Hypothyroidism (Underactive Thyroid) in Grand Rapids, MI

The thyroid is a small, butterfly‑shaped gland located in the neck, just below the Adam’s apple (larynx). It has two lobes on either side of the windpipe, joined in front by a thin bridge of tissue called the isthmus.

This gland produces thyroid hormones that help regulate:

  • Metabolism (how your body uses energy)
  • Growth and development
  • Heart rate and body temperature
  • Brain function and mood

When the thyroid does not make enough hormone, the body’s processes slow down. This condition is called hypothyroidism (underactive thyroid).

What Is Hypothyroidism?

Hypothyroidism means the thyroid gland is underactive and fails to release enough thyroid hormone into the bloodstream.

This leads to a general “slowing down” of many body systems, affecting energy, mood, weight, and even heart function.

In Grand Rapids and across Michigan, hypothyroidism is a common condition seen in primary care and endocrine clinics, including:

  • Spectrum Health and Corewell Health endocrine clinics
  • Trinity Health Grand Rapids
  • Metro Health – University of Michigan Health
  • Mercy Health and community practices throughout Kent County

How Common Is Hypothyroidism?

Hypothyroidism is the most common thyroid disorder.

  • It affects an estimated 6–10% of women
  • The risk increases with age – up to 25% of women over 65 may be affected
  • Men can also develop hypothyroidism, though less frequently

Because symptoms can be subtle and develop slowly, many people in the Grand Rapids area may have undiagnosed hypothyroidism, especially older adults.

Primary vs. Secondary Hypothyroidism

Primary Hypothyroidism

Primary hypothyroidism occurs when the problem is in the thyroid gland itself. Common causes include:

  • Hashimoto’s disease (chronic autoimmune thyroiditis) – the most common cause in the U.S. and in Michigan
  • Iodine deficiency (less common in the U.S., but possible in people who avoid iodized salt and seafood)
  • Thyroid surgery (partial or total removal of the thyroid)
  • Radioactive iodine treatment for hyperthyroidism or thyroid nodules
  • Radiation to the neck or upper chest (for cancers such as lymphoma)
  • Certain medications (for example, lithium, amiodarone)

In Hashimoto’s disease, the immune system mistakenly attacks and gradually destroys thyroid tissue, leading to reduced hormone production.

Secondary (or Central) Hypothyroidism

Secondary hypothyroidism is less common and occurs when the thyroid is normal but does not receive proper signals from the brain.

  • Pituitary gland dysfunction – the pituitary, located in the brain, does not make enough thyroid-stimulating hormone (TSH)
  • Hypothalamic dysfunction – the hypothalamus (another brain structure) does not produce enough thyrotropin‑releasing hormone (TRH), which tells the pituitary to release TSH

Because TSH is the “messenger” that prompts the thyroid to make hormones, low TSH from the pituitary or hypothalamus leads to low thyroid hormone levels.

Thyroid Hormones and Iodine

The thyroid gland makes two main hormones:

  • Thyroxine (T4)
  • Tri‑iodothyronine (T3)

Both hormones contain iodine, a mineral the body must get from food. The average adult needs about 150 micrograms (mcg) of iodine per day.

Iodine Sources

Good dietary sources of iodine include:

  • Iodized table salt
  • Seafood and seaweed
  • Dairy products (milk, yogurt, cheese)
  • Eggs

In Grand Rapids, most residents get enough iodine through iodized salt and common foods, but people on very restricted diets or specialty eating plans may be at risk of deficiency.

When the diet is very low in iodine, the thyroid cannot make enough hormone. The pituitary responds by sending more TSH, which can cause the thyroid to enlarge.

An enlarged thyroid is known as a goitre.

Symptoms of Hypothyroidism

Symptoms of hypothyroidism can be mild, moderate, or severe, and they often develop slowly over months or years.

