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Disease Insights: hypothyroidism





Welcome to the ultimate guide on hypothyroidism. Here, you'll find answers to the most common questions to help you or your loved ones understand and manage this condition better.


Description for hypothyroidism

Hypothyroidism, also called underactive thyroid or low thyroid, is a disorder of the endocrine system in which the thyroid gland does not produce enough thyroid hormone.

Symptoms of hypothyroidism

cold_hands_and_feets, dizziness, fatigue, lethargy, mood_swings, weight_gain, cold intolerance, constipation, dry skin, fatigue, weight gain

Precautions for hypothyroidism

reduce stress, exercise, eat healthy, get proper sleep, Take thyroid medication regularly, Monitor weight and energy levels, Eat a balanced diet, Avoid excessive cold environments

Questions Covered:


  • what is hypothyroidism?
  • What are the usual symptoms of hypothyroidism?
  • causes of hypothyroidism?
  • What are the potential risk factors associated with hypothyroidism?
  • How do doctors usually figure out if someone has hypothyroidism, diagnosis?
  • How do doctors usually treat hypothyroidism?
  • What are the possible complications that could arise from hypothyroidism?

Answers:



Question: what is hypothyroidism?

Hypothyroidism occurs when the thyroid doesn't produce enough thyroid hormones, often causing symptoms like weight gain and fatigue. Medications and certain lifestyle changes may help ease symptoms.
Certain brands and strengths of medication for hypothyroidism (underactive thyroid)
. This is due to the medication having less active drug (levothyroxine) than it is supposed to.
Certain brands and strengths of medication for hypothyroidism (underactive thyroid)
. This is due to the medication having less active drug (levothyroxine) than it is supposed to.



Question: What are the usual symptoms of hypothyroidism?

The effects of hypothyroidism on the body often vary among different people and may be difficult to identify. The severity of the condition also affects which signs and symptoms appear and when.
Early symptoms can include weight gain and fatigue. Note that these both become more common as you age, regardless of your thyroid's health.
As a result, you may not realize that these changes are related to your thyroid until more symptoms appear. For instance, these may include skin changes associated with hypothyroidism, like scaly, rough, and dry skin and fragile nails.
In general, the most common signs and symptoms of hypothyroidism include:
fatigue
weight gain
depression
constipation
feeling cold
decreased sweating
slowed heart rate
elevated blood cholesterol
dry skin
dry, thinning hair
impaired memory
muscle weakness
muscle stiffness, aches, and tenderness
pain and stiffness in your joints
For most people, symptoms of the condition progress gradually over many years. As the thyroid slows more and more, the symptoms may become more easily identified. Of course, many of these symptoms also become more common with age in general.
If you suspect your symptoms are the result of a thyroid problem, talk with your doctor. They can order a blood test to determine whether you have hypothyroidism.
If you don't already have a primary care doctor, you can browse doctors in your area through the Healthline FindCare tool.
Hypothyroidism symptoms in adults
Besides the most common hypothyroidism symptoms, research
indicates that hypothyroidism symptoms in men may also include erectile dysfunction.
Hypothyroidism symptoms in women may additionally include:
fertility difficulties
menstrual changes, particularly irregular or heavy periods
problems during pregnancy, including anemia
It's also possible to develop hypothyroidism during pregnancy. Symptoms will usually be similar to those of other cases of hypothyroidism.
Hypothyroidism in young people
While hypothyroidism is less common in younger people, it can still occur. The condition may cause slower development in children and early puberty in teenagers.
Babies may also be born lacking thyroid function, a condition called congenital hypothyroidism. Symptoms of hypothyroidism in infants may include:
sleeping more than usual
constipation
difficulty with feeding
delayed growth (if the condition is untreated)
In some cases, babies with hypothyroidism may show no symptoms.
Severe hypothyroidism symptoms
If hypothyroidism isn't treated, you may develop additional symptoms:
puffy, sensitive face
hoarseness
anemia
loss of hearing
In rare cases, severe hypothyroidism may result in myxedema coma, a life threatening condition that requires emergency care. While the condition does not actually involve being in a coma, you may experience:
fatigue
hypothermia
low blood pressure
low heart rate


Question: causes of hypothyroidism?

