For many of you, if you have not had surgery or radiation treatment that is an obvious cause of your hypothyroidism, the doctor may dismiss your symptoms, suggesting instead that you are suffering from depression, not enough sleep, a need for exercise, or simply the effects of stress. For women, you might be told these are the symptoms of premenstrual syndrome or menopause or normal post-partum problems.

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The reality is that symptoms such as fatigue, anxiety, unexplained weight gain, hair loss, and depression, may indicate that you have undiagnosed hypothyroidism.

How do you know if you have hypothyroidism, the most commonly diagnosed thyroid problem? Start with a careful review of the above symptoms, and to help, you can download and print out our comprehensive Hypothyroidism Symptoms Checklist.

If your doctor suspects hypothyroidism, he or she will order a TSH (thyroid stimulating hormone) test. Most American laboratories have a normal range from around .5 to 5.5. A TSH level above 5.5 or 6 is usually diagnosed as hypothyroid. An excellent chart showing normal TSH and thyroid lab values is featured here at the site.
 

However, there are doctors who believe that you do not need to have an elevated TSH level in order to actually be diagnosed and treated for hypothyroidism. Increasingly, innovative doctors are also viewing high-normal or normal TSH levels as possible evidence of low-level hypothyroidism. Dr. John Dommisse, in an interview with Mary Shomon, has said that that "The so-called 'normal range' is way too high"

Elizabeth Lee Vliet, M.D., who runs the HER Place hormonal medicine centers in Dallas/Fort Worth and Tucson, and is author of Screaming to Be Heard: Hormonal Connections Women Suspect...and Doctors Ignore, does not tell her patients their thyroids are normal based only on TSH results. According to Vliet, "The normal range is relative. Many women have symptoms -- or are hypothyroid -- when TSH is anywhere but the lower end of the range."

This broader interpretation of what constitutes 'normal' in terms of the thyroid is discussed in greater depth in HELP! My TSH Is "Normal" But I Think I'm Hypothyroid.

Dr. Vliet also tests for elevated thyroid antibodies, and low Free T3 and Free T4 levels. "Most women with elevated antibodies are in the process of developing autoimmune thyroid disease," says Vliet. "And even with normal TSH levels, I've found that majority of women with elevated antibodies, low Free T3 and low Free T4 require thyroid hormone replacement to feel well."

Doctors usually prescribe the synthetic T4 hormone levothyroxine to treat hypothyroidism. Popular brands include Levoxyl and Synthroid Research reported in the New England Journal of Medicine in February of 1999 found that a majority of patients may feel better on a combination of hormones. On that basis of that study, more doctors are also adding synthetic T3 (liothyronine). Alternative physicians tend to prefer Thyrolar, Armour, or Naturethroid, drugs that include both hormones.

For more information, see the Thyroid Drugs Database:
 

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