Mild hypothyroidism may not need treatment

Dear Mayo Clinic: I recently was diagnosed with mild hypothyroidism that isn’t causing symptoms. My doctor says I don’t need treatment now, but she wants me to come back for regular checkups. Does hypothyroidism usually get worse over time? If it does, how is it treated?

A: For mild cases of hypothyroidism, not all patients need treatment. Occasionally, the condition may resolve without treatment. Follow-up appointments are important to monitor hypothyroidism over time, however. If hypothyroidism doesn’t go away on its own within several months, then treatment is necessary. If left untreated, this condition eventually may lead to serious health problems.

The thyroid gland is a small butterfly-shaped gland in the front of the neck that makes the hormones triiodothyronine, or T3, and thyroxine, or T4. Those hormones affect all aspects of your metabolism. They maintain the rate at which your body uses fats and carbohydrates, help control your body temperature, influence your heart rate, and help regulate the production of proteins. The amount of thyroid hormones your body makes is regulated by another hormone called thyroid stimulating hormone, or TSH, that’s produced by the pituitary gland.

Hypothyroidism develops when the thyroid doesn’t make enough hormones. As a result, your metabolism slows down. As thyroid activity slows, the level of T4 in your body decreases, and the level of TSH increases to encourage the thyroid gland to raise T4 production.

Some mild cases of hypothyroidism, called subclinical hypothyroidism, are associated with an elevated TSH while the T4 level stays within the normal range. At that point, the condition may not produce any noticeable symptoms. But if the decrease inT3 and T4 continues (referred to as overt hypothyroidism), it can affect many bodily functions.

Common early symptoms of hypothyroidism include unexplained weight gain, fatigue and low energy. It also may cause dry skin, constipation, sensitivity to cold, a puffy face, muscle weakness, hoarseness, and joint pain or stiffness.