of weight stigma and bias in healthcare settings.

Building an inclusive care team

Finding inclusive doctors can be daunting, especially when seeking treatment for conditions like hypothyroidism. Many healthcare providers still adhere to weight-centric approaches, focusing on weight loss as the primary solution, which can disregard the diverse needs and experiences of patients. That’s why we built Iconic. Our care navigation service is designed to connect members with affirming doctors who are aligned with their specific needs. With Iconic, it’s finally possible to find doctors who prioritize holistic health, emphasize well-being over weight, and provide personalized care for conditions like hypothyroidism.

Build your care team with Iconic for only $14.99/month →

8 sources
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  1. American Thyroid Association. (n.d.). Hypothyroidism. Retrieved from https://www.thyroid.org/hypothyroidism/
  2. Chaker, L., Bianco, A. C., Jonklaas, J., & Peeters, R. P. (2017). Hypothyroidism. The Lancet, 390(10101), 1550-1562.
  3. Garber, J. R., Cobin, R. H., Gharib, H., Hennessey, J. V., Klein, I. L., Mechanick, J. I., ... & Woeber, K. A. (2012). Clinical practice guidelines for hypothyroidism in adults: cosponsored by the American Association of Clinical Endocrinologists and the American Thyroid Association. Thyroid, 22(12), 1200-1235.
  4. Gudzune, K. A., Cooper, L. A., Bleich, S. N., & Clark, J. M (2014). Provider attitudes and beliefs about weight loss and weight-loss medications among obese adults: A qualitative study. Obesity, 22(4), E40-E46. doi:10.1002/oby.20640
  5. Hennessey, J. V. (2017). Hypothyroidism: Overview, clinical manifestations, and diagnosis. In J. L. Jameson, & L. J. De Groot (Eds.), Endocrinology: Adult and Pediatric (pp. 1901-1911). Elsevier.
  6. Jonklaas, J. et al. (2014). Guidelines for the treatment of hypothyroidism: prepared by the American Thyroid Association Task Force on thyroid hormone replacement. Thyroid, 24(12), 1670-1751. doi: 10.1089/thy.2014.0028
  7. Mayo Clinic. (2021). Hypothyroidism (underactive thyroid). Retrieved from https://www.mayoclinic.org/diseases-conditions/hypothyroidism/symptoms-causes/syc-20350284
  8. Phelan, S. M., Burgess, D. J., Yeazel, M. W., Hellerstedt, W. L., Griffin, J. M., & van Ryn, M. (2015). Impact of weight bias and stigma on quality of care and outcomes for patients with obesity. Obesity Reviews, 16(4), 319-326. doi:10.1111/obr.12266