The most common causes of hypothyroidism are:
Hashimoto's thyroiditis
radioactive iodine treatment
thyroid surgery
radiation therapy
medications
iodine deficiency
Less common causes include:
pituitary disorders
congenital disease
pregnancy
de Quervain thyroiditis
Hashimoto's thyroiditis
Your immune system is designed to protect your body's cells against invading bacteria and viruses. When unknown bacteria or viruses enter your body, your immune system responds by sending fighter cells to destroy the foreign cells.
Sometimes, your body confuses normal, healthy cells for invading cells. This is called an autoimmune response. If the autoimmune response isn't regulated or treated, your immune system can attack healthy tissues. This can cause serious medical issues, including conditions such as hypothyroidism.
Hashimoto's thyroiditis is an autoimmune condition and the most common cause
of an underactive thyroid in the United States. This disease attacks your thyroid gland, causing damage that reduces thyroid function.
It most often affects middle-aged women, but it can occur in men and children. This condition also runs in families. If a family member has received a diagnosis of this disease, then your risk of having it is higher.
Radioactive iodine treatment for hyperthyroidism
If your thyroid gland produces too much thyroid hormone, you have a condition known as hyperthyroidism. Treatment for this condition aims to reduce and regulate thyroid hormone production.
Standard treatment for hyperthyroidism uses radioactive iodine to destroy thyroid cells. This may cause the levels of your thyroid hormone to remain low permanently.
Surgical removal of your thyroid
If your entire thyroid gland is removed as a result of thyroid problems, you'll develop hypothyroidism. Using thyroid medication long term is the primary treatment.
If only a portion of the gland is removed, your thyroid may still be able to produce enough hormones on its own. Blood tests will help determine how much thyroid medication you may need.
Radiation therapy
If you've received a diagnosis of cancer of the head or neck, lymphoma, or leukemia, you may have undergone radiation therapy. Radiation used for the treatment of these conditions may slow or halt the production of thyroid hormone, leading to hypothyroidism.
Medications
Several medications may lower thyroid hormone production, resulting in hypothyroidism. These include ones used to treat mental health conditions, cancer, or heart disease, such as:
lithium, which treats mania in bipolar disorder
interleukin-2 (IL-2), an immunotherapy drug
anti-CTLA-4 medications, which treat melanoma
amiodarone (Pacerone), an antiarrhythmic drug
stavudine, a medication for HIV
Iodine deficiency
Iodine deficiency occurs infrequently in the United States, but it is the most common cause of hypothyroidism in other parts of the world. Iodine, which is needed to produce thyroid hormone, is found in foods including:
iodized salt
dairy
seafood
eggs
If you have iodine deficiency, you may develop swelling at the base of your neck. This is called a goiter. It's caused by an enlarged thyroid gland.
Pituitary disorders
Hypothyroidism may also result from problems involving the pituitary gland. This small gland in the brain produces hormones that affect many bodily functions, including the thyroid gland.
Problems with the pituitary gland may cause thyroid issues. Pituitary disorders may result from:
pituitary tumors
medications like dopamine and opioids
radiation therapy around the brain
Sheehan syndrome, which damages the pituitary gland
This type of hypothyroidism is called secondary hypothyroidism because the thyroid gland functions normally. It's less common than primary hypothyroidism, which is caused by a problem with the thyroid gland.
Congenital disease
Congenital hypothyroidism is hypothyroidism that's present in children from birth. It affects between 1 in 2,000 and 1 in 4,000 newborns and is twice as common in females.
The condition occurs when the thyroid gland develops abnormally or is not present at all. Genetics or iodine deficiency may cause this. While some babies may show no symptoms, others will be less active or have trouble feeding.
U.S. hospitals test newborns for the condition. It's important to treat congenital hypothyroidism to prevent it from delaying growth or mental development.
Pregnancy
Around 5
to 10 percent
of pregnant people will develop postpartum thyroiditis several months after their pregnancy. While only some will need treatment, others will develop permanent hypothyroidism.
The following can increase the risk of postpartum thyroiditis:
history of postpartum thyroiditis
presence of antibodies to thyroid peroxidase in the blood
type 1 diabetes
De Quervain thyroiditis
An upper respiratory infection that damages thyroid cells may cause De Quervain thyroiditis, an uncommon condition that is also called subacute granulomatous thyroiditis. It's most common in women and often occurs during the summer and fall
.
Symptoms of de Quervain thyroiditis include:
pain in the neck, jaw, and throat
enlarged, tender thyroid gland
fever
fatigue
body pain
The condition may cause hyperthyroidism followed by hypothyroidism and last 2 to 8 weeks. Typically, thyroid function will then return to normal, though in some cases hypothyroidism may be permanent.


