Hypothyroidism (Underactive Thyroid)

Your thyroid gland produces hormones that control many bodily functions. When your thyroid doesn't make enough of these hormones, it's called hypothyroidism, or an underactive thyroid. In the beginning, you might not notice any problems.

However, if hypothyroidism isn't treated, it can lead to some serious health issues. For example, it can cause high cholesterol levels, which can increase your risk of heart problems. High cholesterol can also contribute to other health problems.

Doctors can easily diagnose hypothyroidism using blood tests. Once diagnosed, treatment usually involves taking medicine to replace the missing thyroid hormone. Finding the right dose of medication is important, but it's typically a straightforward, safe, and effective process with your doctor's guidance.

The thyroid is a small gland located at the base of your neck. It plays a crucial role in regulating your metabolism, which is how your body uses energy. When the thyroid doesn't produce enough hormones, it's called hypothyroidism.

Hypothyroidism often develops gradually over a period of time, making it easy to miss the early signs. In the beginning, symptoms might be subtle, such as feeling tired or gaining a little weight. You might even think these are normal aspects of aging. However, as the body's metabolism slows down further, more noticeable problems appear.

Common Symptoms of Hypothyroidism (Adults):

• Fatigue: Feeling unusually tired and lacking energy.
• Sensitivity to Cold: Finding it harder to tolerate cold temperatures.
• Constipation: Difficulty having bowel movements.
• Dry Skin: Skin that feels rough and lacks moisture.
• Weight Gain: An increase in body weight, often without a change in diet or activity level.
• Puffiness (Swelling) in the Face: A swollen or puffy appearance around the face.
• Hoarse Voice: A voice that sounds raspy or rough.
• Coarse Hair and Skin: Hair and skin that feel rough or lack their usual smoothness.
• Muscle Weakness: Difficulty with everyday movements and activities.
• Muscle Aches, Tenderness and Stiffness: Pain and discomfort in the muscles.
• Irregular or Heavy Periods: Changes in menstrual cycles.
• Thinning Hair: Hair loss.
• Slow Heart Rate (Bradycardia): A slower-than-normal heartbeat.
• Memory Problems: Difficulty with concentrating or remembering things.

Hypothyroidism can affect anyone, even infants. In newborns, the thyroid gland might not develop properly or function correctly. Early symptoms in babies may not be immediately apparent. If untreated, however, symptoms will emerge.

Hypothyroidism Symptoms in Infants:

• Feeding Difficulties: Problems with nursing or bottle-feeding.
• Poor Growth: Slowed physical growth and development.
• Poor Weight Gain: Not gaining weight at the expected rate.
• Jaundice: Yellowing of the skin and whites of the eyes.
• Constipation: Difficulty having bowel movements.
• Poor Muscle Tone: Muscles may feel floppy or weak.
• Dry Skin: Skin that feels rough and lacking moisture.
• Hoarse Crying: A raspy or unusual quality to the baby's cry.
• Enlarged Tongue: A larger-than-normal tongue.
• Umbilical Hernia: A bulge or swelling near the belly button.

Untreated hypothyroidism in infants can lead to significant developmental delays.

Hypothyroidism Symptoms in Children and Teens:

Children and teens with hypothyroidism often experience similar symptoms to adults, but may also have:

• Poor Growth (Short Stature): Slower-than-normal growth.
• Delayed Permanent Teeth Development: Teeth may come in later than expected.
• Delayed Puberty: The onset of sexual maturity may be delayed.
• Poor Mental Development: Slower intellectual development.

If you or someone you know is experiencing these symptoms, it's important to see a doctor for diagnosis and treatment. Early detection and treatment are crucial for managing hypothyroidism and preventing potential complications.

If you're constantly tired for no apparent reason, or have other symptoms of an underactive thyroid (hypothyroidism), see your doctor.

If you're taking medicine to treat your underactive thyroid, follow your doctor's instructions about how often you need checkups. At first, you'll likely need more frequent visits to ensure the medication dosage is correct. As time goes on, your doctor will likely schedule checkups less often to monitor your condition and how well the medicine is working. This helps them adjust your treatment plan as needed.

