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Hypothyroidism: Symptoms, Causes, Treatment

What is hypothyroidism? Meaning, Causes, Symptoms, Diagnosis, Complications, Treatment and Diet of Hypothyroidism...

What is hypothyroidism?

Hypothyroidism is a condition in which the body’s thyroid gland becomes underactive means the thyroid gland fails to produce enough of the thyroid hormones called Triiodothyronine (T3), and Thyroxine (T4).

The thyroid gland is a small, butterfly-shaped which sits at the front of the neck that is responsible for releases hormones to help the body regulate and use energy. Without the proper amount of thyroid hormones, the body’s natural functions begin to slow down.

The hormones produced by the thyroid gland affect the metabolism system of the body. The hormones are responsible to control how energy is used in your body and the resulting rate at which the different organs function in your body.

The general symptoms of hypothyroidism are fatigue, a hoarse voice, constipation, weight gain, pain in the joints, joint aches, thinning hair, muscle stiffness, dry skin, and increased sensitivity to cold.

You have to consult your doctor or a general physician immediately for a diagnosis. If you are diagnosed with hypothyroidism, the doctor should be able to treat and monitor your condition.

You can also consult an endocrinologist for the management of hypothyroidism. However, if your symptoms are more aggressive, he can refer you to an endocrinologist for specialized treatment.


How does hypothyroidism occur?

The thyroid gland is located in front of the neck, below the voice box (larynx). It is a butterfly-shaped gland which has two lobes. The 2 lobes are on either side of the windpipe linked by a thin bridge (isthmus) of thyroid tissue.

The thyroid gland is the part of the endocrine system of the body, which consists of a collection of glands in the body and the hormones produced by those glands.

The hypothalamus located in the brain actively controls the production of the thyroid hormone through the pituitary gland.

It produces the thyrotropin-releasing hormone (TRH), that signals the pituitary gland to release a hormone named thyroid-stimulating hormone (TSH).

The thyroid-stimulating hormone released by the pituitary gland, in turn, signals the thyroid gland to produce the T3 or T4 hormones.

If more T3 or T4 hormones are required, the pituitary gland produces more thyroid-stimulating hormone and if the T3 and T4 levels are already high in the body, the pituitary gland releases less amount of TSH.

Hypothyroidism occurs when the production of T3 and T4 hormones by the thyroid gland is too low for the body which can slow down your metabolism, and growth rate.

Hypothyroidism may sometimes also results in depression.


Cause of Hypothyroidism

Hypothyroidism can be caused by various factors such as:

Hashimoto’s Thyroiditis:

This is a condition in which the thyroid gland gets inflamed which is known as Thyroiditis, this occurs when the body’s own immune system attacks the thyroid gland and destroys it.

Iodine Deficiency:

The thyroid gland requires iodine to be able to produce T3 and T4 hormones. Since our bodies do not produce iodine by itself, we are dependent on the foods we consume to get the required amount of iodine to the body.

Foods which are rich in iodine include milk and milk-based products, yoghurt, saltwater fishes, bananas, eggs, strawberries, cranberries, green beans, and white bread.

Pregnancy:

During pregnancy, few women tend to develop an inflamed thyroid which is also known as postpartum thyroiditis.

Though the cause for this condition is unknown, after a certain time span, the thyroid hormone levels return to normal in such women.

Radiation Therapy:

Radiation falls to the thyroid gland can reduce the production of hormones.

Certain medications:

Some class of medicines can interfere with the normal production of thyroid hormone. Lithium is one of the most common medicines which causes hypothyroidism.

Growths in the thyroid:

Thyroid nodules are abnormal overgrowths of tissue of the thyroid gland that are most often benign—but can be cancerous in some people.

There are a few disorders which can cause these growths, an example of this is the autoimmune disorder known as sarcoidosis.

In sarcoidosis, inflamed tissue forms throughout a person’s body. The inflamed tissue replaces the healthy thyroid tissue, which results in inhibiting thyroid hormone production leads to hypothyroidism.

