“If you have diabetes, you either need a cardiologist now or you likely will need one in the future,” said Catrina R. Hancock, PA-C, physician assistant with Norton Heart & Vascular Institute. “Diabetes has the potential to affect nearly every part of the body, but its impact on the heart is especially serious. The good news is that with proper cardiac care, we can significantly reduce your risk of heart complications.”

How diabetes causes heart disease

People with diabetes are two to four times more likely to develop heart disease and often have other conditions that increase heart disease risks: high blood pressure, high cholesterol, kidney and liver disease, and obesity.

Diabetes affects how your body processes sugar. Over time, high blood sugar acts like sandpaper in your bloodstream, causing damage to arteries. High glucose levels can also cause inflammation throughout the body, making it easier for cholesterol to stick to artery walls and block blood flow to your heart.

Diabetes also can damage the nerves that control your heart rate and blood pressure. This condition, called diabetic neuropathy, can mask typical warning signs of heart issues. Diabetes-related heart damage often happens silently and slowly, making it difficult to detect without regular cardiac monitoring.

Symptoms of diabetes and heart disease

Not everyone with diabetes experiences clear warning signs of heart issues. While chest pain can still occur, many symptoms of diabetes with heart disease can be subtle or mistaken for fatigue, aging or other conditions.

Important symptoms to watch for include:

• Shortness of breath, especially with normal activities
• Chest discomfort, pressure or tightness
• Swelling in the feet, ankles or legs
• Unexplained fatigue or weakness
• Irregular heartbeat or palpitations
• Dizziness or lightheadedness

If you have diabetes and are experiencing any of these symptoms, even occasionally, it’s time to talk to a cardiologist about your risks related to diabetes and heart disease.

Benefits of a cardiologist in diabetes care

Managing heart disease in people who have diabetes extends beyond glucose control. A cardiologist plays an essential role in identifying and helping to control silent cardiovascular risks before they can become major, life-threatening complications.

“Many patients don’t realize how significantly a cardiologist can enhance their overall diabetes management and provide peace of mind regarding their cardiovascular health,” Catrina said.

When you consult with a cardiologist at Norton Heart & Vascular Institute, they will evaluate your cardiovascular health using advanced screenings, imaging and lab tests, specifically designed for diabetes patients.

More advanced diagnostic testing: Cardiologists use specialized tests that can detect cardiovascular issues before a person shows symptoms. These might include coronary artery calcium scoring, advanced lipid panels or cardiac imaging that can reveal early signs of heart disease in patients with diabetes.

Personalized treatment plans: Every person with diabetes has a unique risk profile. A cardiologist can develop a customized treatment plan that considers how long you’ve had diabetes, glycemic control, family history and other individual factors that influence cardiovascular disease development.

Based on your condition, a cardiologist may recommend:

• Medicine that protects the heart and complements your diabetes treatments
• Lifestyle modifications specifically designed to reduce your cardiovascular risk
• Regular monitoring with cardiac imaging or stress testing
• Blood pressure and cholesterol management to address risk factors
• Coordination with your diabetes care team for comprehensive treatment

With appropriate cardiac care, people living with diabetes can dramatically reduce their risk of heart attack, stroke or other long-term disability. Early detection and preventive treatment can minimize diabetes-related cardiovascular complications and improve your overall quality of life.

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Why you might need a heart doctor

Your heart works incredibly hard every single day, and sometimes it needs specialized attention from a qualified heart doctor. Understanding when to seek cardiac care can be the difference between prevention and emergency treatment.

A heart doctor, also called a cardiologist, specializes in diagnosing and treating conditions affecting your heart and blood vessels. These heart specialists are trained to identify early warning signs that there could be issues with your heart.

6 warning signs that you may need to see a heart doctor

1. Chest pain or discomfort

Chest pain is the most common reason people seek care from a heart doctor, and for good reason. Any chest discomfort should be taken seriously and evaluated by a cardiac specialist.

“I tell patients I would rather see them to make sure there is nothing more serious happening,” said Jason A. Hopper, M.D., cardiologist with Norton Heart & Vascular Institute. “Truly, better safe than sorry.”

