Overview
Hypothyroidism (an underactive thyroid) is one of the most common hormonal disorders in Germany and affects women considerably more often than men. The thyroid gland produces too little of the hormones thyroxine and triiodothyronine, which regulate the energy metabolism of almost all organs. Typical consequences are tiredness, weight gain, sensitivity to cold and difficulty concentrating, which often develop gradually over months. The standard treatment is the daily intake of thyroid hormones (levothyroxine), with which the symptoms usually resolve completely once the dose is properly adjusted. Since therapy is generally continued long term, patients regularly need follow-up prescriptions and laboratory checks. This is exactly where the video consultation comes in: if your condition is stable and current laboratory results are available, the doctor can assess your therapy in the consultation and, following medical assessment, issue a private prescription for your usual preparation. This spares you a practice visit for a pure repeat prescription without compromising medical diligence.
Common causes
By far the most common cause of hypothyroidism in Germany is Hashimoto's thyroiditis, a chronic autoimmune inflammation in which the immune system attacks thyroid tissue and hormone production gradually declines. Also common is an underactive thyroid following medical interventions, for example after thyroid surgery or radioiodine therapy. Certain medicines can also impair thyroid function; the doctor will advise you on this based on your medication plan. Pronounced iodine deficiency has become rare in Germany thanks to the use of iodised table salt, but it continues to play a role worldwide. Considerably rarer are congenital forms, which are already detected in newborn screening, as well as so-called secondary hypothyroidism, in which the cause lies not in the thyroid itself but in the higher-level hormonal control by the pituitary gland.
When to see a doctor
Have persistent complaints such as pronounced tiredness, unexplained weight gain, sensitivity to cold or low mood medically evaluated, especially if several symptoms occur together or thyroid disorders are known in your family. If you have already been diagnosed with an underactive thyroid, seek medical advice if new symptoms occur despite regular intake, if your weight changes significantly, or if you are or plan to become pregnant, as the therapy then often needs to be adjusted promptly. A rapidly growing lump in the neck, newly occurring difficulty swallowing or hoarseness should likewise be evaluated promptly by a doctor in person. Rarely, severe untreated hypothyroidism can lead to a life-threatening metabolic crisis: in the event of pronounced drowsiness up to impaired consciousness, confusion, severe hypothermia or a very slow heartbeat, call emergency services 112 immediately.