Genetic Causes:

Damaged genes may also cause hypothyroidism condition. The causes are typically detected during infancy.

Problem with The Hypothalamus:

Hypothalamic dysfunction caused due to surgery, traumatic brain injury, tumours, or radiation can, in turn, can cause hypothyroidism.

The hypothalamus is responsible for controls the pituitary gland, which in turn controls the thyroid gland among others. Hence, any abnormality in the hypothalamus can also cause the thyroid gland to dysfunction.

Pituitary Gland Disorder:

The pituitary gland is responsible for controls the thyroid gland among others. So, any abnormal functioning of the pituitary gland affects the thyroid gland.


Symptoms of Hypothyroidism

The signs and symptoms of hypothyroidism include:

Symptoms of Hypothyroidism

Physical Symptoms:

  • Hair thinning
  • Brittle Nails
  • Dry Skin
  • Constipation
  • Fatigue
  • Weight gain
  • Menstruation problems in women (Heavy bleeding or change in the cycle)
  • Intolerance to cold
  • Joint pain
  • Muscle ache
  • High Cholesterol
  • Slow heart rate
  • infertility in women

Emotional Symptoms:

  • Anxiety
  • Depression

Mental Symptoms:

  • Memory problem
  • Racing thoughts leading to mental fatigue

Other symptoms:

  • Decreased sweating
  • Puffy, sensitive face
  • Hoarseness
  • Tenderness

Hypothyroidism Diagnosis

Two primary tools are used to examine if a person has hypothyroidism:

Medical evaluation

The doctor will do a thorough physical exam and medical history. They’ll check for physical signs and symptoms of hypothyroidism, including:

  • Dry skin
  • Slowed reflexes
  • Swelling
  • A slower heart rate

In addition, the doctor can ask the patient to report any symptoms he has been experiencing, like fatigue, depression, constipation, or feeling constantly cold.

If a patient has a known family history of thyroid conditions he has to report during the consultation.

Blood tests

Blood tests are the only way to a reliable diagnosis of hypothyroidism.

A TSH (thyroid-stimulating hormone) test measures how much TSH patient’s pituitary gland is creating:

  • When thyroid gland isn’t producing enough hormones, the pituitary gland will boost TSH to increase thyroid hormone production.
  • If a patient has hypothyroidism, then the TSH levels are high, as the body is trying to stimulate more thyroid hormone activity.
  • If a patient has hyperthyroidism, then the TSH levels are low, as the body is trying to stop excessive thyroid hormone production.

Thyroxine (T4) level examination is also useful in diagnosing hypothyroidism. T4 is one of the hormones directly produced by the thyroid gland. Used together, T4 and TSH tests help precisely evaluate the thyroid function.

Generally, if a patient has a low level of T4 along with a high level of TSH, he has hypothyroidism. However, there is a spectrum of thyroid disease, and other thyroid function tests may be needed to properly diagnose the condition.


Complications of Hypothyroidism

The complications of hypothyroidism can be:

  • Rapid ageing
  • Dry skin
  • Wrinkles
  • Prematurely greying hair
  • Infertility in women
  • Cardiac complications
  • Nerve damage
  • Renal complications
  • Pregnancy-related complications
  • Myxedema (Which is a life-threatening form of hypothyroidism which can cause death)
  • Obesity

Who is at higher risk to hypothyroidism?

Some people are at higher risk to hypothyroidism than others such as:

  • A person with a family history of hypothyroidism
  • A person with the previous history of thyroid problems
  • Older people as the risk increases with the age
  • Women
  • A person suffering from autoimmune disorders like Diabetes Type 1, multiple sclerosis, rheumatoid arthritis, celiac disease, Addison’s disease, pernicious anemia, or vitiligo
  • Individual with Down syndrome
  • A person with Turner syndrome
  • A person with bipolar disorder

Treatment of Hypothyroidism

Medical Treatment

The doctor will prescribe some medications which will help reduce the hypothyroidism symptoms. He can also recommend some supplements as well as changes in the diet.

