- Inability of the thyroid gland to produce adequate amount of the hormone results in hypothyroidism.
- Feeling exhausted, cold sensitivity, constipation, forgetfulness, irregular menstrual periods, brittle nails, and dryness of skin are the most common symptoms of hypothyroidism.
- The first steps in the diagnosis of hypothyroidism are thorough physical examination and medical history.
Hypothyroidism is characterized by an under active thyroid gland that fails to produce an adequate amount of thyroid hormones. These hormones are important in maintaining an adequate metabolic rate and energy production. Thus, low levels of thyroid hormones affect each and every organ of the body, making a person with untreated hypothyroidism very exhausted and weak. It is very common in the population and may affect millions. It is thought that many people have hypothyroidism and do not know it. This is largely due to misdiagnosis and neglecting symptoms for other conditions or reasons.
Who is affected by hypothyroidism?
People of any age may be affected by hypothyroidism. However, it is more common among elderly people above 60 years of age. Women are also more likely to have hypothyroidism than men. The risk of hypothyroidism increases significantly with family history of the condition.
What causes hypothyroidism?
The inability of the thyroid gland to produce adequate amounts of the thyroid hormones results in hypothyroidism. Reduced secretion of the thyroid-stimulating hormone (TSH) by the pituitary gland may also lead to hypothyroidism, as it fails to stimulate the thyroid gland to produce enough hormones. In some other cases, insufficient production of thyrotropin-releasing hormone (TRH) from the hypothalamus causes inadequate stimulation of the pituitary, which in turn negatively affects the production of thyroid hormones by the thyroid gland.
Iodine deficiency is the most important cause of hypothyroidism worldwide. In countries where the iodine intake is insufficient, Hashimoto’s thyroiditis is the most common form of hypothyroidism. In this condition, the immune system destroys the tissues of thyroid gland. This is considered to be an autoimmune disorder for this reason.
Surgical removal of thyroid gland and radiation therapy for cancer may also lead to hypothyroidism in a similar manner.
What are the symptoms of hypothyroidism?
Feeling exhausted, severe sensitivity to the cold, constipation, forgetfulness, headaches, irregular menstrual periods, brittle nails, lack of appetite, and dryness of skin are the most common symptoms of hypothyroidism. Additionally, many people with hypothyroidism begin to lose their hair, and their hair becomes more dry and prone to breakage. They may also notice that the outer ends of their eyebrows become sparse and sometimes parts of the eyebrows become nonexistent. Unexplained and unusual weight gain often occurs, as well. It is also important to evaluate mood changes, which may include increased depression and anxiety. These symptoms usually develop gradually over a period of time, making them more difficult to detect. These symptoms are often ignored or attributed to aging or stress. It is important to see a physician if any of these symptoms are present, especially if they persist.
How is hypothyroidism diagnosed?
The first steps in the diagnosis of hypothyroidism include a thorough physical examination and medical history. Further tests are necessary to confirm the diagnosis, if the doctor suspects hypothyroidism. Tests used to confirm this condition are TSH test and thyroxine (thyroid hormone T4) evaluation. A doctor may test for other conditions during this time, as well. This will help eliminate other possible diagnoses, such as anemia.
If the tests mentioned above return with normal results, a doctor may suggest an anti-thyroid antibody tests to check for Hashimoto’s disease. In some rare cases, ultrasound scan of the thyroid gland may be suggested to evaluate the gland for abnormalities. A computed tomography (CT/CAT) scan or a magnetic resonance imaging (MRI) scan may be used to assess the pituitary and hypothalamus in the brain.
How is hypothyroidism treated?
When left untreated, hypothyroidism can lead to an increase in blood cholesterol levels, which is a major risk factor for various heart diseases. Hypothyroidism during pregnancy can harm the developing fetus. It may even affect a woman's ability to become pregnant in the first place. In children, hypothyroidism may result in intellectual disability. Lung and breathing issues are also more likely to occur when hypothyroidism is not treated. Hence, treatment of hypothyroidism is very important.
The most common method of treatment of hypothyroidism is hormone therapy using synthetic thyroid hormone levothyroxine, which replenishes the T4 thyroid hormone. Appropriate dosage for each person may differ depending on individual needs. Receiving adequate amounts of the hormone is important, because deficiency and excess can both cause hypothyroid symptoms. Initial dosage is often kept lower in patients with heart diseases and then increased gradually so as to allow the heart to adjust to increased metabolic rate. Some doctors will prescribe a higher dose than necessary to initially jump start the treatment, and then they will lower it until they find they correct dosage.
If levothyroxine is not proving to help as much as desired, a more natural replacement may be given. Medications like Nature-Throid and others are created using bovine or porcine thyroid glands. Because T4 is generally converted to the more active T3 thyroid hormone by the body, T4 requires more processes than T3 itself. If the body is not efficiently converting T4 to T3, a doctor may recommend switching to a medication like Nature-Throid, because it contains T3 and T4, which allows the body to do less work than is necessary for levothyroxine to work effectively.
Symptoms show improvement within a few weeks of hormone replacement and may fully disappear within few months of treatment. The response may be delayed in elderly people and in patients with other medical conditions. Normal thyroid gland function may be restored in patients with Hashimoto’s disease after some time, even without any specific treatment. Treating the infections or stopping the medications that cause hypothyroidism also help to return the thyroid gland functioning. However, many patients will need to supplement with medication for the rest of their lives, and they may have lingering symptoms, even after their thyroid levels are back to normal.
Many people will still feel the effects of hypothyroidism with treatment. These symptoms may include continued headaches, lack of appetite, and fatigue. These symptoms may persist even if the thyroid hormones appear to be at normal levels, so it is important to discuss all treatment options with your physician. Additionally, getting quality sleep, eating healthy foods, and exercising may mitigate lingering hypothyroidism symptoms.