Common symptoms include:

  • Fatigue and low energy levels
  • Feeling unusually cold (cold intolerance) – especially noticeable during West Michigan winters
  • Unexplained weight gain or difficulty losing weight
  • Slow heart rate
  • Depressed mood or low motivation
  • Dry, coarse skin
  • Hair loss or thinning hair
  • Puffy face or swelling around the eyes
  • Constipation
  • Aching, stiff, or weak muscles
  • Heavy or irregular menstrual periods
  • Problems with concentration and memory (“brain fog”)
  • Hoarse voice
  • Goitre (enlarged thyroid gland in the neck)

Because Michigan winters are long and cold, it can be easy to dismiss cold intolerance, fatigue, and low mood as “just the weather” in Grand Rapids. Persistent symptoms should be evaluated by a healthcare provider.

Severe Hypothyroidism (Myxoedema Coma)

In its most severe form, hypothyroidism can progress to myxoedema coma, a life‑threatening emergency.

Warning signs can include:

  • Extreme drowsiness or confusion
  • Very low body temperature
  • Slow heart rate and low blood pressure
  • Difficulty breathing

Myxoedema coma requires urgent hospital treatment, typically in an intensive care unit. Local emergency care is available at Grand Rapids hospitals such as Spectrum Health and Trinity Health Grand Rapids.

Hypothyroidism in Babies and Children

Thyroid hormones are essential for normal growth and brain development.

  • Congenital hypothyroidism occurs when a baby is born with an absent or underdeveloped thyroid gland, or with a defect in thyroid hormone production.
  • Without treatment, this can lead to stunted growth and permanent brain damage.

Newborn screening programs in Michigan routinely test babies for congenital hypothyroidism so treatment can start early.

Iodine deficiency in pregnancy and childhood can also cause growth and developmental problems. Pregnant people in Grand Rapids should talk with their OB‑GYN or midwife about appropriate prenatal vitamins that include iodine.

Causes of Hypothyroidism

Common causes include:

  • Hashimoto’s disease (autoimmune thyroiditis)
  • Iodine deficiency (rare in the U.S., but possible in certain diets)
  • Thyroid surgery (for thyroid cancer, large goitre, or hyperthyroidism)
  • Radioactive iodine therapy (often used to treat hyperthyroidism)
  • Radiation exposure to the neck or upper chest (past cancer treatments, older X‑ray techniques)
  • Medications
    • Lithium (used for some mental health conditions)
    • Amiodarone (heart rhythm medication)
    • Some cancer therapies and immune‑modulating drugs
  • Birth defects (congenital absence or malformation of the thyroid)
  • Pituitary gland dysfunction (low TSH production)
  • Hypothalamic dysfunction (low TRH production, affecting TSH and thyroid function)

Some treatments for hyperthyroidism (overactive thyroid) – including surgery and radioactive iodine – often lead to permanent hypothyroidism, requiring lifelong thyroid hormone replacement.

Hypothyroidism vs. Hyperthyroidism

People treated for hyperthyroidism can sometimes receive too much thyroid hormone replacement, or residual thyroid tissue can become overactive. This may lead to hyperthyroidism (overactive thyroid).

Symptoms of hyperthyroidism include:

  • Rapid or irregular heartbeat (palpitations)
  • Unexplained and sudden weight loss
  • Feeling hot or sweating more than usual
  • Nervousness, agitation, or anxiety
  • Tremor (shaking hands)
  • Insomnia (trouble sleeping)
  • Diarrhea or frequent bowel movements

If you are taking thyroid medication in Grand Rapids and develop symptoms of hyperthyroidism, contact your doctor or endocrinologist promptly to adjust your dose.

How Hypothyroidism Is Diagnosed in Grand Rapids

Diagnosis typically involves:

1. Medical History and Physical Exam

Your healthcare provider will:

  • Review your symptoms (fatigue, weight changes, cold intolerance, etc.)
  • Ask about family history of thyroid disease
  • Check your neck for an enlarged thyroid (goitre)
  • Review your medications and past treatments (especially radiation or thyroid surgery)

2. Blood Tests

Key blood tests include:

  • TSH (thyroid‑stimulating hormone) – usually high in primary hypothyroidism
  • Free T4 (thyroxine) – usually low in hypothyroidism
  • Sometimes T3 and thyroid antibody tests (for Hashimoto’s disease)

These tests are widely available through laboratories and hospital systems in Grand Rapids, including Spectrum Health, Trinity Health, Metro Health, and independent labs.