That tightness, pressure or pain you’re experiencing? Don’t ignore it. It could be a warning sign of:

• Heart attack or angina
• Coronary artery disease
• Heart valve issues
• Inflammation of the heart muscle (pericarditis)

A heart doctor can distinguish between cardiac chest pain and other causes, such as muscle strain or acid reflux. Even if your chest pain isn’t heart-related, seeing a heart doctor can provide peace of mind and rule out serious conditions.

2. Shortness of breath, even at rest

Experiencing unexplained shortness of breath is a significant red flag that requires immediate evaluation by a heart doctor. This symptom can indicate that your heart is struggling to pump blood effectively throughout your body.

Especially concerning is shortness of breath that’s new or getting worse. A heart doctor should evaluate you if you experience:

• Difficulty breathing during normal activities
• Breathlessness while lying flat
• Waking up short of breath at night
• Breathing issues that interfere with daily life

These symptoms could indicate heart failure, coronary artery disease or other serious cardiac conditions that require prompt treatment from a heart doctor.

3. High blood pressure

Uncontrolled high blood pressure can cause significant damage to your heart over time. A heart doctor can help you understand your blood pressure readings and develop an effective management strategy.

Consider seeing a heart doctor if:

• Your blood pressure consistently reads above 140/90 (measured in millimeters of mercury, abbreviated as mmHg)
• You’re taking medication but still have elevated readings
• You have other cardiovascular risk factors
• You’ve been diagnosed with high blood pressure but haven’t seen a specialist

“High blood pressure often has no symptoms,” Dr. Hopper said. “Keeping a baseline of your blood pressure is crucial for preventing heart attack, stroke and heart failure.”

4. Family history of heart disease

If heart issues run in your family, it’s smart to get ahead of conditions by consulting with a heart doctor. Heart disease is influenced by genetics, so knowing your family history and taking proactive action can save your life.

A heart doctor should evaluate you if you have:

• Parents or siblings with heart disease
• Family history of heart attacks before age 65
• Genetic conditions affecting the heart
• Multiple relatives with cardiovascular issues

Even if you’re currently healthy, a heart doctor can assess your risk and recommend preventive measures based on your family history.

5. Irregular heartbeat or palpitations (rapid or abnormal heartbeat)

Your heart should maintain a steady, regular rhythm. If your heart feels like it’s skipping, fluttering or racing, it’s time to check it out with a heart doctor.

Seek evaluation from a heart doctor if you experience:

• Heart palpitations that occur frequently
• Feeling like your heart is skipping beats
• Rapid or slow heart rate without explanation
• Irregular heartbeat patterns

While occasional palpitations can be normal, irregular heartbeats that don’t go away could indicate arrhythmias that require treatment from a heart doctor.

6. You have diabetes

Diabetes significantly increases your risk of heart disease, making regular check-ins with a specialist essential for managing your overall health. A heart doctor can help prevent cardiovascular complications associated with diabetes.

If you have diabetes, a heart doctor can:

• Monitor your cardiovascular risk factors
• Adjust medications to protect your heart
• Provide specialized care for diabetic heart disease
• Help manage your condition to prevent heart issues

Diabetes increases your risk of heart disease because high blood sugar damages blood vessels over time. Regular consultations with a heart doctor can help manage your condition and prevent serious complications.

Don’t wait for a crisis: Early action saves lives

You don’t need to wait for a medical emergency to see a cardiac specialist. If something feels off with your heart or you simply want peace of mind about your cardiovascular health, seeing a heart doctor can be a smart move.

Listen to your body and trust your gut. Early detection and treatment by a qualified heart doctor can prevent minor issues from becoming life-threatening emergencies. 

What to expect during your first heart doctor visit

When you visit a heart doctor for the first time, they will:

• Review your medical history and family history
• Perform a comprehensive physical examination
• Order diagnostic tests such as an electrocardiogram (abbreviated as EKG) echocardiogram, stress testing or cardiac CT scan.
• Discuss your symptoms and risk factors
• Develop a personalized treatment plan

Benefits of regular cardiac care

Working with a heart doctor provides numerous advantages for your cardiovascular health:

Early detection: Heart doctors can identify problems before they become serious, allowing for early intervention and better outcomes.

