How do you look when hypothyroid

I posted recently and got some really good advice - all of which I am motivated to act on. I have been reading some past posts by others and in one post it mentioned "looking hypothyroid". I know age is a big factor and I am about to hit 50 but as I posted I had my dose reduced 12 months ago and replies to my post suggest my treatment is low and my doctor is not in agreeance. However, I feel my facial features have changed over the 12 months beyond what one would expect with ageing. I have permanent black bags under my eyes, my skin is flakey and dry despite putting emollient on regularly and my face looks puffy (although I have gained 2 stones in this time too). my question is - should I accept this as ageing or will an increased dose make any difference and I can show these physical signs to my GP as well as asking him to re-do my bloods in an effort to convince him to increase the dose or will he just dismiss this as bonkers and an excuse to fob me off again ?

18 Replies

  • Have a look at the picture of the lady at the start of the video on this link. I think it's quite typical

  • Annegal,

    There is no hypothyroid 'look' some people have a goitre, some are puffy and gain weight, others may be slim, while some may have thinning hair and dry skin.

    Please post your thyroid results and ranges and members will advise whether you are optimally medicated or require a dose increase. Please also include any results you have for ferritin, vitamin D, B12 and folate.

  • annegal

    should I accept this as ageing or will an increased dose make any difference

    No, I don't think you should accept this as ageing. Not yet anyway. Take a few good photos of yourself as you are right now. Keep these so that you can use them for comparison after you've been on an increased dose for a few weeks. Often, it is only by such comparison that we can convince those who doubt us, such as GPs, that we were right.

    If you want to see some really shocking before and after photos, take a look at this PDF of an old paper in a 1949 edition of the BMJ by a famous doctor called Richard Asher.

  • Dr Richard Asher, in his seminal paper, MYXOEDEMATOUS MADNESS, included the then-remarkable number of ten photographs/groups of photographs of patients. I believe that Dr Asher did this very intentionally – to provide clear examples of the “hypothyroid look” to other doctors with the express intention of making diagnosis more likely in future.

    Mostly, ascribing motives to long dead people is a questionable approach. One full of potholes, assumptions, uncertain motives (in the ascriber’s mind) and, frankly, a lot of baloney. Maybe I am wrong, but I have not been able to dissuade myself of this being Dr Asher’s reason in this case.

    We see a lot of people diagnosed well before they reach the awful depths illustrated in this paper. But I wouldn’t for one moment assume that no-one ever reaches them, just that we don’t see them able to post here, nor do we see any photographs of them anywhere.

    Even at my very slight level of hypothyroidism, some of the characteristics were starting to be visible to someone who understands what to look for and how to interpret what they see.

    At least mostly now resolved.

  • Just a note for anyone who reads that link, I ***think*** that the doses mentioned, being for Thyroid BP, are approximately half the potency of current-day desiccated thyroid preparations.

  • For absolute clarity, wasn't Thyroid BP the UK version of desiccated thyroid i.e. what is now commonly referred to as NDT?

  • Yes - it was. :-) Until withdrawn in the early 1980s.

    (Whereas Thyroid USP - which would initially appear to be the USA version - is actually the desiccated thyroid powder before being made into tablets.)

  • helvella RedApple I find it really hard to understand, when there is evidence like that, how the medical profession today can dismiss the proof that dessicated thyroid was so successful. It's so plain to see and that makes it all the more frustrating and sad that the closed minds of doctors today are willing to allow patients' health to deteriorate to such an extent.

    Dr P and the late Dr S surely can't be the only ones who know that synthetic Levo doesn't work for everyone and know that there is an alternative that works. There must be others - but of course they won't stand up and be counted. Such a pity. And this is progress :(

  • Irony - in Mark Vanderpump's Milton Keynes presentation:

    Pages 7 and 9 show (one photographically, the other in text) without a shadow of a doubt that animal thyroid works. And that MVDP knows and acknowledges that it works.

    Then on page 10 - the damning of desiccated thyroid by the "eminent" endocrinologists. On grounds which were questionable then, and are nowadays overtaken by reality. A reality today in which desiccated thyroid is often regarded as less variable than levothyroxine, in which triiodothyronine (liothyronine/T3) is progressively less and less available, and in which shelf-life of desiccated thyroid is comparable, sometimes longer, than that of levothyroxine.

    (I really do wonder if at least some doctors dosed using Thyroid BP at the numbers of grains as USA and other doctors were using - despite the 100% greater potency of the USA products. That could explain some under-performance of Thyroid BP. (Think of the Mars spacecraft where Europe and the USA used different units - metric against old-fashioned USA feet and inches - and failed the mission.)

  • So true SeasideSusie. The words stubborn and arrogance come to mind. Often today's medics seem to be saying that synthetic thyroxine is better simply because man invented it, and desiccated thyroid is an old fashioned 'crude', 'alternative' remedy. So the 'progress' is all about man's invention of synthetic thyroxine (and of course the 'exquisite' TSH test), not about the health of today's hypothyroid patients.

  • its not ageing its hypothyroid and only correct treatment for the hypo gets rid of the black eye problems etc

  • There's is definitely a hypothyroid look. I had it when I was three stone overweightvwith half my hair missing!

  • Thank you for the links. I found the first link interesting pictures - they all looked so sad - but the BMJ full of relevant cases which helps me to understand my own position. It's interesting that I was diagnosed 26 years ago but have never researched the condition before until I have hit some physical problems. My eldest sister was diagnosed with Hashimotos 2 years ago and my next elder sister was diagnosed with thyroid cancer and had total removal 4 years ago. So we all have different diagnoses but same end result. I am also wondering about our mum - she had a test done which we were told was normal but she (at 79) is becoming very confused and interestingly has raised cholesterol as in the BMJ case studies. She is due to have a CT scan for dementia this week. I might probe further what her results actually were along with sorting out my own needs.

  • annegal, with regard to your mum, see here

    Current guidelines from the American Academy of Neurology recommend routine thyroid function testing in all patients newly diagnosed with dementia. Even though this study found that subclinical hyperthyroidism was associated with dementia, there was a lot of variation in the reference ranges for thyroid hormone used and methods for assessing cognition and dementia diagnosis between the included studies. It is still uncertain whether subclinical thyroid dysfunction is truly associated with dementia and whether normalization of thyroid function in these patients would improve cognitive outcomes.

  • Thanks - I see what this implies. Will just check her levels as I am now educated from this fab forum as my GP told me I myself was above range and reduced my Levothyroxine but when I asked for the result earlier this week as suggested on the forum it was clearly below and I need to question that.

  • My own thoughts on dementia are linked to there being more receptors for T3 in the brain than anywhere else. So as the T3 is rarely checked on the NHS or low in range acceptable - then the connection is missed.

    Also the fact that millions are on statins - and yes the brain is made up of at least 25% cholesterol.

    Then there is the added problems caused by inflammation in the gut leading to brain issues .... and so it goes on. Noone is joining up the dots ....

    Common sense is not a money making machine for Big Pharma - they just assume we are devoid of knowledge and will swallow their poison. 😊

  • A moon face in my case!

  • Send your GP a copy of the following link. He might also take notice of the 50+. It is well known that if not on an optimum of thyroid hormones our metabolism is far too low as they are absolute about keeping the TSH in the range, instead of low.

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