When you are low on your thyroid, or hypothyroid, you may feel sluggish, gain weight, and think slowly. When your body produces too much thyroid hormone, and you have hyperthyroidism, you may feel nervous, shake, and lose weight.

During a physical examination, the doctor should palpate, or feel, your thyroid gland, which is in the neck, straddling the wind pipe, below the larynx, or voice box. If it is enlarged or bumpy, there may well be an abnormality,  most common of which is a generalized enlargement, usually due to Hashimoto’s thyroiditis, which eventually leads to hypothyroidism, or a low functioning of the thyroid.

Because of its importance, thyroid function is often taken as a screening test.

When there is not enough thyroid hormone in your bloodstream, the pituitary, or master gland  increases the TSH, or thyroid stimulating hormone. Less commonly, when the function is excessive, the TSH drops to an excessively low level.

The thyroid panel usually consist of FT4, or free thyroxin, and a TSH, as a counter check.

Sometimes, often in older people, the TSH rises for seemingly no reason, although the FT4 remains normal. The doctor then determines clinically whether or not your thyroid  is low and you need to have oral thyroid supplementation.

                      Result value.                Ref. Range.

FT4.                  1.03 ng./dL.              0.76 – 1.46 ng./dL

TSH.                  12.10.  (H).                0.36 – 3.74 uIU/mL.

I am Currently not taking any thyroid supplements. I feel a little fatigued much of the time, but I’m losing, rather than gaining weight, and sometimes I feel pretty peppy. I also have atrial fibrillation, and have had NSVT, which could be worsened by thyroid supplementation. With my age, my physician is comfortable not giving me thyroid, and so am I.

—Dr. C.