Thyroid is not a disease: it is a normal butterfly shaped gland in the neck, located in front of the airway. It releases thyroid hormones that travel through the blood to all tissues of the body and regulate our body's metabolism. They tell the organs how fast or slow they should work. Thyroid hormones also regulate the consumption of oxygen and the production of heat.

There can be 3 major kinds of thyroid problems -

1. Hypothyroidism: When the gland doesnot produce enough thyroid hormones to fulfil your body requirements.

2. Hyperthyroidism: When the gland is overactive and releases too much thyroid hormone.

3. Thyroid nodules: When the whole gland or a part of it is enlarged.

Symptoms of hypothyroidism include:

• Fatigue
• Mental depression & forgetfulness
• Feeling cold
• Hoarseness of voice
• Dry skin and hair
• Constipation
• Menstrual irregularities
• Difficulty in conceiving or recurrent abortions

Weight gain often occurs in patients with hypothyroidism but is not always necessary. Also, not all weight gain is due to hypothyroidism.

It must be kept in mind that you may be having hypothyroidism even if you do not have any of these frank symptoms. Hypothyroidism can develop at any time. One normal test report doesnot mean that you can never have a thyroid problem. If you have any of the suggestive features, your doctor may advise you to get your thyroid tests done.

The treatment of hypothyoidism is usually lifelong and must not be stopped when you get a normal thyroid report while taking thyroxine. There is a usual tendency among certain people to do that, justifying that there thyroid is normal now. Only sometimes, you may be having a disease that is transient; but more often, hypothyroidism is a chronic problem and you would put yourself into trouble if you stop thyroxine.

Long-standing untreated hypothyroidism increases the risk for high blood pressure, carpal tunnel syndrome, high cholesterol and triglycerides, cardiac disease and stroke; and if you have severe disease, it may put you at risk of a life-threatening condition called myxedema coma.

Once thyroid replacement with thyroixine is begun, the dose of thyroxine is monitored by serum TSH assay. The target is to keep TSH levels in the normal range. There may be variations in dose requirements over time. so it is advisable to get your TSH checked at least every six months and consult your endocrinologist for dose adjustments. In addition, you may also require monitoring of blood glucose, lipid profile, blood pressure and cardiac status.Tests are required more frequently in children, pregnant ladies and during the initial few months after starting treatment. The frequency of testing will be determined by you doctor.

I must be understood that thyroxine is a hormone that your body produces and is essential for survival. If you have hypothyroidism, your body is not producing enough thyroxine. Replacement of thyroxine in the form of a medicine doesnot cause any side-effects provided you are taking the correct dose of thyroxine. However, you will experience problems if your dose is too high or too less. This dose is determined to keep your TSH in the normal range. It is advisable to consult an endocrinologist.