Specialized expertise: Heart doctors have advanced training in cardiac conditions.

Advanced testing: Heart doctors have access to sophisticated diagnostic equipment and testing procedures.

Comprehensive care: A heart doctor can coordinate with other specialists to provide complete cardiovascular care.

Peace of mind: Regular checkups with a heart doctor can provide reassurance about your heart health.

Don’t delay seeking care if you’re experiencing any warning signs. However, even if you’re symptom-free, consider seeking cardiology care if you:

• Are over 40 with multiple risk factors
• Have concerns about your cardiovascular health
• Want to establish baseline heart health
• Need guidance on heart-healthy diet and lifestyle changes

Heart disease remains one of the leading causes of death, but it’s also largely preventable with proper care from qualified medical professionals. A heart doctor can help you understand your risk factors and take steps to protect your heart.

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The cath lab technology also offers intravascular ultrasound, which uses sound waves to evaluate the coronary arteries. In the coming months, the cath lab also will begin offering 3D modeling technology that helps providers more quickly diagnose heart blockages and determine the best course of treatment, whether a stent or surgical procedure.

The renovated cath lab opening coincides with an imaging renovation that includes a new CT scanner. While the CT scanner can be used for any area of the body, it also can be used to identify heart disease, issues with heart valves and heart defects. It boasts faster scan times and higher resolution — benefits for both patients and clinicians.

“This is a huge investment in heart and imaging services in Southern Indiana and is something we’re really excited about,” said Kathleen S. Exline, DNP, R.N., chief administrative officer, Norton Clark Hospital. “For cardiac catheterizations alone, we currently are on pace to exceed the 823 procedures we performed last year, showing that more people are choosing us for care.

“It’s really gratifying to know that, coupled with the expertise of Norton Heart & Vascular Institute, heart patients have access to this level of care in Southern Indiana — close to home.”

Renovation of the hospital’s second cath lab is being planned, and a time frame has not yet been determined.

“People in Southern Indiana should have easy access to heart care,” said Ann Marie Holas-Dryps, system vice president, Norton Heart & Vascular Institute. “We’re committed to ensuring these services are here.”

Norton Heart & Vascular Institute offers experience, expertise and a commitment to making it as easy as possible to get care.

Norton Clark Hospital has received Chest Pain Center Accreditation with Primary PCI by the American College of Cardiology. The designation is based on a rigorous on-site evaluation of the staff’s ability to evaluate, diagnose and treat patients who may be experiencing a heart attack. The hospital also is a STEMI Receiving Center, which means it is equipped and designated for proper care of people having a ST-elevation myocardial infarction (STEMI), also known as a “widow-maker” heart attack. This deadliest form of heart attack is a complete blockage in a major artery to the heart. 

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For some patients with high blood pressure, the nerves near the kidneys can become overactive. Applying radiofrequency energy to these nerves can help calm them, thereby reducing blood pressure. The new Symplicity Spyral renal denervation (RDN) system is the only one of its kind offered in the United States.

“We take a very thin tube into the artery that goes to the kidney and send electrical pulses to calm those nerves,” said Matthew J. Sousa, M.D., interventional cardiologist, Norton Heart & Vascular Institute. “It’s a simple, minimally invasive procedure that only requires minimal sedation, and the patient can usually go home the same day.”

Elevated blood pressure is a reading above 120/80 mmHg. For some people, blood pressure can reach a seriously elevated level categorized as advanced hypertension. Advanced hypertension, or Stage 2 hypertension, is defined as systolic (the top number) blood pressure of 140 mmHg or higher, or a diastolic (the bottom number) blood pressure of 90 mmHg or higher. This level of high blood pressure requires serious medical attention. If left untreated, stage 2 hypertension can lead to stroke, heart attack and serious damage to the kidneys, eyes and brain.

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Heart attack symptoms in women are often more subtle than those in men, making them easier to overlook or confuse with other health issues. Unlike the stereotypical crushing chest pain associated with heart attacks, women’s heart attack symptoms can resemble the flu, heartburn or even an ulcer.

