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About Hypothyroidism

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Hypothyroidism, also known as an underactive thyroid, is a disorder in which your thyroid gland doesn’t make enough hormones to meet your body’s needs. The thyroid is a small, butterfly-shaped gland in the front of your neck which produces hormones that control how your body uses energy. These important hormones control many of your body’s most important functions including your metabolism, breathing, heart rate, digestion, and mood. When your thyroid slows down, these functions can be negatively affected.

Some symptoms of a slow thyroid include:

  • Fatigue
  • Depression
  • Constipation
  • Muscle weakness, stiffness, and/or aches
  • Joint pain, stiffness, or swelling
  • Memory problems
  • Sudden weight gain (and difficulty losing it)
  • High cholesterol
  • Slow heart rate
  • Dry, thinning hair
  • Dry skin
  • Decreased tolerance for cold
  • Swelling of the thyroid gland (called a goiter)
  • A puffy face

Women may experience heavy or irregular periods and fertility problems

Hypothyroidism generally develops slowly. Because of this, it sometimes takes several months, or even years, before the symptoms are noticed. Once detected, however, it is usually treatable.

Common Medication
Treatment Options

Below is a list of common medications used to treat hypothyroidism, which a doctor or provider on Sesame can prescribe for just $5 through SesameRx.

Note that all prescriptions are at the discretion of your doctor.

Look below for more information about medications used to treat hypothyroidsm. During your appointment, talk to your doctor about whether or not a hormone replacement treatment plan is right for you.

FAQs

Hypothyroidism Care

What is hypothyroidism/ hyperthyroidism?

The thyroid gland produces the hormones triiodothyronine (T3) and thyroxine (T4), which help regulate metabolism. Metabolism can affect your weight, body temperature, and energy. An under or overactive thyroid can alter your heart rhythms, which may lead to heart failure.

Hypothyroidism: An underactive thyroid gland slows down the metabolism, which can lead to weight gain and fatigue. Other symptoms of hypothyroidism include:


  • Sensitivity to cold
  • Constipation
  • Change in menstrual periods
  • Muscle pain/ weakness
  • Joint pain/ stiffness
  • Dry skin and hair
  • Increased cholesterol levels
  • Hoarseness
  • Depression
  • Confusion and memory problems

Hypothyroidism is commonly caused by Hashimoto’s disease, an autoimmune disease in which cells in the thyroid are mistakenly attacked by your body’s immune system. An underactive thyroid can lead to heart problems, mental health problems, nerve damage, infertility, and other complications.

Hyperthyroidism: An overactive thyroid gland produces excessive levels of T3 and T4 hormones. This can produce symptoms such as:


  • Weight loss
  • Rapid heartbeat (tachycardia)
  • Nervousness or anxiety
  • Tremor (trembling in the hands and fingers)
  • Diarrhea
  • Increased appetite
  • Changes in menstrual cycles
  • Sensitivity to heat and excessive sweating
  • Sleep problems
  • Fatigue
  • Bulging eyes (common in Grave’s disease)
  • Hair loss, or thinning of hair

Hyperthyroidism can lead to complications such as heart problems, brittle bones, eye problems (especially common with Grave’s disease), and thyrotoxic crisis. This last condition results in a sudden increase in the severity of your symptoms and delirium. A thyrotoxic crisis is a medical emergency and requires immediate care.

How are thyroid conditions treated?

Hyper/ hypothyroidism treatments are meant to manage hormone levels.

For an underactive thyroid, your doctor may prescribe you a hormone replacement medication that will replace the hormones that your thyroid gland is not producing enough of. The most common medication used for this therapy is levothyroxine, which increases the levels of T4 and T3 in your blood.

For an overactive thyroid, your doctor may prescribe methimazole or propylthiouracil, both of which block your thyroid’s ability to make T4 and T3. You may also be prescribed radioactive iodine, an oral tablet that shrinks your thyroid glands. This leads to a decrease in thyroid hormone production but usually results in permanent damage to the thyroid gland. After taking this medication, you may be prescribed hormone replacement therapy to keep hormone levels balanced.

What is a thyroid panel?

A thyroid panel is a series of blood tests that help determine whether or not your thyroid gland is functioning properly. The thyroid is a butterfly-shaped gland that lies below your Adam’s apple in the front of the neck. The gland is responsible for the production of the triiodothyronine (T3) and thyroxine (T4) hormones, which regulate your body’s metabolism. Thyroid panel tests are used to determine the levels of thyroid hormones you have in your body.

What conditions does a thyroid panel help detect?

