Hypothyroidism is a condition in which the thyroid gland is not producing the thyroid hormones normally. This is a fairly common condition. When levels of thyroid hormones are low, your body’s natural functions slow down and lag. This causes many symptoms, including fatigue, weight gain, and even depression. These are the Hypothyroidism symptoms in which doctor consultation is essential.
What is the thyroid gland?
The thyroid gland is a small butterfly-shaped gland located just below Adam’s apple. It encircles the windpipe or the trachea. It is about 4 cm in height and weighs about 18 gm. This gland is responsible for the secretion of thyroid hormones. Hormones are chemicals produced by special glands like the thyroid, adrenals, ovaries, etc. They act as messengers and are carried by the blood to the various target organs.
Hormones produced by the thyroid gland and their functions
The thyroid hormones are of two types – T3 (Triiodothyronine) and T4 (Thyroxine). These hormones are mainly responsible for the body’s metabolism – a process in which food is converted into energy in the cells. They influence growth and development and regulate various bodily functions which are mentioned below:
- Body temperature
- Body weight
- Metabolism of fat
- Menstrual cycles in females
- Functioning of Nervous system
- Burning calories etc.
What is Hypothyroidism and its symptoms?
Generally, not enough production of hormones by the thyroid gland is termed hypothyroidism. This is also called the Underactive thyroid state. Hypothyroidism can make the body’s development slow down and reduces metabolism rates.
Causes of Hypothyroidism
Generally, several factors are the cause of hypothyroidism.
This is the commonest cause. This is an autoimmune disorder (normally body’s defence system fights against external infections. In autoimmune disorder the defence system attacks the healthy cells of the body by mistake). In Hashimoto’s thyroiditis, the immune system/defence system produces antibodies. They attack the thyroid gland and destroy it.
Iodine deficiency in diet
For the production of thyroid hormones iodine is very important. The body does not produce iodine normally, so it needs to be supplemented from outside. Iodine is mainly present in the food we eat. It is mainly present in shellfish, salt-water fish, eggs, dairy products. If a person does not eat iodine-rich foods, he may end up with iodine deficiency leading to hypothyroidism. Currently, this causative factor is on the decline due to the government initiatives of table salt with iodine.
Surgery to remove the thyroid gland (e.g. thyroid cancer treatment, overactive thyroid etc.)
Radiation to the neck (to treat cancer in the neck area)
The thyroid gland cells are damaged due to the radiation.
Treatment with radioactive iodine:
Generally, this treatment can help for managing hyperthyroidism/overactive thyroid, where the thyroid gland produces excessive thyroid hormones. One of the treatment modalities is radioactive iodine. However, sometimes this radiotherapy destroys normal functioning cells which lead to hypothyroidism.
Certain medicines are used to treat heart conditions, cancer, psychiatric conditions etc. – for e.g. aminodarone, lithium, interleukin-2, interferon-alpha.
Hypothyroidism symptoms in Pregnancy
Pregnancy (the reason is unclear but it has been noticed that the thyroid may get inflamed after delivery – this is called Postpartum thyroiditis.
Damage to the pituitary gland
The pituitary gland is a gland that is present in the brain. It produces a hormone called TSH (Thyroxine-Stimulating hormone). The TSH tells the thyroid gland how much thyroid hormone it should make. If the levels of thyroid hormone in the blood are low, then the TSH will stimulate the thyroid gland to produce more Thyroid hormone.
This is an organ in the brain. This produces a hormone called TRH (Thyrotropin Releasing Hormone) which acts on the Pituitary gland to secrete TSH. So any disorder of the Pituitary gland will indirectly affect the production and secretion of thyroid hormones. Therefore these are very rare disorders.
Congenital hypothyroidism defects
Some babies are born with thyroid problems. This is due to insufficient production of the thyroid during pregnancy. Sometimes the thyroid gland does not function normally. This can be identified by screening for thyroid disorders in the first week after delivery. This is usually done by a blood test using a small drop of blood from the baby’s heel.
Types of hypothyroidism and its symptoms
One classification is based on whether the defect is with the thyroid gland or not:
- Primary hypothyroidism: The problem is in the thyroid gland itself and thus there is reduced production /secretion of thyroid hormones.
