Diagnosing Hypothyroidism

Dr. Richard Bebb, MD, ABIM, FRCPC, Endocrinologist, discusses hypothyroidism diagnosis and treatment.

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Dr. Richard Bebb, MD, ABIM, FRCPC, Endocrinologist, discusses hypothyroidism diagnosis and treatment.
Video transcript

Featuring Dr. Richard Bebb, MD, ABIM, FRCPC, Endocrinologist

Duration: 2 minutes, 22 seconds

The treatment of an underactive thyroid depends a bit on the cause. There are some causes which will actually solve themselves. Most of the time, however, it requires taking replacement thyroid hormone.

Some of the causes, for example, that may result in underactive thyroid can be a drug side effect, or a result of having inflammation in your thyroid, and the thyroid will pass through a phase of low levels. It won’t be able to produce its required amount, but eventually will rally – heal itself – and you won’t require long-term thyroid replacement.

But for most patients, when their thyroid is underactive spontaneously, it’s due to a disease called Hashimoto's thyroiditis. Hashimoto's thyroiditis is an autoimmune disease. Your immune system gets a bit confused, and instead of fighting off bacteria or viruses, it turns on your thyroid and actually causes damage.

And we don’t have an accepted way to stop that inflammation, and we’re left just replacing your thyroid hormone to restore normal physiology and restore normal health and make you feel normal.

To diagnose low thyroid, or hypothyroidism, first is to suspect it from the symptoms, because some of the symptoms are really not very specific; fatigue – everything causes fatigue. But once you have a clinical suspicion of it, the test to do is a TSH test (thyroid stimulating hormone test).

And while not a perfect test, it’s very good in most circumstances, to diagnose an underactive thyroid. When your thyroid level is low, your TSH level goes up. And it can be used both to diagnose thyroid disease, and it’s also one of our key measures that we use when we start treating thyroid deficiency, to know that we have put you on an appropriate physiological dose of thyroid hormone.

If you have any further questions on the diagnosis or treatment of thyroid deficiency, do check with your primary care practitioner.

Presenter: Dr. Richard Bebb, Endocrinologist, Victoria, BC

Local Practitioners: Endocrinologist

Video Quiz ( 18 participated.)

Test your knowledge by answering the following questions:


One of the most common causes of an underactive thyroid is a disease called Hashimoto's thyroiditis.


Diagnosing an underactive thyroid can be difficult when going by symptoms alone due to non-specific symptoms such as 'fatigue'.


Hypothyroidism is hard to detect through blood testing and is difficult to treat.


A TSH blood test can detect hypothyroidism.  When the level of TSH (thyroid stimulating hormone) in the blood is elevated it means that the body's natural thyroid hormone level is down.  

This content is for informational purposes only, and is not intended to be a substitute for professional medical advice, diagnosis or treatment. Always seek the advice of your physician or other qualified healthcare professional with any questions you may have regarding a medical condition.

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