Hypothyroidism (Underactive Thyroid) Online

What is hypothyroidism?

Hypothyroidism, or underactive thyroid, is a condition in which the thyroid gland does not produce enough thyroid hormone. Thyroid hormones regulate metabolism, energy, body temperature, and many other functions. The most common cause in Australia is autoimmune thyroiditis (Hashimoto's disease). It is more common in women and tends to develop with age.

Symptoms can include fatigue, weight gain, cold intolerance, dry skin, constipation, hair thinning, low mood, and menstrual changes. Many symptoms are non-specific, which is why a blood test is essential for diagnosis.

How a telehealth GP can help

A NewDoc GP can take a history of your symptoms, order a thyroid function test, review the results with you, and commence or adjust thyroid hormone replacement therapy if indicated. Thyroid hormone replacement is available on the PBS and can be prescribed via eScript. Dose titration usually happens over several follow-up consultations.

Your GP can also arrange referrals to an endocrinologist for complex cases, and coordinate other relevant investigations such as cholesterol, ferritin, and vitamin D levels. Once stable on treatment, repeat prescriptions can often be managed via telehealth.

When to see a GP

Persistent fatigue, unexplained weight changes, or any of the symptoms above are reason to speak with a GP. Hypothyroidism is also relevant in pregnancy and fertility; if you are planning or are pregnant, speak with your GP promptly as monitoring requirements change.

Seek urgent care if you experience severe symptoms such as profound drowsiness, hypothermia, or confusion, which may indicate uncommon but serious complications.

Risk factors for hypothyroidism

Hypothyroidism is more common in women and in people over 60, though it can occur at any age. A family history of thyroid or autoimmune disease may increase risk. People with type 1 diabetes, coeliac disease, vitiligo, or other autoimmune conditions are also more likely to develop thyroid disease.

Previous thyroid surgery, radioactive iodine treatment, neck radiotherapy, and certain medications can all contribute. Pregnancy and the postpartum period are also recognised triggers for thyroid changes. Iodine deficiency is uncommon in Australia but remains a cause globally. Some women develop hypothyroidism after giving birth; symptoms can overlap with iron deficiency and require blood tests to differentiate.

Treatment options for hypothyroidism

The main treatment for hypothyroidism is thyroid hormone replacement, most commonly with levothyroxine (a synthetic form of the T4 hormone). It is usually taken once daily, typically in the morning on an empty stomach, with a waiting period before food, coffee, or certain supplements. Your GP will advise on timing and interactions specific to your other medications.

Treatment aims to return TSH and free T4 to normal ranges while improving symptoms. Dose adjustments are guided by repeat blood tests and clinical response. Treatment is usually long term. Some patients with subclinical hypothyroidism (mildly raised TSH with normal T4) may be monitored without immediate treatment; your GP will discuss whether treatment is appropriate in your case.

Monitoring and follow-up

When starting or adjusting thyroid hormone replacement, repeat thyroid function tests are usually done every 6 to 8 weeks until levels are stable. Once stable, annual testing is common. Any change in symptoms, pregnancy, or new medications may warrant an earlier review.

Telehealth follow-up with your NewDoc GP is well suited to this kind of review. Your GP can review results, adjust doses, send eScripts, and coordinate specialist input when needed. Consistency in brand and timing of thyroid hormone replacement may support more stable levels, so your GP may discuss this with you.