- Secondary hypothyroidism: Here the problem is with the Pituitary gland or the Hypothalamus. This results in abnormal production of TSH or TRH, which indirectly leads to less production and secretion of thyroid hormones.
Another classification is based on the symptoms and levels of the thyroid hormones and TSH:
- Overt hypothyroidism: Here the patient is having the symptoms. Further the T3/T4 are low and TSH is high
- Subclinical hypothyroidism: Here patient may or may not have symptoms. The T3/T4 levels are normal but TSH is high. In this situation the patient is at an increased risk of developing overt hypothyroidism in the future especially if he has Thyroid peroxidase antibodies on testing.
Who are at risk of developing Hypothyroidism?
- Women have a higher risk of suffering from hypothyroidism than men.
- Likewise older people are at increased risk.
- People suffering from other autoimmune diseases like Coeliac disease, Type- Diabetes Millitus, Vitiligo, Pernicious anemia, Multiple sclerosis, Rheumatoid arthritis and, Addison’s disease etc.
- Person with psychiatric conditions such as bipolar disorder
- People with Chromosomal abnormalities like Down syndrome, Turners syndrome also have a high risk of suffering from hypothyroidism.
Symptoms vary from person to person. They may also mimic other conditions and hence be difficult to diagnose. Symptoms may also develop very slowly over a span of moths-years.
Some of the characteristic symptoms of this disease are:
- Dry hair
- Dryness of the skin
- Body pains
- Fluid retension in the body
- Irregular menstrual cycles
- Increased sensitivity to cold
- Reduced heart rate
- Increase in size of the thyroid gland – called Goitre. This is due to constant stimulation of the thyroid gland by TSH.
- Weight gain
- Carpal tunnel syndrome
- Hoarse voice
- Loss of libido/sex drive
- Confusion or memory problems especially in the elderly
Hypothroidism symptoms to look for in a baby if you are suspected?
Generally, infants suffering from congenital hypothyroidism may show no symptoms or exhibit signs of excessive drowsiness, cold hands, cold feet, constipation, hoarse cry, poor growth or absent growth, poor appetite, bloating of the abdomen, puffiness of the face, swollen tongue, persistent jaundice.
How to diagnose hypothyroidism?
- TSH: This hormone is made in the pituitary gland and it stimulates the thyroid gland to produce thyroxine. Such as if the thyroxine levels are low in the blood, the pituitary gland produces and secretes more TSH into the blood to act on the thyroid gland to produce more thyroxine. As a result of a raised TSH level indicates hypothyroidism. Other tests are not usually necessary unless a rare cause of hypothyroidism.
- T4: A low level of thyroxine indicates hypothyroidism.
- T3: these levels are generally not necessary to diagnose hypothyroidism
- Anti-Thyroid peroxidase antibodies (anti-TPO antibodies) or Anti- thyroglobulin antibodies are present in 90-95% of patient with autoimmune thyroiditis.
- Other blood tests include Creatinine Kinase, Serum Lipids, Complete blood picture etc.
- Ultrasound of the neck is necessary if the patient presents with a thyroid swelling.
Treatment of hypothyroidism
Overt hypothyroidism is treated by synthetic Thyroxin hormone which should be taken every day on an empty stomach at least 30 – 45 minutes before breakfast. The treatment is continued for the rest of the patient’s life. Regular thyroid function tests are essential once every 8 weeks-12 weeks to adjust the thyroxine dose in the initial diagnosis period. Once the thyroxine dose is maintained, the tests can be done even once a year. This treatment is quite effective.
In particular Sub-clinical hypothyroidism is only treated if the patient is a woman and is contemplating pregnancy, in patients with symptoms or if the TSH is quite high.
What are the side effects of thyroxine medication?
There are few side effects if any. Most people tolerate these medications quite well. An important consideration before starting medication is to check if the patient has chest pain/angina. These people thyroxine starts on the least doses. However, the higher dose can worsen their angina pains.
Side effects mainly occur if the thyroxine dose is high which leads to hyperthyroidism. The symptoms of this could be palpitations, it can increase heartbeat), weight loss, profuse sweating, anxiety, irritability, etc.