Medications for hypothyroidism

Hypothyroidism is a lifelong disease. For a few people, medication reduces or alleviates the symptoms.

Hypothyroidism is better treated by getting levothyroxine. This synthetic alternative of the T4 hormone copies the action of the thyroid hormone the body would normally produce.

The medication is developed to return adequate levels of thyroid hormone to your blood. Once hormone levels are restored, symptoms of the condition are mostly disappeared or at least become much more manageable.

Once a patient start treatment, it takes a few weeks before he begins feeling relief. A patient will require follow-up blood tests to monitor the progress.

Patient and doctor will work together to find a dose and a treatment plan that best suitable to current symptoms.

In most cases, people with hypothyroidism should remain on this medication for their entire lives.

However, it’s unlikely they will continue to take the same dose. To make sure that the medication is still working properly, the doctor should test TSH levels yearly.

Alternative treatment for hypothyroidism

Animal extracts which contain thyroid hormone are available in the market that extracts from the thyroid glands of pigs contains both T4 and triiodothyronine (T3) hormones.

If you are on levothyroxine, you’re only receiving T4. But that’s all you need as your body is capable of producing T3 from the synthetic version of T4.

These alternative animal extracts aren’t routinely recommended as it is often unreliable in dosing and haven’t been shown in studies to be better than levothyroxine.

Additionally, the patient can purchase glandular extracts in some health food stores. These products aren’t monitored or regulated by the USFDA (U.S. Food and Drug Administration).

Because of non-regulation, their potency, legitimacy, and purity aren’t guaranteed. Patient has to use these products at their own risk.

But do discuss with your doctor if you decide to try these products so they can adjust your treatment accordingly.

Exercise

Following the right exercise regimen can help decrease hypothyroidism symptoms.

Performing low-impact aerobic exercises can get the heart rate up and lungs going without putting too much pressure on the joints. This is important because joint pain is a common symptom of the hypothyroidism.

Strength training exercises like lunges, push-ups and leg raise,  or those involving weight-training machines can build muscle mass, and muscle burns more calories than fat, even when you’re at rest.

Yoga can improve the core muscles and ease back and hip pain associated with hypothyroidism. Walking is also extremely beneficial exercise as well.


Diet for people with hypothyroidism

There is no specific rule for diet, However, here are some recommendations:

Eat a balanced diet

Your thyroid gland needs adequate amounts of iodine in order to be fully functional. A balanced diet of whole beans, grains, lean proteins, and fruits and vegetables can provide enough iodine. You don’t need to take an iodine supplement to fulfil this requirement.

Monitor soy intake

If you drink or eat too much soy products then you may not be able to properly absorb your medication.

Be smart with fiber

Like soy, fibre can also interfere with hormone absorption. The high amount of dietary fiber may prevent your body from getting the hormones it needs. However, Fiber is important, so don’t avoid it entirely. Instead, avoid taking your medicine within several hours of consuming high-fibre foods.

Don’t take thyroid medicine with other supplements

If you take supplements or medications along with thyroid medicine, try to take these medicines at different times. It’s better to take thyroid medicine on an empty stomach and without other medicines or foods as other medications and foods can interfere with absorption


Facts and statistics about hypothyroidism

Hypothyroidism is generally a common condition. About 4.6% of Americans ages 12 and above have hypothyroidism. That’s about 10 million people in the USA living with the condition.

The disease gets more common with age. People ABOVE age 60 experience it more frequently.

Women are more prone to have an underactive thyroid. In fact, 1 out of 5 women will develop hypothyroidism by the age of 60.

One of the most common reasons for an underactive thyroid gland is Hashimoto’s disease which affects the middle-aged women most commonly, but it can also occur in men and children.

This condition also passes in families. If a family member has been diagnosed with this disease, you are also at risk for having it is higher

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