Some people are born with hypothyroidism, for a variety of reasons. Infants with untreated congenital hypothyroidism can develop a number of serious developmental problems as they mature, including mental retardation and stunted growth—a condition once known as "cretinism" (think of that next time you want to call someone a "cretin", eh? I don't think I've used that particular insult in months, for just that reason!).

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As I've mentioned here before, in 2003 the American Association of Clinical Endocrinologists recommended that the "normal" range of TSH be changed from 05.–5.0 to 0.3–3.04. However, for those of you who still feel crummy anywhere above 2.0, there's still hope to convince your doctor: Way back in 2002, the National Academy of Clinical Biochemistry suggested the ceiling for "normal" TSH be lowered to 2.5, "because >95% of rigorously screened normal euthyroid volunteers have serum TSH values between 0.4 and 2.5 mIU/L."

So, my repeated comments here that folks without thyroid problems generally have a TSH around or below 1 is somewhat incorrect. There is a wider range of truly "normal" TSH values than I had heard, but a narrower range of normal TSH than most doctors use when evaluating their patients' test results.

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There are a few questions that keep coming up in comments to other entries here, so I thought I'd just do a "quick review" entry of a few basic facts about hypothyroidism and the treatments for it, based on my own research. Mind you (once again) I am not a doctor. But I figure if multiple reputable sources all agree on a certain point, it's most likely true.

1. The current "normal" range for TSH tests is NOT 05.–5.5. In November of 2002, the American Association of Clinical Endocrinologists updated the "normal" range to 0.3–3.04. In "real life" people without thyroid problems generally have a TSH around 1.0 or lower.

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Yet another hypothyroid symptom that I am seeing relief from: hair loss. According to my doctor (who hasn't been wrong about *everything*), it can take months for hypothyroid-caused hair loss and breakage to start showing improvement. This makes sense, since even a normal person's hair only grows so fast... Even if your hair becomes perfectly healthy the day after you start thyroid medication, it's going to take a while for the new, healthy hair to grow out far enough to make a difference.

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A fairly obvious cause of hypothyroidism is previous treatment for a hyperthyroid condition. This probably doesn't need much discussion, but I thought I should cover it for the sake of thoroughness...

Some hyperthyroid conditions may be treated via thyroidectomy: partial or complete surgical removal of the thyroid.

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There was a time when the leading cause of hypothyroidism was iodine deficiency. In some areas of the world, this may still be the case, but in most of the northern hemisphere the advent of iodized salt and multivitamin supplements, and "enriched" food products have pretty much eliminated iodine deficiency. Anyone who tells you to take iodine supplements for your hypothyroidism had better have just gotten test results back indicating an iodine deficiency in your specific case... otherwise, their advice is likely to be utterly irrelevant to your situation.

There are a number of other causes for hypothyroidism. Unfortunately, most of them are poorly understood, and the treatment still almost universally consists of "take replacment thyroid hormones in a quanitity sufficient to return your TSH/T4/T3 blood levels to normal," as the underlying triggers are mostly impossible to verify or reliably address. Nonetheless, here's Part One of a basic overview of the most common causes of hypothyroidism, according to my personal research:

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The anterior pituitary secretes growth hormone, prolactin, follicle-stimulating hormone, luteinizing hormone, thyroid-stimulating hormone, adrenocorticotropic hormone, endorphins and other hormones. It does this in response to a variety of chemical signals from the hypothalamus.... --Wikipedia

The pea-sized pituitary gland seems to control just about everything, including the thyroid and its freqent partner in mysterious maladies: the adrenal gland.

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If you go into your doctor asking to be tested for thyroid function, there are a number of tests they can run. Most will start with a simple TSH (Thyroid Stimulator Hormone) test, and may tell you everything is OK if that test comes back normal. However, if you're experiencing a lot of hypothyroid symptoms, or if your TSH test comes back abnormal, there are two other tests that should be run: Free Thyroxine (T-4) and Free T-3.

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Before the doctor precribed my thyroid medication, she'd already seen blood test results showing "really low" numbers for my thyroid... so she asked about a bunch of symptoms. Because I thought we were looking at a recent problem, I answered "nothing new" or "nothing unusual" to a lot of her questions. Don't make that mistake yourself! When I started researching hypothyroid symptoms online after the appointment, I realized I'd had many common symptoms for years... some for as long as I can remember. Which makes me wonder if it would've ever become so acute, if I'd started treatment sooner?

Look over this list of common hypothyroid symptoms. If you find yourself recognizing a lot of them (either long term, or recent-onset), you may want to request a thyroid test from your doctor!

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