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Hypothyroidism
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Hypothyroidism is a condition of low thyroid function. The thyroid gland is a butterfly shaped gland in the front of the neck that makes hormones that regulate metabolism. Hypothyroidism is very common and occurs more often in women older than age 50. Having a low thyroid condition is upsetting to the thyroid balance in the body and can result in problems in other areas of the body, such as obesity, infertility, joint pain and heart disease.
The signs and symptoms of low thyroid or hypothyroidism include symptoms that are so mild that you don't know you have it to severe symptoms that can only be attributable to hypothyroidism. The main symptoms include feeling sluggish, tired, sensitivity to cold, constipation, puffiness in the face, pale skin, dry skin, hoarse voice, high cholesterol levels, unexplained weigh gain, tenderness in the muscles and achy muscles, heavy menses, depression and brittle hair and fingernails.
Untreated hypothyroidism causes an increase in severity of symptoms. The thyroid gland can be enlarged, you can forget things and you may have slowness in your thought processes. Severe hypothyroidism is known as myxedema. Myxedema can result in low blood pressure, low breathing rate, shallow breathing and decreased body temperature and possible coma and death.
Hypothyroidism can occur in children and teens but this is less likely. Babies can be born with the condition but is tested for as a part of neonatal screening. It can result in jaundice, choking spells, a large protruding tongue and a puffy face. As the baby develops, muscle tone can be diminished and they can develop constipation and excessive tiredness. Severe mental retardation and physical delay can occur if the disease is left untreated. If children and teens develop hypothyroidism, they get poor growth and short stature, delayed puberty, delayed tooth development and mental retardation.
There are two main hormones that are produced by the thyroid gland. These are thyroxine and triiodothyronine. These are respectively known as T4 and T3. They regulate metabolism at the cellular level. The thyroid also produces calcitonin, which regulates calcium metabolism in the body. T3 and T4 are hormones under control by TSH or thyroid stimulating hormone, produced by the pituitary gland. High levels of TSH mean that the thyroid hormones are low and need boosting. The TSH is the main test done to determine the degree of thyroid function.
The causes of hypothyroidism include an autoimmune disease, such as Hashimoto's thyroiditis. This is when the body makes auto-antibodies against otherwise normal cellular tissues. Treatment for a high thyroid condition such as surgery or radioactive iodine treatment can result in a low thyroid condition or hypothyroidism. Radiation to the neck can produce hypothyroidism. Certain medications, such as lithium, can cause the thyroid gland to become underactive. Babies can be born with hypothyroidism at a rate of one out of 3000 births. Problems with the pituitary gland can affect the TSH and therefore the thyroid gland. Pregnant women can suffer from a low thyroid condition during pregnancy. In inland developing countries, low thyroid can occur as a result of iodine deficiency.
Those at increased risk for hypothyroidism include woman who are older than 50 years of age, have an autoimmune disease, have been treated with anti-thyroid medications including radioactive iodine, have a relative with an autoimmune disease, have had some or all of the thyroid removed or had radiation to the neck or upper chest.
Tests for hypothyroidism include a test for TSH levels. If the TSH is elevated, it means the thyroid gland is calling to the pituitary gland to make more TSH to bring up the T4 and T3 levels. Tests for TSH showing an elevated level is most likely a positive diagnosis for hypothyroidism. The TSH test is very sensitive and can diagnose hypothyroidism at an early stage.
Treatment for hypothyroidism includes giving levothyroxine or T4 to replace the lost T4 made by the thyroid gland. Levels are adjusted to keep the TSH within the normal range. It takes about two weeks to see an improvement in the symptoms and to begin to feel better. Care must be taken not to give too much T4 or the patient might develop an elevated thyroid condition.