Description

Hypothyroidism occurs when the thyroid gland does not produce enough thyroid hormone. This condition is also called underactive thyroid. Hypothyroidism may not cause noticeable symptoms in its early stages. Over time, the hypothyroidism is not treated can lead to other health problems, such as high cholesterol and heart problems.

Blood tests are used to diagnose hypothyroidism. Treatment with thyroid hormone is usually simple, safe and effective once you and your doctor find the right dose for you.

Symptoms

The hypothyroidism symptoms depend on the severity of the condition. The problems tend to develop slowly, often over several years.

In the first place, you can barely notice the symptoms of hypothyroidism, such as fatigue and weight gain. Or you may think that you are just a part of aging. But as your metabolism continues to slow, you may develop more obvious problems.

Hypothyroidism symptoms can include:

  • Fatigue.
  • Most of the sensitivity to the cold.
  • The constipation.
  • Dry skin.
  • The increase of weight.
  • Puffy face.
  • The hoarse voice.
  • The coarse hair and skin.
  • The muscle weakness.
  • Muscle aches, tenderness and stiffness.
  • Menstrual cycles that are heavier than usual or irregular.
  • The thinning of the hair.
  • Slow heart rate, also called bradycardia.
  • Depression.
  • Memory problems.

The hypothyroidism in infants

Anyone can have hypothyroidism, including infants. The majority of babies born without a thyroid gland or with a gland that doesn't work properly don't have symptoms right away. But if the hypothyroidism was not diagnosed and treated, the symptoms begin to appear. They may include:

  • Feeding problems.
  • Poor growth.
  • Poor weight gain.
  • Yellowing of the skin and the whites of the eyes, a condition called jaundice.
  • The constipation.
  • Lack of muscle tone.
  • Dry skin.
  • Hoarse crying.
  • Enlargement of the tongue.
  • A soft swelling or bulge near the navel, a condition called umbilical hernia.

When hypothyroidism in infants isn't treated, even mild cases can lead to serious physical and mental development problems.

Hypothyroidism in children and adolescents

In general, children and adolescents with hypothyroidism have symptoms similar to those of adults. But they can also have:

  • Poor growth leading to short stature.
  • Delay in the development of the permanent teeth.
  • The delay of puberty.
  • Poor mental development.

When to see a doctor

Consult your health care provider if you feel tired for no reason, or if you have other symptoms of hypothyroidism.

If you are taking a thyroid hormone medicine for hypothyroidism, follow your healthcare provider's advice on how often you need medical appointments. In the first place, you may need to have regular appointments to ensure that you are receiving the correct dose of medication. With time, you may need tests that your doctor can monitor your illness and medication.

Causes

The thyroid is a small butterfly-shaped gland located at the base of the neck just under the Adam's apple. The thyroid gland produces two main hormones: thyroxine (T-4) and triiodothyronine (T-3). These hormones affect every cell in the body. They support the speed at which the body uses fats and carbohydrates. Help to control the body temperature. Have an effect on heart rate. And help to control the amount of protein that the body makes.

Hypothyroidism occurs when the thyroid gland does not produce enough of the hormone. Conditions or problems that can lead to hypothyroidism, which include:

  • Autoimmune disease. The most common cause of hypothyroidism is an autoimmune disease called Hashimoto's disease. Autoimmune diseases occur when the immune system produces antibodies that attack healthy tissues. Sometimes this process involves your thyroid gland and affects its ability to produce hormones.
  • Surgery of the thyroid. The surgery to remove all or part of the thyroid gland can diminish the ability of the gland to make thyroid hormones or to stop it completely.
  • The radiation therapy. Radiation is used to treat cancers of the head and neck can affect the thyroid gland and lead to hypothyroidism.
  • Thyroiditis. Thyroiditis occurs when the thyroid gland becomes inflamed. This may be due to an infection. Or may be the result of an autoimmune disorder or other medical condition affecting the thyroid. Thyroiditis can activate the thyroid gland to release all of its stored thyroid hormone at the same time. That produces an increase in activity of the thyroid, a condition called hyperthyroidism. After, the thyroid becomes underactive.
  • Of medicine. A number of medications can cause hypothyroidism. One such medication is lithium, which is used for the treatment of some psychiatric disorders. If you are taking medications, ask your doctor about its effect on the thyroid gland.