“It is critical that women understand what a heart attack can feel like for them, so they get immediate medical care,” said Li Zhou, M.D., Ph.D., medical director of the Norton Heart & Vascular Institute Women’s Heart Program. “Any delay in seeking treatment can result in more damage to the heart muscle and can be life-threatening.”

Subtle signs: How heart attack symptoms in women differ

In general, heart attack symptoms in women may not include severe chest pain. Instead, women may experience:

• Unusual fatigue or exhaustion
• Nausea or vomiting
• Stomach pain, indigestion or heartburn
• Dizziness or lightheadedness
• Shortness of breath
• Breaking into a cold sweat
• Pain in the jaw, neck or upper back
• Pressure or pain in the chest that may come and go

These symptoms can go unnoticed or can be mistaken for less serious conditions, such as anxiety, gastrointestinal issues or muscle pain.

Almost 1 in 3 heart attack patients experience no chest pain at all — and this is more common among women. This is sometimes called a silent heart attack.

When to seek help for heart attack symptoms

If you suspect you are having a heart attack, do not wait. Call 911 immediately or have someone take you to the nearest emergency room.

While waiting for emergency services:

• Take nitroglycerin if it’s been prescribed by your doctor.
• Take aspirin only if a medical professional has previously advised you to do so — as it may interact with other medications.

Key differences in heart attack symptoms: Women vs. men

There are notable differences in how heart attacks present in men and women. Men often report pain and numbness in the left arm or side of the chest. In contrast, women may feel pain on the right side, in the back or not in the chest at all.

In some cases, chest pain in women is caused by microvascular disease — a condition affecting the small arteries of the heart rather than a typical blockage. This condition often is linked to diabetes, high blood pressure or inherited heart disease.

Other conditions that can mimic heart attack symptoms in women

Several other health issues can resemble heart attack symptoms in women, including:

• Panic attacks: Often mistaken for heart attacks, panic attacks can cause chest pain, rapid heartbeat, shortness of breath and a feeling of dread. These episodes typically involve sharp, stabbing pain that lasts only a few seconds and is localized.
• Gastroesophageal reflux disease (GERD): Symptoms like acid reflux can cause burning chest pain that mimics a heart attack.
• Muscle strain: Especially in the chest or back, muscle injury can cause pain during movement or deep breathing.
• Stroke: Weakness in the arms or an inability to raise both arms evenly could indicate a stroke rather than a heart attack.

Risk factors for heart attack in women

• Smoking is a greater risk factor for heart disease in women than it is in men. 
• Not being active is a major risk factor for heart disease.
• Emotional stress and depression may affect women’s hearts more than men’s. Experiencing these can make it difficult to be active or make healthy choices. 
• Diabetes increases your heart attack risk. Women with diabetes are more likely to develop heart disease than are men with diabetes. Diabetes damages the blood vessels and can change the way people feel pain, so you may be at a higher risk for silent heart attack.
• Menopause causes drops in estrogen, which increase the risk of developing small vessel heart disease.
• Pregnancy complications, including high blood pressure (preeclampsia) or diabetes during pregnancy, can increase women’s long-term risk of high blood pressure and diabetes.
• Family history of early heart disease may be a greater risk factor in women than in men.
• Other health conditions, such as autoimmune diseases or inflammatory conditions, can increase the risk of heart attack. 

Heart attacks during and after pregnancy

Although rare, heart attacks during pregnancy or shortly afterward can occur. A common cause is spontaneous coronary artery dissection, a condition where a tear forms in a coronary artery, disrupting blood flow to the heart.

Awareness of heart attack symptoms in women

Heart disease is the leading cause of death in women in the United States. According to the Centers for Disease Control and Prevention, more than 267,000 women die from heart attacks each year. Understanding heart attack symptoms in women — and how they may differ from men’s — can be lifesaving. If something doesn’t feel right, trust your instincts and seek immediate medical care.

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Many adults enjoy alcohol or use cannabis products for a variety of reasons. They may use these as ways to relax, but did you know that these substances can raise blood pressure? Here’s what you need to know about how alcohol and cannabis may raise blood pressure in adults.* 

Alcohol is a buzzkill for your liver

Alcohol is processed by the liver, which can handle only so much at a time. Too much alcohol can damage the liver over time. Drinking too much alcohol — beer, wine, or liquor — can raise the force your blood exerts on your arteries. What is “too much”? As with many substances, the poison is in the dose, which means — it depends on how much, your size, gender and age.

