Hypothyroidism, a disorder with symptoms in its own right, has major impact on a wide range of other non-communicative diseases, many of which are significant causes of poor health, poor quality of life and mortality. This learning journey comprises a series of online activities to explore the effects of hypothyroidism on liver function, kidney function and cardiovascular function and how imbalance in each of these areas impacts each of the others, collectively contributing, with insulin resistance, to metabolic dysfunction. Treatment for hypothyroidism, and by extension, the metabolic problems created by it, is levothyroxine therapy. Therapy is effective, but is difficult to optimise for patients, and indeed, vigilance is needed to keep patients euthyroid through all stages of their life, but particularly during pregnancy and as patients age. New research is demonstrating the impact of the gut thyroid axis and the importance of a healthy gut microbiome to metabolic homeostasis. This series of educational activities aims to raise awareness of the role that hypothyroidism plays in diseases affecting other organs, emphasizing the inter-relationships between metabolic disturbances, encouraging inter-departmental collaboration on patient care and sharing of screening and patient management.