Thyroid panel tests are used to determine the levels of T3 and T4 hormones in your blood. Low amounts of these hormones indicate an underactive thyroid gland (hypothyroidism), where excessive levels of T3 and T4 indicate an overactive thyroid (hyperthyroidism).

Detecting an under or overactive thyroid can help doctors diagnose thyroid-related disorders such as:


- Thyroid cancer

- Goiter: An enlargement of the thyroid gland which can cause pain, hoarseness, swelling, and dizziness.

- Hashimoto’s disease: An autoimmune disorder that attacks cells in the thyroid gland, resulting in hypothyroidism.

- Thyroiditis: Inflammation of the thyroid, which can result in hypothyroidism or hyperthyroidism.

- Grave’s disease: An autoimmune disorder that results in hyperthyroidism.

What blood tests are performed during a thyroid panel?

A comprehensive thyroid panel will evaluate your thyroid function with 3 different tests:

- TSH test: A thyroid-stimulating hormone (TSH) test is a lab test that evaluates how well your thyroid is working by measuring your thyroid-stimulating hormone. Your doctor may recommend a TSH test if you're experiencing symptoms of hyperthyroidism or hypothyroidism, including anxiety, weight gain/loss, tiredness, hair loss, irregular menstrual periods, changes in your heart rate, puffiness, and more.

- T4 Test: A thyroxine (T4) test measures the level of T4 in the blood.

- T3 Test: A triiodothyronine (T3) test measures the level of T3 in the blood.

Other blood tests that may be performed during a thyroid panel include:

- Thyroid antibody test: This test measures levels of thyroid antibodies that are produced to determine whether or not the immune system is mistakenly creating antibodies to attack the thyroid gland. By doing this, thyroid antibody tests can help detect underlying autoimmune causes of hyper/hypothyroidism such as Grave’s disease or Hashimoto’s disease.

- Thyroglobulin: This test measures the thyroglobulin protein, which is produced by the thyroid gland or thyroid cancer cells. A thyroglobulin test can help detect inflammation of the thyroid gland- especially in patients who have had their thyroid gland removed due to thyroid cancer.

What is a TSH test?

A thyroid-stimulating hormone (TSH) test is a blood test used to measure levels of TSH in the blood. This helps doctors determine how well the thyroid gland is working. The thyroid is a butterfly-shaped gland that lies below your Adam’s apple in the front of the neck. The gland is responsible for the production of the triiodothyronine (T3) and thyroxine (T4) hormones, which regulate your body’s metabolism. TSH is produced by the pituitary gland in the brain and acts as a stimulant for the thyroid gland. If thyroid hormone levels are too low, TSH will be produced by the pituitary gland to provoke hormone production from the thyroid gland. If thyroid hormone levels are high, your pituitary gland should produce less TSH.

Why would I need a TSH test?

Levels of TSH in the blood can help doctors determine the function of the thyroid gland. High levels of TSH might mean an underactive thyroid, whereas low levels of TSH may indicate an overactive thyroid. This test helps doctors detect and diagnose possible thyroid disorders such as hyperthyroidism and hypothyroidism.

What happens during a TSH test?

A blood sample is taken to measure TSH levels. To do this, your doctor will insert a small needle into a vein in your forearm. Before the needle is put into your skin, the area will be sanitized. You may feel a pinch as the needle punctures your skin, but this discomfort should subside within a few seconds.

Blood drawn from your arm is deposited in a small vial or tube. Once the desired amount of blood is taken from the arm, the puncture site will be cleaned and bandaged. The vial will be given to the lab for analysis.

TSH tests are quick and do not require sedation. You will be cleared to leave the clinic and resume your daily activities once the testing is finished.

You should receive the results of your TSH test within 1-3 days of your appointment. Your primary care provider will inform you of the results of the analysis. Depending on the findings, you may be asked to come back to the clinic for follow-up testing to definitively diagnose any thyroid conditions. Thyroid cancer, for instance, requires a biopsy or diagnostic imaging test (such as a CT or X-ray scan) before treatment can begin.

The results of a TSH test do not necessarily indicate a hormone condition. TSH levels correspond to levels of T3 and T4 in the blood. Because of this, you will likely be asked to undergo further testing before you are diagnosed with a thyroid condition. TSH tests are commonly performed in tandem with other thyroid tests as a part of a comprehensive thyroid panel. These tests measure various determinants of thyroid function, such as T3 and T4 levels. Comprehensive thyroid panels are commonly performed for individuals at risk of a thyroid condition, or for individuals taking medication that affects thyroid function - such as lithium.