“We process alcohol differently as we age,” said Joshua H. Brandon, M.D., family medicine physician with Norton Community Medical Associates. “Men and women handle alcohol differently. Medications also can impact how your body responds to alcohol.” 

Moderate drinking is considered to be two drinks or less in a day for men and one drink or less for women. Binge drinking means four or more drinks for women, or five or more drinks for men during an occasion. Heavy drinking means eight or more drinks for women, or 15 or more drinks for men during a week.

A “drink” is:

• 12 ounces of beer with 5% alcohol
• 8 ounces of malt liquor with 7% alcohol
• 5 ounces of wine with 12% alcohol
• A shot or 1.5 ounces of liquor or distilled spirts (80-proof liquor)
  • 80 proof means the liquor has 40% alcohol.
  • Types of liquor include brandy, gin, rum, tequila vodka, and whiskey.

“Even moderate alcohol consumption can interfere with blood pressure medication,” Dr. Brandon said. 

According to the National Institute on Alcohol Abuse and Alcoholism: 

• Alcohol can alter the metabolism of a medication, speeding or slowing the clearance of the medication from the body and thus lowering or raising the blood levels of the medication.
• A medication can influence the absorption and metabolism of alcohol, potentially resulting in higher blood alcohol concentrations (BACs) and other adverse effects. 
• Alcohol can alter the pharmacological effects of the medication, which can increase or decrease the effect of the medication on the body.

Cannabis is not a chill as you might think (at least for your heart)

Tetrahydrocannabinol (THC) is the primary active compound in cannabis. It’s what gives users a “high.” THC can cause temporary spikes in heart rate and blood pressure. How your body responds to THC depends on several factors, including:

• Dose
• Method — smoking, gummies, edibles
• Overall health, including the presence of chronic conditions
• The presence of other substances, such as medications, alcohol, or tobacco
• Age
• Frequency and duration of use

The side effects of cannabis taken with blood pressure medication include:

• Marijuana’s biggest-known impact is with opioids, sleep medications, muscle relaxants and alcohol, because all affect the central nervous system. Marijuana use combined with these may boost the effects of both.
• Marijuana may increase the risk of bleeding when taken with drugs that increase the risk of bleeding, such as aspirin, blood thinners or other pain relievers, including ibuprofen and naproxen.
• Marijuana may affect blood sugar levels. If you are taking medication or insulin for diabetes, you should be watched closely by a health care provider.  
• Marijuana may cause low blood pressure, which may affect people on high blood pressure medication. 

As cannabis becomes legal in more places, both for recreational use and for medical purposes, people should stay informed about the potential health risks. One small study showed a moderate increase in systolic blood pressure with cannabis use. The general consensus is more research is needed, especially in older adults. 

Blood pressure and substance use

High blood pressure is referred to as a “silent killer,” due to the lack of symptoms. Long-term high blood pressure increases the risk of heart attack, heart disease, stroke and kidney disease.

• High blood pressure is often symptom-free — hence “the silent killer.”
• Long-term high blood pressure  increases risk of heart attack, stroke and kidney disease.
• Alcohol and cannabis can make it harder to manage or detect changes in blood pressure.
• Getting blood pressure checked regularly is key — even if you feel fine.

No judgment, just things to know:

• Your first step should be awareness. Get a baseline blood pressure reading with your health care provider at your annual checkup. Keep track of your blood pressure using an at-home monitor. Check your blood pressure after alcohol consumption or cannabis use. 
• Be honest with your health care provider so they can give you the best care and offer options to keep you safe and healthy. This may help you make smarter choices for your health. 
• Little tweaks can add up, and your doctor can help by adjusting medications or explaining how much to cut back. 

Checking in with your heart

Heart health isn’t about giving up things you enjoy; it’s about understanding how your lifestyle may affect your health. Talk to your doctor honestly about your drinking, even if it’s an uncomfortable topic.

