Hypothyroidism
Overview
Hypothyroidism
Hypothyroidism, also known as underactive thyroid, is a common condition resulting from a decreased production of crucial thyroid hormones by the thyroid gland. The thyroid gland is a butterfly-shaped gland located in the lower front of the neck. It makes thyroid hormones that help the body regulate metabolism, stay warm, and keep the heart, muscles, brain, and other organs working properly.
There is no known cure for hypothyroidism, but treatments can help manage this condition. Hypothyroidism tends to run in families, and those most often affected are females ages 60 and older. Researchers estimate that one in eight women will develop a thyroid disorder during her lifetime. Even though older women are most likely to develop hypothyroidism, anyone can have it, including infants.
There are more than 200,000 cases diagnosed per year in the United States. About 4.6 percent of the population in the United States ages 12 and older have hypothyroidism. However, most cases are so mild that most of those with thyroid disease are unaware of their condition.
Hypothyroidism may not cause noticeable symptoms in the early stages. However, hypothyroidism can cause obesity, infertility, joint pain, depression, confusion or impaired memory, an enlarged thyroid gland (goiter), and heart diseases if left untreated. Hypothyroidism can also cause peripheral neuropathy due to damage to the nerves outside of the brain and spinal cord. Peripheral neuropathy can cause weakness, numbness, and pain, usually in your hands and feet, but it can also affect other areas of your body.
Besides older women and those who have hypothyroidism in their family, groups at a greater risk of developing hypothyroidism include those who:
- Have an Iodine deficiency
- Have been treated for hyperthyroidism
- Have been taking antipsychotic medications
- Have received radiation to the neck or upper chest
- Have had thyroid surgery (full or partial thyroidectomy)
- Have been born with a defective thyroid gland or no thyroid gland
- Have been pregnant or delivered a baby within the past six months
- Have been treated with radioactive iodine or anti-thyroid medications
- Have an autoimmune disease (there are more than 100 autoimmune diseases including type 1 diabetes, celiac disease, psoriasis, scleroderma, lupus, Crohn’s disease, and more)
- Have a pituitary disorder resulting in decreased production of a particular hormone (TSH)
Symptoms
Hypothyroidism Symptoms
Hypothyroidism symptoms differ from person to person and vary depending on the severity of the hormone deficiency. Problems usually develop over time, and the first overtly noticeable sign might be an enlarged thyroid gland (goiter) at the base of the front of your neck. Less obvious but more likely hypothyroidism symptoms include fatigue and weight gain, but you may attribute that to getting older. However, as your metabolism continues to slow, you may develop more apparent problems. Additional hypothyroidism symptoms to look for include:
Diagnosis
Hypothyroidism Diagnosis
Diagnosis of hypothyroidism begins with a doctor’s visit, where you will receive an examination, have your medical history and your family’s medical history taken, and talk about your symptoms. Your doctor may check your thyroid gland and look for changes such swelling, dry skin, slower reflexes, or a slower heart rate.
Because hypothyroidism does not have any specific symptoms that are unique to this disease, your doctor may order blood tests to check the thyroid hormone -T4 levels (tetraiodothyronine and thyroxine), TSH, and T3 levels in your blood. The doctor may also order a thyroid scan to check for abnormalities in the gland.
It is important to let your doctor know of any medicines, vitamins, or supplements you are taking because some, like heparin and biotin, can affect your test results. In contrast, other drugs like amiodarone and lithium can cause hypothyroidism.
Treatments
Hypothyroidism Treatments
Although there is no cure for hypothyroidism, you can fully control it with medications in most cases. Most people will have hypothyroidism for life, but there are exceptions. In many patients with viral thyroiditis, their thyroid function will eventually return to normal. Also, in some patients with thyroiditis after pregnancy, their thyroid function will eventually return to normal.
Hypothyroidism is typically treated with synthetic thyroid hormones (thyroxine) to regulate your bodily functions. Treatment with synthetic thyroid hormone is usually straightforward, safe, and effective once your doctor finds the correct dose for you. If you prefer not to take synthetic thyroxine, then natural extracts containing thyroid hormones from animals are available by prescription. The Food and Drug Administration does not regulate these natural products, and their potency and purity are not guaranteed.
You must continue taking your medications even if you start to feel well or you will again begin experiencing symptoms of hypothyroidism.
You should start feeling better soon after beginning treatment, but determining the proper dosage for you may take time. Your doctor may check your TSH levels six to eight weeks after beginning your treatment, then recheck your TSH levels every six months to make sure your medications are working correctly.
With continued treatment, you should have no symptoms of hypothyroidism, and it should not become life-threatening.
Certain medications, supplements, and even some foods may affect the effectiveness of your treatment. Talk to your doctor about your diet, other medicines, vitamins, and supplements, especially:
Calcium supplements
You should wait at least four hours after taking your thyroid medicine before taking calcium supplements or antacids to keep them from interfering with your body’s ability to absorb your medicine.
Some antacids containing Aluminum hydroxide
Iron supplements or multivitamins that contain iron
In addition to medications, eating the following foods could help improve your thyroid health:
Foods that contain selenium
such as sunflower seeds and Brazil nuts
Foods that contain tyrosine
such as legumes, dairy, and various meats
Antioxidant-rich foods
like tomatoes, blueberries, bell peppers, and whole grains
Avoid or limit the following:
Soy
You should wait at least four hours after taking your thyroid medicine before ingesting any soy products to keep the soy from interfering with your body’s ability to absorb your medication.
Alcohol
The majority of research strongly indicates that alcohol suppresses thyroid function by reducing your thyrotropin-releasing hormone response and causes a decrease in crucial peripheral thyroid hormones.
Cigarettes
Tobacco smoke is detrimental to thyroid gland function and harms the gland itself; it can even increase your risk of developing thyroid disorders if you do not already have thyroid disorders.
Caffeinated foods and beverages
Caffeinated foods and drinks may seem like a good idea to combat the fatigue associated with thyroid disease, but it adversely stresses the thyroid gland by interfering with the absorption and effectiveness of your thyroid medications.
Food high in iodine
such as iodized salt
Cruciferous vegetables
such as cabbage, kale, spinach, broccoli, and brussels sprouts
Calcium supplements and antacids
You should wait at least four hours after taking your thyroid medicine before taking calcium supplements or antacids to keep them from interfering with your body’s ability to absorb your medicine.
Specialists
