Hypothyroidism

Hypothyroidism is a common type of hormone deficiency. It occurs when the thyroid gland does not produce enough of the proper types of thyroid hormone. If the body does not have enough thyroid hormone, its cells cannot function properly, and the patient’s health and overall quality of life can be affected. Unfortunately, many patients are not diagnosed and are denied treatment because most doctors rely entirely on the result of a single thyroid blood test. The real key to the accurate diagnosis and successful treatment of hypothyroidism is listening to patients and paying attention to their symptoms.

Dr. Hugh Melnick has been treating patients with hypothyroidism for over 40 years. He believes that the most important part of treating hypothyroidism is listening to his patients. A blood test can show that a patient’s thyroid hormone levels are in a “normal” range, but a patient may still have hallmark symptoms of hypothyroidism. In many ways, Dr. M, as he is called, believes the patient’s symptoms are more important than the results of the blood test. He takes the time to learn about all of the patient’s symptoms so that he can recommend the right treatment.

Common Symptoms of Hypothyroidism

Hypothyroidism can cause a wide variety of symptoms. While every patient is different, symptoms of hypothyroidism may include the following:

  • Confusion or feeling mentally “foggy”
  • Hoarse voice
  • Fatigue or decreased stamina
  • Depression
  • Cold extremities
  • Weight gain or difficulty losing weight
  • Slow speech
  • Hair loss
  • Premature graying of the hair
  • Low body temperature
  • Cracked heels and dry feet
  • High cholesterol
  • Ringing of the ears
  • Constipation
  • Anxiety and/or palpitations
  • Slow pulse
  • Decreased tendon reflexes
  • Droopy eyelids
  • Puffy and swollen face
  • Sparse, coarse, and dry hair
  • Coarse, dry, and thickened skin
  • Carpal tunnel syndrome
  • Hand tingling or pain
  • Muscle cramps
  • Orange-colored soles and palms
  • Sides of eyebrows thin or fall out
  • Increased menstrual flow in women
  • Infertility and miscarriages

If you are experiencing any of these symptoms, it may be beneficial to be evaluated by a specialist like Dr. Melnick.

Evaluating and Diagnosing Hypothyroidism

Since blood work results are often needed, Dr. Melnick’s staff will email the patient a laboratory requisition to have testing done at a convenient lab. Remember not to take your thyroid medication on the day of your blood draw, as taking meds will distort your results. Fasting is not necessary prior to the test. For ease in obtaining the results of your blood test, it is best to use a national clinical laboratory such as Quest Labs, because Dr. Melnick has an online connection with them.

A thyroid sonogram may also be recommended as a diagnostic test for hypothyroidism. In many cases of hypothyroidism, the sonogram shows the thyroid gland to be enlarged or have nodules, both of which are indicators of hypothyroidism.

Hashimoto’s Thyroiditis

In some cases, a patient may have an underactive thyroid gland, and may also test positive for antithyroid antibodies. This is an autoimmune condition called Hashimoto’s Thyroiditis. Essentially, the body’s immune system mistakes healthy thyroid cells as a biological threat and attacks them. This condition is often treated with a combination of thyroid medication and diet, as diet often plays a large role in many autoimmune disorders.

Learn more about Hashimoto’s Thyroiditis »

Treating Hypothyroidism

Most doctors prescribe synthetic thyroid hormone medications, such as Synthroid or Levothyroxine, to patients with hypothyroidism. However, 40% of patients do not experience relief from their symptoms with these medications. For this reason, Dr. Melnick prefers to prescribe natural thyroid medication made from the thyroid glands of pigs, which contain the identical thyroid hormones produced by the human thyroid gland.

Dr. Melnick has prescribed natural thyroid medication since he began his practice over 40 years ago. From his clinical observations, as well as his own personal experience taking natural thyroid medication, Dr. Melnick believes the results of treatment with natural thyroid medication are far superior to those seen with the synthetic medication that is commonly used today.


The optimal dose of natural thyroid cannot be determined by a person’s bloodwork. Dr. Melnick will gradually increase the dose of thyroid medication depending upon improvement in symptoms. It can take up to 12 weeks to find the ideal dosage to alleviate symptoms and lead to a better quality of life. During this time, Dr. Melnick will see the patient every 3-4 weeks to check in on symptoms and adjust dosages as needed. Diet can also play a major role in hypothyroidism, so this is discussed during followup visits as well. Often, these check-ins can be done via telemedicine, which is more efficient for patients who lead busy lifestyles.

Learn more about Treating Hypothyroidism with Telemedicine »

Hypothyroidism and Fertility

Hypothyroidism can also affect a woman’s fertility, leading to low egg quality and quantity. Patients with hypothyroidism also tend to have a higher risk of early menopause. Dr. Melnick often recommends fertility testing for younger women with hypothyroidism who want to have children in the future. This information will allow the patient to consider fertility options like egg freezing, since she has a higher risk of having problems conceiving.


Treatment for Hypothyroidism in New York City

Dr. Melnick has over 40 years of experience in treating patients with hypothyroidism. He believes it is important to take the time to listen to his patients’ symptoms, as blood tests often will only tell part of the story. Dr. Melnick also uses natural thyroid medication instead of synthetic medication, and also offers virtual care options for hypothyroidism. If you would like to schedule a consultation with Dr. Melnick, please call our office at (212) 369-8700, or use our convenient appointment request form.

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1625 Third Avenue, New York, NY 10128