Question

February 2006 I was diagnosed with hypothyroid and also prescribed with Synthroid 75 mcg. At the time that I had found out about being diagnosed w/ hypothyroid, my husband and I were and are trying to have a baby. In June 2006, I was late for my period for two months and now again 2 weeks late. I have been taking Synthroid since February and why now am I having irregular period? Can I take fertility pills? I am going nuts?!?!? I have had a girl 1994 and twin boys 1999. What is going on with me? I am 28 yrs old. Please HELP?!?!?

Yvette

Answer

Dear Yvette,

The thyroid gland produces a hormone that keeps the body’s metabolism running smoothly, and using energy using energy appropriately. When the thyroid underfunctions, the body feels tired, low energy, even depressed, and gains weight and gets puffy. It can lead to serious organ damage and slow death if not treated appropriately.

A hypothyroid condition could be due to several causes. The most common cause is that the thyroid itself stops functioning as well for some unknown reason. The second most common is an autoimmune reaction, in which the body’s immune system starts to attack its own organs, and the thyroid is a common target. Rarely, it is caused by either too much or too little iodine in the diet. Or certain drugs can suppress the thyroid---such as lithium, aminosalicylate sodium (PAS, an antituberculous drug), sulfonamides, phenylbutazone, amiodarone, and thiourea. These are all considered primary thyroid problems.

There are also secondary thyroid problems, in which the thyroid underfunctions because of a problem with the brain’s pituitary gland.

There are also tertiary thyroid problems, in which the thyroid underfunctions because the pituitary underfunctions because the brain’s hypothalamus underfunctions.

Rarely, there is a condition in which the thyroid itself is functioning normally, but the whole body is just not responding to its hormones.

When a patient is diagnosed with hypothyroid, it is important for the doctor to try to figure out what is causing the thyroid to underfunction, but most of the time it is just that the thyroid itself stops functioning as well for some unknown reason, and no other problem is identified.

Then, when treatment is started, it is important for the patient to revisit with the doctor, usually every month at first, to make sure that the body is responding appropriately. Blood tests done every 2 months help guide the dosages.

If periods become irregular, the dosage may be wrong, and should be adjusted carefully. Sometimes the problem with irregular periods are not related to the thyroid, but signify a different problem altogether. For this reason, it becomes very helpful to have accurate menstrual cycle charts both before and after thyroid hormones (or any other medications) are started. You can look for an instructor in your area to teach you how to chart at www.canfp.org looking under "Find a Local Resource".

Dr. Peter Sultana

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