“It is important for your health care provider to know if you are using alcohol or cannabis, even if it’s moderate use,” Dr. Brandon said. “There may be potentially harmful interactions that you don’t know about.” 

*Disclaimer: Recreational cannabis use is currently illegal in Kentucky and Indiana.

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Is Your Condition Putting Your Heart at Risk?

Heart and vascular disease — including heart failure — doesn’t always begin in the heart. Conditions like high blood pressure, diabetes, obesity, sleep disorders and chronic stress can damage your cardiovascular system quietly over time. Understand how your condition may be affecting your heart. Learn the signs, reduce your risk and take action with innovative cardiology care.​​

Awards and Accreditations

• All of Norton Healthcare’s adult-service hospitals in Louisville have received Chest Pain Center accreditation from the American College of Cardiology (ACC).
• Norton Audubon Hospital has been named a HeartCare Center National Distinction of Excellence year after year by the American College of Cardiology. This is the only hospital in Louisville to be recognized for this distinction.
• Norton Audubon Hospital, Norton Brownsboro Hospital and Norton Hospital all are recognized as having ACC Chest Pain Center with Primary PCI accreditation.
• Norton Audubon Hospital earned ventricular assist device (VAD) accreditation from DNV and the Centers for Medicare & Medicaid Services.

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To appreciate her aspirations, you have to appreciate her incredible health journey, one that began suddenly with a massive heart attack in October 2015.

“I never had any indications,” said Terrie, now a peppy, 74-year-old, semiretired schoolteacher. “I thought I was healthy.”

Terrie survived a second heart attack a few days later while waiting for initial complications to improve before undergoing triple-bypass heart surgery. Following surgery, she remained unconscious for three weeks due to additional setbacks. Eventually, Terrie would need her left foot and part of her left leg to be amputated, as a result of weakened blood flow during her recovery. According to Terri, her family wasn’t sure she would survive.

Nearly 10 years later, she’s alive and thriving, thanks to an incredible team of physicians and therapists, which includes the cardiac rehabilitation team at Norton King’s Daughters’ Health in Madison, Indiana.

“The staff encourages you and holds you accountable,” Terrie said. “It’s comforting to know they are tracking your heart rate and blood pressure. They are always willing to answer questions and check on you; it’s such a huge benefit.”

When Terrie first began cardiac rehabilitation in January 2016, nearly four months after her heart attack, her initial ejection fraction — or EF as she calls it — was only 30%. Ejection fraction is one indicator of the heart’s efficiency at pumping blood. Through Terrie’s hard work and continuous effort, her heart’s ejection fraction is now 50% to 55%, which Terrie described as “low normal” for someone her age.  After barely being able to exercise for six minutes initially, she now attends cardiac rehab twice a week for 45 minutes.

“Even if I was disciplined enough to keep exercising on my own, it’s a huge benefit coming here,” Terrie said.

She continues in the maintenance phase, or Phase 3, of cardiac rehabilitation at Norton King’s Daughters’ Health.

“The team becomes like family. You also get to encourage other people and get encouragement from them,” Terrie said. “It was a long journey for me; maybe I can help someone else.”

Throughout her stints in physical therapy, which included learning how to use her prosthetic foot and leg, Terrie cherished her local access to heart care.

“I doubt I would have driven somewhere two or three times a week,” she said. “Having local care makes all the difference. The people are wonderful.”

Jared Rogers, exercise physiologist, and Nancy Gibson, a cardiovascular technician, both with the rehab program in Madison, “are great,” according to Terrie.

Jared sees firsthand the difference cardiac rehab makes in the lives of heart patients.  Initially, patients complete Phase 1, which focuses on regaining strength and conditioning. Phase 2 helps patients transition to independence, which is the goal of the cardiac rehab program. Phase 3 is a self-pay option for patients who simply want to maintain their success. 

“Patients like the social atmosphere and building relationships,” Jared said. “We want to help patients understand that it takes a lifestyle change to be successful. It’s rewarding to see patients reach their goals and make improvements. We want them to be independent.”

Steven L. Vorhies, M.D., is a family medicine specialist at Norton Community Medical Associates and is Terrie’s primary care physician. He praised Terrie’s mental fortitude as a reason for her success.

