Call 911 or other emergency services immediately if you or a person you know has hypothyroidism and has signs of myxedema coma, such as:

• Mental deterioration, such as apathy, confusion, and psychosis.
• Extreme weakness and fatigue that progress to loss of consciousness (coma).
• Severe breathing difficulties, slow heart rate (less than 60 beats per minute), or low body temperature [95 F or below].

See your health professional if you have any symptoms that don't go away, including:

• Feeling tired, sluggish, or weak.
• Memory problems, depression, or difficulty concentrating.
• An inability to tolerate cold.
• Dry skin, brittle nails, or a yellowish tint to the skin.
• Constipation.
• Heavy or irregular menstrual periods that may last longer than 5 to 7 days.

If you have one or two of the above symptoms that have not changed or have changed very little over a long period of time, it is less likely that the symptoms are caused by hypothyroidism. Consult your health professional.

Talk to a health professional if you are pregnant and have some of the above symptoms. Also talk to a health professional if you have hypothyroidism and are pregnant or are trying to become pregnant: your dose of thyroid hormone medicine may need to be changed.

Watchful Waiting

Watchful waiting-a period of time during which you and your health professional observe your symptoms or condition without using medical treatment-is not appropriate for hypothyroidism that is causing symptoms. Treatment should begin as soon as the condition is diagnosed.

Watchful waiting may be appropriate for certain adults with mild (subclinical) hypothyroidism whose blood tests show only modest changes. Talk to your health professional about treatment, its cost and possible risks and benefits. Watch for any signs that you may be getting hypothyroidism. Health professionals often want people to have yearly thyroid function blood tests to check to see if thyroid hormone production is normal.

Who To See

Hypothyroidism can be diagnosed by a:

• Family medicine doctor or other primary care doctor.
• Internist.
• Pediatrician.
• Physician assistant.
• Nurse practitioner.

Hypothyroidism also may be diagnosed by a specialist, such as a gastroenterologist, gynecologist, or psychiatrist, depending on the symptoms you have and who you see to evaluate the symptoms.

Complicated or unusual cases of hypothyroidism may require consultation with an endocrinologist.

To prepare for your appointment, see the topic Making the Most of Your Appointment