Question: What are the potential risk factors associated with hypothyroidism?

Factors that can increase your risk of developing hypothyroidism include:
being female
being at least 60 years old
being treated with radiation therapy to your neck or chest
recently being pregnant
having a family history of thyroid disorders
having certain autoimmune conditions, such as Sj'gren's disease and type 1 diabetes


Question: How do doctors usually figure out if someone has hypothyroidism, diagnosis?

Two primary tools are used to determine whether you have hypothyroidism: a medical evaluation and blood tests.
Medical evaluation
Your doctor will complete a thorough physical exam and medical history. They'll check for physical signs of hypothyroidism, including:
dry skin
slowed reflexes
swelling in the neck
a slower heart rate
In addition, your doctor will ask you to report any symptoms you've been experiencing, such as fatigue, constipation, or constantly feeling cold.
If you have a known family history of thyroid conditions, tell your doctor during this exam.
Blood tests
Blood tests are the only way to reliably confirm a diagnosis of hypothyroidism.
A thyroid-stimulating hormone (TSH) test measures how much TSH your pituitary gland is creating:
If your thyroid isn't producing enough hormones, the pituitary gland will boost TSH to increase thyroid hormone production. The high TSH levels indicate hypothyroidism.
If you have hyperthyroidism, your TSH levels will be low, as your body is trying to stop excessive thyroid hormone production.
A thyroxine (T4) level test is also useful in diagnosing hypothyroidism. T4 is one of the hormones directly produced by your thyroid. Used together, T4 and TSH tests can help evaluate thyroid function.
Typically, if you have a low level of T4 along with a high level of TSH, you have hypothyroidism. If you have subclinical hypothyroidism, though, you may have normal T4 with a high TSH level.
Since there's a spectrum of thyroid disease, other thyroid function tests may be necessary to properly diagnose your condition.
If your T4 test is normal, you may also receive a triiodothyronine (T3) test. Low T3 levels may indicate hypothyroidism, though again, T3 levels may be normal in subclinical hypothyroidism.
Finally, thyroid antibody tests look for antibodies in your blood to diagnose autoimmune thyroid disorders like Hashimoto's thyroiditis.


Question: How do doctors usually treat hypothyroidism?

Besides standard thyroid medications, animal extracts that contain thyroid hormone are also available. These extracts come from the thyroid glands of pigs. They contain both T4 and triiodothyronine (T3).
If you take levothyroxine, you're only receiving T4. However, that's all you need because your body is capable of producing T3 from the synthetic T4.
Research has found medications with animal extracts to be similar to levothyroxine. Other studies have indicated that taking animal thyroid extract may reduce thyroid symptoms but cause more side effects. Currently, animal thyroid extracts aren't routinely recommended.
You can also buy glandular extract supplements in some health food stores. Additionally, studies suggest that selenium supplements may help people with hypothyroidism caused by autoimmune disease, though research is mixed.
Note that dietary supplements aren't regulated as drugs by the Food and Drug Administration (FDA). Because of this, their potency, legitimacy, and purity aren't guaranteed.
Use these products at your own risk. It's important to tell your doctor if you decide to try a supplement so they can adjust your treatment accordingly.


Question: What are the possible complications that could arise from hypothyroidism?

Complications of hypothyroidism include:
heart problems
goiter
nerve injury
peripheral neuropathy
carpal tunnel syndrome
reduced kidney function
myxedema coma, in cases of severe disease
obstructive sleep apnea
mental health issues, like anxiety and depression
joint pain
balance issues
obesity, though the link
is still being studied, and moderate weight gain is most likely
high cholesterol
infertility
preeclampsia and anemia during pregnancy
birth defects







Conclusion & Takeaways


Learning about hypothyroidism is the first step toward taking control of your health. By understanding its causes, symptoms, and treatments, you empower yourself to make informed decisions. Remember to consult healthcare professionals for personalized advice and support.