The thyroid is a small, butterfly-shaped gland located in your neck, just below your Adam's apple. This gland produces two important hormones, thyroxine (T4) and triiodothyronine (T3). These hormones affect nearly every part of your body. They regulate how quickly your body burns fats and carbohydrates, control your body temperature, influence your heart rate, and affect how much protein your body builds.

Sometimes, the thyroid doesn't produce enough of these crucial hormones. This is called hypothyroidism. Several factors can lead to this:

Common Causes:

• Autoimmune Diseases: The most frequent cause is Hashimoto's disease, an autoimmune disorder. In autoimmune diseases, the body's immune system mistakenly attacks its own tissues. In Hashimoto's, the immune system targets the thyroid, hindering its ability to make hormones.
• Surgery: If your thyroid gland needs to be partially or completely removed surgically, this can reduce or stop its ability to produce hormones.
• Radiation Treatment: Radiation therapy used to treat cancers in the head or neck can sometimes harm the thyroid gland, leading to hypothyroidism.
• Medications: Certain medications, like lithium, used to treat some mental health conditions, can affect thyroid function. Always ask your doctor about any possible medication interactions with your thyroid health.

Less Common Causes:

• Congenital Problems: In some cases, babies are born with a thyroid gland that isn't working correctly, or they may not have a thyroid gland at all. The reasons for this are often unclear, but sometimes it's a genetic condition. Infants with this condition may not show symptoms right away, which is why many countries test newborns for thyroid problems.
• Pituitary Gland Issues: The pituitary gland, located near the brain, makes a hormone that tells the thyroid to produce its hormones. Sometimes, a non-cancerous tumor in the pituitary gland can disrupt this process, causing hypothyroidism.
• Iodine Deficiency: The thyroid needs iodine to make its hormones. Iodine is found in many foods, including seafood, seaweed, and iodized salt. If you don't get enough iodine in your diet, it can lead to hypothyroidism. Conversely, too much iodine can also be a problem for those already struggling with thyroid function. In the past, iodine deficiency was a significant concern in some regions, but the addition of iodine to table salt has greatly reduced this problem in many developed countries.

Understanding the potential causes of hypothyroidism is crucial for early diagnosis and treatment. If you have concerns about your thyroid health, talk to your doctor.

Hypothyroidism, a condition where your thyroid gland doesn't produce enough hormones, can affect anyone. However, some people are more likely to develop it than others. These factors increase your risk:

• Being a woman: Women are more prone to hypothyroidism than men. This is a general observation, and there isn't a single, simple reason for this.

• Family history of thyroid problems: If someone in your family has had thyroid issues, you might have a higher chance of developing hypothyroidism yourself. This suggests a possible genetic predisposition.

• Autoimmune diseases: Conditions like type 1 diabetes and celiac disease are linked to an overactive immune system attacking healthy parts of the body. This can sometimes affect the thyroid, increasing the risk of hypothyroidism. Essentially, your body's defense system might mistakenly attack your thyroid gland.

• Prior treatment for hyperthyroidism: Hyperthyroidism is when your thyroid produces too much hormone. Treatment for hyperthyroidism sometimes can lead to an underactive thyroid later on. This is a potential side effect of some treatments.

• Radiation treatment to the neck or upper chest: Radiation therapy can damage the thyroid gland, reducing its ability to function correctly and potentially leading to hypothyroidism.

• Prior thyroid surgery: Surgery to remove part or all of your thyroid gland can disrupt its normal hormone production, increasing the risk of developing hypothyroidism. This is a direct consequence of the surgery itself.

Untreated hypothyroidism can lead to several health problems.

Enlarged Thyroid (Goiter): When your thyroid is underactive, it sometimes gets bigger. This is called a goiter. A large goiter can make it hard to swallow or breathe comfortably.

Heart Issues: An underactive thyroid can increase your risk of heart problems, including heart disease and heart failure. This is often because people with hypothyroidism tend to have higher levels of "bad" cholesterol (LDL).

Nerve Damage (Peripheral Neuropathy): If hypothyroidism isn't treated, it can damage the nerves that send signals from your brain and spinal cord to the rest of your body. This nerve damage can cause pain, numbness, and tingling in your arms and legs.

Infertility: Low thyroid hormone levels can affect a woman's ovulation, making it harder to get pregnant. Some underlying causes of hypothyroidism, such as autoimmune diseases, can also impact fertility.