3. Imaging (If Needed)

In some cases, your doctor may order:

  • Thyroid ultrasound – to look at the size, shape, and texture of the thyroid and check for nodules
  • Radioactive iodine uptake or scan – to assess how the thyroid is functioning

Treatment for Hypothyroidism

The main treatment for hypothyroidism is thyroid hormone replacement with a synthetic form of T4 called levothyroxine (often referred to as “thyroxine”).

How Thyroid Hormone Replacement Works

  • Taken as a daily tablet, usually in the morning on an empty stomach
  • Restores normal thyroid hormone levels in the blood
  • Helps relieve symptoms such as fatigue, weight gain, and cold intolerance
  • Prevents long‑term complications, including high cholesterol, heart disease, and severe hypothyroidism

For autoimmune hypothyroidism (Hashimoto’s disease), there is no cure for the underlying autoimmune process, so medication is typically required for life.

Monitoring and Adjusting Medication

The Dose Must Be Carefully Monitored

Too little medication:

  • Symptoms of hypothyroidism may persist
  • You may continue to feel tired, cold, or depressed

Too much medication:

  • Can cause symptoms of hyperthyroidism, such as
    • Feeling hot or sweaty
    • Rapid heartbeat or palpitations
    • Anxiety or nervousness
    • Unexplained weight loss
    • Trouble sleeping

Your doctor will:

  • Check TSH and free T4 levels periodically (often every 6–8 weeks when adjusting doses, then every 6–12 months once stable)
  • Adjust your dose based on lab results, symptoms, age, weight, and other medical conditions

In Grand Rapids, follow‑up can be done through:

  • Primary care providers (family medicine, internal medicine)
  • Endocrinologists at Spectrum Health, Trinity Health Grand Rapids, Metro Health, and other specialty clinics

Local Considerations for Grand Rapids Residents

  • Cold winters: Hypothyroidism can make you more sensitive to cold, which may be especially noticeable during West Michigan’s long, snowy winters.
  • Seasonal mood changes: Fatigue and low mood from hypothyroidism can be mistaken for seasonal affective disorder (SAD). Proper thyroid testing helps clarify the cause.
  • Access to care: Grand Rapids has multiple hospital systems and clinics, plus community resources through the Kent County Health Department and Grand Rapids Public Health that can help connect residents to screening and treatment.

If you are uninsured or underinsured, local health departments and community clinics may offer low‑cost or sliding‑scale thyroid testing and medication assistance.

When to See a Doctor in Grand Rapids

Contact a healthcare provider if you:

  • Feel unusually tired or sluggish most days
  • Notice unexplained weight gain
  • Are sensitive to cold more than others around you
  • Have dry skin, hair loss, or constipation
  • Experience depression or “brain fog”
  • See or feel swelling in the front of your neck (possible goitre)
  • Have a family history of thyroid disease

You can start with:

  • Your primary care provider
  • An endocrinologist (thyroid specialist)
  • Local health centers connected with Spectrum Health, Trinity Health Grand Rapids, Metro Health, or Mercy Health

Key Points About Hypothyroidism

  • Hypothyroidism causes the body’s processes to slow down.
  • It is the most common thyroid disorder, affecting an estimated 6–10% of women, with higher rates in older adults.
  • Hypothyroidism can be primary (thyroid gland problem) or secondary (pituitary or hypothalamus problem).
  • In its severest form, myxoedema coma is life‑threatening and needs emergency treatment.
  • The thyroid gland makes two main hormones – thyroxine (T4) and tri‑iodothyronine (T3) – which require iodine.
  • Diagnosis is made with blood tests (TSH and free T4), and sometimes imaging.
  • Treatment is with thyroxine (levothyroxine) tablets, usually taken for life, with doses carefully monitored to avoid both under‑ and over‑treatment.

If you live in Grand Rapids, MI and suspect you may have hypothyroidism, talk with your doctor or an endocrinologist about testing and treatment options available through local healthcare systems and community resources.