How do I prepare for a TSH test?

TSH tests require no specific preparation. If your health care provider has ordered other blood tests to be performed along with a TSH test, you may need to fast for 8-12 hours before your appointment. If this is not the case, then there is nothing you need to do to prepare for a TSH test.

What is a T4 test?

Thyroxine (T4) is a hormone produced by the thyroid gland. The thyroid is a butterfly-shaped gland that lies below your Adam’s apple in the front of the neck. The gland is responsible for the production of the triiodothyronine (T3) and thyroxine (T4) hormones, which regulate your body’s metabolism and growth. T4 tests are used to determine the levels of the thyroxine hormone you have in your body. Too much or too little T4 can indicate a problem with your thyroid gland such as hyperthyroidism or hypothyroidism.

What conditions does a T4 test help detect?

Thyroxine blood tests are used to determine the levels of T4 hormones in your blood. There are two forms of T4: free T4 and bound T4. Free T4 flows freely through the bloodstream on its own. Bound T4 attaches itself to proteins in the blood. Low amounts of these two types of the T4 hormone indicate an underactive thyroid gland (hypothyroidism), where excessive levels of T4 indicate an overactive thyroid (hyperthyroidism).

Detecting an under or overactive thyroid can help doctors diagnose thyroid-related disorders such as:


- Thyroid cancer

- Goiter: An enlargement of the thyroid gland which can cause pain, hoarseness, swelling, and dizziness.

- Hashimoto’s disease: An autoimmune disorder that attacks cells in the thyroid gland, resulting in hypothyroidism.

- Thyroiditis: Inflammation of the thyroid, which can result in hypothyroidism or hyperthyroidism.

- Grave’s disease: An autoimmune disorder that results in hyperthyroidism.

What happens during a T4 test?

A blood sample is taken to measure T4 levels. To do this, your doctor will insert a small needle into a vein in your forearm. Before the needle is put into your skin, the area will be sanitized. You may feel a pinch as the needle punctures your skin, but this discomfort should subside within a few seconds.

Blood drawn from your arm is deposited in a small vial or tube. Once the desired amount of blood is taken from the arm, the puncture site will be cleaned and bandaged. The vial will be given to the lab for analysis.

T4 tests are quick and do not require sedation. You will be cleared to leave the clinic and resume your daily activities once the testing is finished.

You should receive the results of your T4 test within 1-3 days of your appointment. Your primary care provider will inform you of the results of the analysis. Depending on the findings, you may be asked to come back to the clinic for follow-up testing to definitively diagnose any thyroid conditions. Thyroid cancer may require a biopsy or diagnostic imaging test (such as a CT or X-ray scan).

What is levothyroxine?

Levothyroxine is a prescription medication used to treat thyroid conditions. It is a hormone replacement drug usually prescribed to treat hypothyroidism, a condition in which the body does not produce enough thyroid hormone to properly regulate your metabolism and weight. Levothyroxine may also be prescribed to help treat thyroid cancer.

Hypothyroidism affects almost 5% of the U.S. population. Without the proper amount of thyroid hormone, people with hypothyroidism often suffer from fatigue, poor growth, constipation, weight gain, hair loss, muscle pain, depression, and more.

What is levothyroxine used to treat?

Levothyroxine is generally used to treat thyroid conditions, including hypothyroidism and thyroid cancer.

The thyroid is often referred to as the body’s thermostat; it produces thyroid hormone, the chemical responsible for stabilizing your weight, regulating your metabolism, and maintaining your mental health. People with hypothyroidism can no longer produce this hormone in sufficient quantities, causing a range of health conditions from depression to weight gain. For patients with hypothyroidism, levothyroxine is prescribed to supply the body with the level of thyroid hormone it needs. Levothyroxine supplements - and in some cases, completely replaces - your body’s diminished supply of thyroid hormone, helping you feel like yourself again.

Alongside surgery and radioiodine therapy, levothyroxine is sometimes prescribed to help treat thyroid cancer.

There are some thyroid conditions, however, that levothyroxine is not approved to treat. These include benign thyroid nodules, goiters, and subacute thyroiditis.

How does levothyroxine work?

Levothyroxine treats hypothyroidism by supplying the body directly with thyroid hormone, a natural chemical responsible for regulating your body’s metabolism. People with hypothyroidism can no longer produce this hormone, leading to a host of health problems. Levothyroxine acts as a stand-in for your underactive thyroid gland, helping supply the necessary amount of thyroid hormone to your body.

