Hypothyroidism:
Sequoia Medical 360

Expert Diagnosis & Treatment for Underactive Thyroid in Bronxville & Westchester, NY

Hypothyroidism occurs when the thyroid gland fails to produce enough hormone, slowing metabolism and disrupting nearly every organ system. Fatigue, weight gain, cold intolerance, constipation, dry skin, hair thinning, and cognitive changes are common — but the condition also carries long-term risks, including heart disease, infertility, and osteoporosis, if left untreated.
At Sequoia Medical 360, we deliver comprehensive, concierge-level care for hypothyroidism, using advanced diagnostics and individualized treatment plans. Whether your condition is autoimmune, central, inflammatory, or pregnancy-related, Dr. Tony Mathews’ dual fellowship training in Endocrinology and Preventive Cardiology ensures that your thyroid health is managed with both precision and foresight.

Common Causes of Hypothyroidism

Hashimoto’s Thyroiditis

The most common cause of hypothyroidism, Hashimoto’s is an autoimmune condition in which the immune system mistakenly attacks thyroid tissue. Over time, this damages the gland’s ability to produce hormone.

Symptoms: Fatigue, weight gain, cold sensitivity, hair thinning, swelling of the neck (goiter).
Diagnosis: TSH, free T4, free T3 (as indicated), and thyroid antibody testing (anti-TPO, anti-thyroglobulin). Ultrasound may show a heterogeneous gland consistent with autoimmune inflammation.
Management: Lifelong thyroid hormone replacement (usually levothyroxine, sometimes T4/T3 combinations), supported by nutrition, stress reduction, and autoimmune monitoring.

Central Hypothyroidism

Unlike primary hypothyroidism (where the thyroid itself fails), central hypothyroidism results from problems in the pituitary gland or hypothalamus, which fail to send the thyroid the stimulation it needs.

Causes: Pituitary tumors, prior surgery or radiation, genetic conditions, or infiltrative diseases
Diagnosis: Low thyroid hormone levels (free T4, sometimes free T3) with inappropriately normal or low TSH. Evaluation often includes pituitary hormone panels and MRI imaging.
Management: Thyroid hormone replacement, while also addressing any pituitary or hypothalamic dysfunction. Careful coordination is essential, especially when adrenal insufficiency is also present.

Thyroiditis (Subacute & Chronic Forms)

Thyroiditis refers to inflammation of the thyroid gland. It can appear in different forms:

Subacute thyroiditis: Often post-viral, causing neck pain, tenderness, fever, and a temporary overactive thyroid phase, followed by hypothyroidism.
Silent thyroiditis: A painless, autoimmune-mediated form, sometimes overlapping with Hashimoto’s.
Chronic thyroiditis: Longer-term inflammation leading to gradual hypothyroidism.
Management: Anti-inflammatory medications may help during the painful phase; thyroid hormone replacement is prescribed if hypothyroidism persists.

Postpartum Thyroiditis

A unique autoimmune thyroid disorder that affects some women in the first year after childbirth.

Phases: Begins with a temporary hyperthyroid phase (anxiety, palpitations, weight loss), followed by a hypothyroid phase (fatigue, weight gain, low mood). Some women return to normal function, while others develop permanent hypothyroidism.
Diagnosis: Thyroid function testing at the onset of symptoms; antibody screening can help identify those at higher risk.
Management: Supportive treatment during hyperthyroidism (often beta-blockers), followed by thyroid hormone replacement if hypothyroidism persists. Close follow-up is essential for family planning and future pregnancies.

Myxedema Coma (Severe Hypothyroidism)

Rare but life-threatening, myxedema coma represents the extreme end of untreated or uncontrolled hypothyroidism.

Triggers: Severe illness, cold exposure, trauma, or sedating medications in patients with longstanding untreated hypothyroidism.
Symptoms: Severe fatigue, confusion, hypothermia, low blood pressure, slow breathing, and ultimately coma.
Management: Immediate hospitalization with intravenous thyroid hormone replacement, supportive care, and treatment of precipitating factors.At Sequoia, our proactive monitoring is designed to prevent hypothyroidism from ever progressing to such extremes.

Our Diagnostic Approach at Sequoia Medical 360

We look beyond a single TSH value. Our thyroid evaluation may include:

Comprehensive hormone panels (TSH, free T4, free T3)
Antibody testing for autoimmune thyroid disease
Advanced imaging: High-resolution thyroid ultrasound when nodules or autoimmune changes are suspected
Body composition analysis: InBody 770 testing to evaluate how thyroid imbalance affects fat, muscle, and water distribution
Body composition analysis: InBody 770 testing to evaluate how thyroid imbalance affects fat, muscle, and water distribution

Personalized Treatment Strategies

Levothyroxine (T4): Gold standard therapy, with individualized dosing for weight, absorption, cardiac risk, and pregnancy planning.
T4/T3 combination therapy: Considered in select patients with persistent symptoms despite optimized T4.
Lifestyle integration: Nutrition, exercise, and stress management strategies tailored to autoimmune or inflammatory thyroid disease.
Long-term follow-up: Regular labs (typically every 6–8 weeks initially, then every 6–12 months once stable) with adjustments guided by both numbers and how you feel.

The Sequoia Medical 360 Advantage

Quadruple board-certified expertise in Endocrinology, Lipidology, Obesity Medicine, and Internal Medicine
Dual fellowship training in Endocrinology/Metabolism and Preventive Cardiology
Direct Physician Counsel: Ample, scheduled exam time and streamlined communication to review results with the depth your physiology requires.
Integrated care: Linking thyroid management to cardiovascular risk, metabolic health, and longevity goals

Restore Your Thyroid Balance

An underactive thyroid doesn’t just slow your metabolism — it affects your energy, mood, and long-term health. At Sequoia Medical 360, we provide precision thyroid care that restores balance and safeguards your future.

Meet Dr. Mathews
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Tony Mathews, MD 116 Kraft Ave, Suite 4 Bronxville NY 10708
(914) 292-0300
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