“Her mental approach to recovery … is remarkable,” Dr. Vorhies said. “Her rehab helped her immensely.  She set a goal to be active, live her life and do what she wants to do. Her mental attitude is wonderful.  She’s always smiling.”

Today, Terrie enjoys spending time with her husband of 53 years, Curt. Their family consists of three adult children and a grandson, whom Terrie enjoys watching play a variety of sports, including baseball, basketball and football.

“I can do most things I want to do,” Terrie said. “My leg limits me more than my heart.”

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Untreated hypothyroidism can lead to complications, such as heart disease, goiter, peripheral neuropathy, pregnancy complications and, very rarely, myxedema coma.

The thyroid is a small, butterfly-shaped gland at the base of your neck. In adults who’ve acquired hypothyroidism, the cause is typically Hashimoto disease or Hashimoto thyroiditis, an autoimmune disorder. Rather than fight infection, the immune system attacks the thyroid gland. Hashimoto thyroiditis runs in families, but the cause isn’t known.

Surgery or radioactive iodine therapy for a thyroid disorder, such as hyperthyroidism (overactive thyroid) or thyroid cancer, can damage the gland and lead to an underactive thyroid. 

Postpartum thyroiditis is a rare thyroid disease that occurs within a year of pregnancy and can lead to hypothyroidism. Symptoms of postpartum thyroiditis can be improperly attributed to postpartum depression or new parent stress.

Some children are born with a low-functioning or nonfunctioning thyroid. Congenital hypothyroidism is a thyroid disease with no symptoms, but the condition easily can be detected through newborn screening and treated with thyroid hormone replacement medication. If left untreated, congenital hypothyroidism can lead to permanent mental disabilities.

Hypothyroidism Symptoms

Hypothyroidism symptoms tend to develop slowly and easily can be mistaken for another condition. If you have any of the following symptoms, discuss them with a medical provider or at your next annual checkup. The only way to know whether you have hypothyroidism is a routine blood test to check your thyroid hormone level.

Common hypothyroidism symptoms, according to the American Thyroid Association, include:

• Feeling colder
• Tiring more easily
• Dry skin
• Becoming forgetful
• Feeling depressed
• Constipation

Thyroid Function Test

A routine blood test can measure the thyroid hormone level in your blood. The test typically looks for thyroid stimulating hormone (TSH), triiodothyronine (T3) and thyroxine (T4). 

T3 and T4 are hormones the thyroid makes. TSH is made by the pituitary gland that tells the thyroid how much T4 and T3 to make. If your thyroid isn’t making enough T3 or T4, the pituitary may release excess TSH into your bloodstream.

An elevated level of TSH but normal T4 and T3 can be an indication of subclinical hypothyroidism. It typically has no symptoms but can develop into clinical hypothyroidism with low T4 levels and should be monitored.

Very high or low T4 levels may not mean you have thyroid dysfunction. If you are pregnant or are taking oral contraceptives, your thyroid hormone levels will be higher. Severe illness or the use of corticosteroids (medicines to treat asthma, arthritis, skin conditions and other health issues) can lower T4 levels.

Measuring levels of thyroid antibodies may help diagnose Hashimoto disease, as thyroid antibodies are made when your immune system attacks the thyroid gland.

Other tests may include imaging, such as a thyroid scan, which uses radioactive iodine to help the doctor see your thyroid clearly. This test can show thyroid nodules, which are small, often harmless lumps on the gland. It also can detect inflammation, an enlarged thyroid and other abnormalities.

Hypothyroidism Treatment

There is no cure for thyroid disease, but several treatment options can manage hypothyroidism by regulating hormone levels and addressing symptoms with thyroid medication.

Thyroid hormone replacement therapy with a synthetic thyroid hormone such as levothyroxine can improve symptoms significantly. In addition, lifestyle changes — such as a healthy diet rich in iodine and selenium, regular exercise, and stress management techniques — can help.

You’ll need to monitor your thyroid hormone level to ensure the treatment is working and dosage is appropriate. 

You’ll likely start to feel better one or two weeks after you begin treatment. Treatment with levothyroxine likely will be lifelong. 

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