How long does it take for levothyroxine to work?

The amount of time it takes for levothyroxine to take effect depends on a variety of factors, including your age, body weight, and cardiovascular health. In general, most people start to feel better within 4-6 weeks of starting levothyroxine. It is important to keep taking your scheduled dosage, even if you do not immediately feel its effects. Consult your doctor before stopping levothyroxine.

What are the most common side effects of levothyroxine?

While levothyroxine may cause you to experience some adverse side effects, it is important to remember that your doctor prescribed levothyroxine because its ability to stabilize thyroid hormones in your body outweighs the side effects it may produce.

You may experience some hair loss as you begin taking levothyroxine. This is temporary and does not generally persist as you continue taking levothyroxine.

Rare but serious side effects may include:

Arrhythmias Myocardial infarction (heart attack) Dyspnea Muscle spasm Headache Nervousness Irritability Insomnia Tremors Muscle weakness Increased appetite Weight loss Diarrhea Heat intolerance Menstrual irregularities Skin rash

Notify your doctor if you experience any of these adverse effects.

Can I get levothyroxine online?

Yep! Get medication delivered right to your door with free and fast delivery - without insurance. Our fully-integrated prescription service lets your doctor write you a prescription (or refill an existing one) during your visit. That way, you can focus on getting better and not worry about how and when you’ll get your prescription.

Please note that all prescriptions are at the discretion of your doctor.

Can my provider prescribe medication?

Yes, physicians on Sesame can prescribe a wide range of medications, which can be useful for infections, allergies, and other acute ailments. Please note that they will not prescribe certain drugs, such as narcotics or medications that have been designated controlled substances through telehealth.

Otherwise, many of the prescriptions available in an office setting or urgent care can be prescribed if your clinician deems it appropriate.

How does booking care on Sesame work?

Sesame makes it easier than ever to find and pay doctors online directly - allowing you to book an in-person or telehealth appointment in less than two minutes. To get care today, follow these easy steps:
- Search for telehealth or in-person appointments by specialty, condition, or doctor
- Choose a doctor at the right price and time for you.
- Pay for your appointment online at direct-discount prices.
- Before your appointment begins, complete a brief medical history form.
- If you’re seeing a doctor online, click the link sent to your email to join a secure online telehealth appointment. If you’re seeing a doctor in person, go to their office at the time of your appointment.
- If you are prescribed medication and choose medication delivery, it is usually delivered to your home within 2-3 business days. Otherwise, you can select a local pharmacy often with same-day pick-up. Providers on Sesame can prescribe anything medically appropriate, except for the limited set of controlled substances (as defined under the Controlled Substances Act).

How do I access my telehealth appointment?

After you book a video appointment, you will receive both an initial confirmation and a reminder via email and text.

There are three ways in which a video visit can be accessed:
- Select "Join virtual appointment" from the booking confirmation email.
- If you have an existing account or created one at purchase, log in at sesamecare.com, navigate to 'My appointments,' and select "Join virtual appointment."
- Click the link in the text message sent to you 15 minutes prior to your scheduled appointment time.

We suggest using Google Chrome, Firefox, or Safari to connect to your visit.

Should I use my phone, tablet, or computer for my telehealth appointment?

You can use your phone, tablet, or computer for a telehealth appointment on Sesame. Sesame works on the web through your web browser - Google Chrome, Safari, Microsoft Edge or Firefox. It is easy to connect in just a few seconds with a quality Sesame provider who is ready to listen to your medical concerns.

Sesame supports face to face video communications, but turning on your video is not required if this makes you uncomfortable.

Do I need health insurance to book telehealth services?

Nope! Sesame connects patients directly to doctors through our easy-to-use booking platform. That means you can get great care with top-rated health care providers without involving insurance companies. Skip the costly co-pays and premiums when you book a doctor's appointment through Sesame. Prices on Sesame are transparent, and payment is easy. In many cases, you can pay for your visit with a one-time upfront cash price - usually 60% less than what you'll find through insurance networks. So, not only are you saving money, but you're also getting the best care available from the comfort of your own home.

Are telehealth appointments through Sesame HIPAA compliant?

Yes, Sesame is a HIPAA compliant organization. The safety of your sensitive health interactions is very important to us. This is something that every employee at Sesame and every provider takes very seriously.

Sesame’s telehealth technology is HIPAA-compliant. Sesame employees must go through annual HIPAA training to ensure compliance. All data systems are encrypted and password protected. At Sesame, we go beyond the mandated standards to protect your health data as if it were our own.

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