Symptoms like weight gain, cold sensitivity, dry skin, and fatigue might have sent you to your doctor for a diagnosis. Now that you know you have hypothyroidism — an underactive thyroid gland — you can focus on managing the symptoms and learning to live with the condition.

In addition to seeing your primary care doctor, you might also visit a specialist who treats thyroid disorders, called an endocrinologist. Because you only have a limited amount of time with your doctor at each visit, it helps to come prepared.

Use this list of questions to guide your exam, and make sure you learn everything you can about your hypothyroidism and its treatment.

1. What caused my hypothyroidism?

Women are more likely than men to get this condition. You might have developed hypothyroidism if a disease or surgery damaged your thyroid gland and prevented it from making enough of its hormone.

Causes for hypothyroidism include:

  • surgery or radiation to your thyroid gland
  • Hashimoto’s disease — a disease in which your immune system attacks your thyroid gland
  • thyroiditis or inflammation of your thyroid gland
  • certain medicines such as amiodarone, interferon alpha, lithium, and interleukin-2

2. What treatment do I need?

The treatment you get for hypothyroidism will depend on how low your thyroid hormone level has dropped. Doctors usually treat this condition with a man-made form of thyroid hormone called levothyroxine (Levothroid, Levoxyl Synthroid). This drug will bring your thyroid hormone levels back up to normal, which should relieve your symptoms. If your thyroid hormone level is only slightly low, you might not need treatment.

3. How will you figure out my dose?

Your doctor will choose your thyroid hormone dose based on your weight, age, and any other conditions you have. You’ll get a blood test about once every six to eight weeks after you start taking thyroid hormone. This test checks your levels of thyroid-stimulating hormone, which directs your thyroid gland to release its hormone. Your doctor will adjust your thyroid hormone dose based on the test result.

Once your thyroid hormone level stabilizes, you’ll have tests about once every six months to make sure you’re still on the right dose.

4. How often will I need to take the medicine?

Most people take this drug every day. Ask your doctor for specific recommendations.

5. How do I take thyroid hormone?

Your doctor might suggest that you take this drug in the morning when your stomach is empty. Having food in your stomach can prevent thyroid hormone from fully absorbing. Some medications and supplements can interfere with the absorption of thyroid hormone. It’s usually recommended to take levothyroxine four hours before or after taking these.

6. What if I miss a dose?

If you miss a dose, it’s best to take it as soon as you remember. If it’s almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Don’t double up on the dosage.

7. Can I switch to another thyroid drug?

Several different brand names and generic versions of thyroid hormone replacement are available. Still, it’s a good idea to stay on the same medicine. Even though all of these drugs contain the same active ingredient, they can also contain different inactive ingredients that might affect your treatment.

8. For how long will I need to be on thyroid hormone?

You might need to be on thyroid hormone for the rest of your life. But the dosage could change over time, depending on your hormone levels.

9. What side effects can thyroid hormone cause?

When you take thyroid hormone in the recommended dose, it shouldn’t have many side effects. In larger amounts, it might cause:

  • trouble sleeping
  • pounding heart
  • shakiness
  • increased appetite

10. For which side effects should I call you?

Ask your doctor which side effects are serious enough to schedule a visit.

11. Which drugs or foods can interact with my medicine?

Some medicines and foods can prevent your body from properly absorbing levothyroxine. Ask your doctor if you need to stop eating or taking any of these:

  • vitamins or supplements that contain iron or calcium
  • soy foods
  • antacids that contain aluminum hydroxide
  • birth control pills
  • antiseizure drugs
  • antidepressants
  • cholesterol-lowering drugs
  • cholestyramine

12. What changes should I make to my diet?

Find out if you should limit or avoid any foods. If you have Hashimoto’s disease, you might have to be careful about eating foods that are high in iodine, like kelp and seaweed. Some cough syrups also contain iodine.

13. What health problems can hypothyroidism cause?

Hypothyroidism can increase your LDL (“bad”) cholesterol level, which could lead to heart disease. Other complications include depression, nerve damage, and infertility. Rarely, untreated hypothyroidism can cause a life-threatening condition called myxedema coma.

14. Is it safe for me to exercise?

Because hypothyroidism slows your heart rate, suddenly jumping into an exercise program could be dangerous. You might need to wait until your thyroid hormone level stabilizes. Ask your doctor when you can start to exercise again, and how to safely begin a new routine.

15. What happens if I get pregnant?

Treatment is especially important during your pregnancy. Untreated hypothyroidism can be dangerous to both you and your baby. In pregnant women, low thyroid hormone levels can cause anemia, preeclampsia, congestive heart failure, and postpartum bleeding. Babies need thyroid hormone for their brain to develop normally. Talk to your doctor about any concerns you have regarding hypothyroidism treatment while pregnant.