Some tablets increase with thyroxine tablets. These include carbamazepine, iron supplements, calcium supplements, rifampicin, phenytoin, warfarin, etc.
What are the complications if Hypothyroidism is untreated?
If untreated hypothyroidism can lead to:
- Heart problems like heart attack due to increased levels of bad cholesterol like LDL, or heart failure due to fluid retention
- Joint pains
- A pregnant woman with hypothyroidism is at increased risk of giving birth to a baby with congenital hypothyroidism, also known as cretinism. Further, the woman may have pregnancy related complications like pre-eclampsia, premature delivery, low birth weight baby, anemia, post-partum haemorrhage (bleeding after delivery) etc.
- Myxoedema is another complication where the patient has extremely low levels of thyroid hormone. The body temperature drops drastically making the person lose consciousness or go into a coma. If you wish to discuss about any specific problem, you can consult an endocrinlogist.
Who requires hypothroidism treatment?
The treatment can work best when diagnosed in the starting stage. Hence, if we notice any symptoms then a checkup with our doctor for thyroid disorders is necessary. Before starting any treatment our doctor should know about our physical condition and our allergic levels.
If we are under medications for certain other conditions, then we should let our doctor know about it.
Who is not eligible for the treatment?
The treatment is eligible for a person in whom symptoms appear. Before taking the treatment, the doctor should know about the medicines, we are undertaking currently. The thyroid medications can even cause some reaction to the pills, which we are going to take.
What are the post-treatment guidelines
Most of the treatment depends on the post-treatment guidelines. We need to intake certain foods like, increase salt intake to maintain iodine levels. We need to change our lifestyle. Keep track of thyroid levels periodically with the doctor. In surgery, we need to rest for some weeks for recovery and start work again.
Hypothyroidism Duration of recovery
Generally, recovery depends on how our body responds to the treatment. Our thyroid levels can increase slowly, it may take some time before full recovery. Increasing or decreasing, the dosages of the pills and the medications have to be as per our thyroid needs. We should consult with our doctor regularly and have periodic checkups.
The surgical procedure is done by precision a type of laser or keyhole surgery. In which a very minimal incision is very small. As a result, recovery is very fast.
Is curing hypothyroidism permanently possible
Generally, treatment depends on increasing our thyroid levels. It depends on and our lifestyle and medical conditions. It can reappear again. Checking with our doctor periodically is essential. We can avoid such situations by following a diet plan along with the medication.
In short, when these two thyroid hormones level is very low it causes hypothyroidism.
- triiodothyronine (T3)
- thyroxine (T4).
Food with medication in hypothyroidism are:
Although only food is not a matter, that will change the levels, it can surely help in improving the absorption level of the body to absorb these hormones. Also changing our dietary habits can help us
- Food rich in nutrients: They helps to improve our health and even benefits our thyroid gland.
- Antioxidant-rich fruits and vegetables: Tomatoes, bell peppers, blueberries and food which are rich in antioxidants. It can improve the health of a person and gives benefit to the thyroid gland.
We should avoid some food such as:
- iodine-rich food
- iron and calcium
- supplements high-fiber food
- certain vegetables like cabbage, broccoli, spinach, kale, sprouts as that contain medication of thyroid absorption.
Bad eating habits, stress, or missing food are some causes.
Natural remedies for hypothyroidism
- Sugar-free diet: Eliminating sugar from our diet may regulate the level of our energy. Starting a sugar-free diet may help benefits your thyroid health.
- Vitamin B: Vitamin B makes an impact on your thyroid level. Body’s vitamin B-12 levels affects due to the low thyroid hormones.
- Probiotics: Probiotic food, there are live bacteria because it contains live bacteria which helps to keep our stomach and intestine healthy.
Alternatives treatment for Hypothyroidism
To treat this disease there are some other alternatives also.
- Homeopathy can also cure hypothyroid.
- Herbal medicine
- Changing lifestyle
- adding a healthy diet
- Increasing idolized salt
- adding food rich in Omega 3 Fatty acids in diet will help us a lot.
As with any treatment you’re considering, consult with your doctor before
following any medication — natural or otherwise.