Problems During Pregnancy and for Babies: If a person has untreated hypothyroidism during pregnancy, there's a greater chance of birth defects in the baby. Babies born with untreated hypothyroidism face serious problems with physical and mental development. However, if hypothyroidism is diagnosed and treated in the first few months of a baby's life, the chances of normal development are very good.

Severe Hypothyroidism (Myxedema Coma): In rare cases, untreated hypothyroidism can lead to a serious, life-threatening condition called myxedema coma. This can be triggered by things like medication, infections, or other stresses on the body. Symptoms include extreme coldness, drowsiness, a loss of energy, and eventually unconsciousness. Myxedema coma needs immediate medical attention.

Hypothyroidism symptoms vary from person to person, often mimicking other health issues. Therefore, diagnosing hypothyroidism isn't just about how you feel. Doctors usually need blood tests.

The first test typically checks the level of thyroid-stimulating hormone (TSH) in your blood. If the TSH level is high, a second test is needed to confirm the diagnosis. This second test measures both TSH and another thyroid hormone called T4. If the TSH is high and the T4 level is low, then the diagnosis is hypothyroidism. Sometimes, a third test for T3 is also performed.

If the second test shows a high TSH level, but the T4 and T3 levels are normal, it suggests a condition called subclinical hypothyroidism. This often doesn't cause noticeable symptoms.

Blood tests, especially TSH levels, are also crucial for managing hypothyroidism over time. They help your doctor determine and adjust the correct medication dose for you.

The results of these blood tests can sometimes be affected by certain medications and supplements. For example, biotin, a vitamin often taken as a supplement, can influence the results. Always inform your doctor about any medications or supplements you're taking before having blood tests.

Treating Hypothyroidism with Levothyroxine

Hypothyroidism is a condition where your thyroid gland doesn't produce enough hormones. This can lead to various symptoms, and treatment usually involves taking a daily dose of levothyroxine, a synthetic thyroid hormone. Levothyroxine comes in tablet form and is taken by mouth. This medicine helps restore healthy hormone levels, relieving hypothyroidism symptoms.

Most people notice improvement within a week or two of starting treatment. Since this medication is usually needed long-term, your doctor will likely monitor your thyroid-stimulating hormone (TSH) levels annually to adjust the dosage as needed.

Finding the right dose involves a few steps. Typically, your doctor will check your TSH levels about two months after you start taking levothyroxine. Another test may be needed six months later.

Important Note: Taking too much levothyroxine can cause side effects, including:

• Fatigue
• Increased hunger
• Trouble sleeping
• Shakiness
• A racing heartbeat (palpitations)

These side effects usually don't occur if the dose is correct. If you switch brands of levothyroxine, let your doctor know, as the dosage might need adjusting.

Starting Treatment: For people with heart conditions (like coronary artery disease) or severe hypothyroidism, your doctor might start with a lower dose and gradually increase it. This allows your body's metabolism to adjust more smoothly.

How to Take Levothyroxine:

• Take the pill on an empty stomach, ideally in the morning.
• Wait 30 to 60 minutes before eating or taking other medications.
• If you take it at night, wait at least four hours after your last meal.

Important Reminders:

• Never skip or stop your medication, even if you feel better. This can cause your symptoms to return.
• If you miss a dose, take two pills the next day. Don't take extra pills on other days.
• Certain substances can affect how well your body absorbs levothyroxine. Talk to your doctor if you:
  • Consume large amounts of soy products.
  • Follow a high-fiber diet.
  • Take other medications, particularly:
    • Iron supplements or multivitamins with iron.
    • Aluminum hydroxide-containing antacids.
    • Calcium supplements.

Subclinical Hypothyroidism: If you have subclinical hypothyroidism, discuss treatment options with your doctor. A mild increase in TSH might not require medication. If the TSH level is higher, but still within the subclinical range, medication might help improve symptoms.

Alternative Treatment (Less Recommended): While levothyroxine is the standard treatment, a medication derived from pig thyroid glands (desiccated thyroid extract) is sometimes used. However, the consistency of hormone levels in this extract varies between batches, making it less reliable. It's also not recommended for pregnant women as it may affect fetal development.