Less frequently, the hypothyroidism can be caused by:

  • The problems that are present at birth. Some babies are born with a thyroid gland that is not functioning properly. Others are born with no thyroid gland. In most cases, the reason for which the thyroid gland does not develop properly is not clear. But some children have an inherited form of a thyroid disorder. Often, babies born with hypothyroidism has no obvious symptoms at first. That is one reason why most states require newborn thyroid screening.
  • The pituitary gland disorder. A relatively rare cause of hypothyroidism is the failure of the pituitary gland to produce enough thyroid-stimulating hormone (TSH). This is usually due to a noncancerous tumor of the pituitary gland.
  • Pregnancy. Some people develop hypothyroidism during or after pregnancy. If hypothyroidism occurs during pregnancy and does not receive treatment, increases the risk of pregnancy loss, preterm birth, and preeclampsia. Preeclampsia causes a significant increase in blood pressure during the last three months of pregnancy. The hypothyroidism can also seriously affect the developing fetus.
  • There is not enough iodine. The thyroid gland needs the mineral iodine to produce thyroid hormones. The iodine-found primarily in seafood, seaweed, plants grown in iodine-rich soil and iodized salt. Too little iodine can cause hypothyroidism. Too much iodine can make hypothyroidism worse in people who already have the disease. In some parts of the world, it is common that people do not get enough iodine in your diet. The addition of iodine to table salt has almost eliminated this problem in the united States.

Risk factors

Although any person can develop hypothyroidism, you are at higher risk if you:

  • Are a woman.
  • Having a family history of thyroid disease.
  • You have an autoimmune disease, such as type 1 diabetes or celiac disease.
  • Have received treatment for hyperthyroidism.
  • Received radiation to your neck or upper chest.
  • Have had thyroid surgery.

Complications

The hypothyroidism is not treated can lead to other health problems, including:

  • The goiter. Hypothyroidism can cause the thyroid gland to become larger. This condition is called a goiter. A large goiter can cause problems with swallowing or breathing.
  • The problems of the heart. The hypothyroidism can lead to a higher risk of heart disease and heart failure. That's mainly because people with an underactive thyroid tend to develop high levels of low-density lipoprotein (LDL) cholesterol-the "bad"cholesterol.
  • The peripheral neuropathy. The hypothyroidism without treatment for a long time can damage the peripheral nerves. These are the nerves that carry information from the brain and the spinal cord to the rest of the body. Peripheral neuropathy can cause pain, numbness, and tingling in the arms and legs.
  • The infertility. Low levels of thyroid hormone can interfere with ovulation, which may limit fertility. Some of the causes of hypothyroidism, such as autoimmune disorders, may also impair fertility.
  • Birth defects.Babies born to people who do not receive treatment for thyroid disease may have a higher risk of birth defects compared with babies born to mothers who do not have thyroid disease. Babies with hypothyroidism present at birth are treated are at risk of serious physical and mental development problems. But if the condition is diagnosed in the first few months of life, the possibilities of typical development are excellent.
  • Myxedema coma. This rare, life-threatening condition can happen when the hypothyroidism without treatment for a long time. A myxedema coma may be triggered by sedatives, infection or other stress on the body. Its symptoms include intense cold intolerance and drowsiness, followed by an extreme lack of energy, and then unconsciousness. Myxedema coma requires emergency medical treatment.

Birth defects. Babies born to people who do not receive treatment for thyroid disease may have a higher risk of birth defects compared with babies born to mothers who do not have thyroid disease.

Babies with hypothyroidism present at birth are treated are at risk of serious physical and mental development problems. But if the condition is diagnosed in the first few months of life, the possibilities of typical development are excellent.

Diagnosis

The symptoms of hypothyroidism can be different from person to person. And that often resemble the symptoms of other health problems. Therefore, a diagnosis of hypothyroidism is not based on symptoms. Usually based on the results of blood tests.

The first blood test is usually done to diagnose hypothyroidism measures the level of thyroid-stimulating hormone (TSH) in the blood. If it is high, the test is done again, along with a blood test for thyroid hormone T-4 . If the results show that the TSH is high and the T-4 is low, then the diagnosis is hypothyroidism. In some cases, the hormone of the thyroid T-3 can be measured as well.

If the second test shows high TSH, but T-4 and T-3 are found in the standard range, then the diagnosis is a condition called subclinical hypothyroidism. Not usually cause any noticeable symptoms.

TSH tests also play an important role in the management of hypothyroidism throughout the time. They help your doctor find and keep the right dose of medicine for you.

The results of these blood tests may be affected by some medications or supplements. This includes biotin, a vitamin taken as a stand-alone supplement or as part of a multivitamin. Before doing blood tests, tell your healthcare provider about all the medicines or supplements you take.

Treatment

The treatment for hypothyroidism usually includes taking thyroid hormone levothyroxine (Levo-T, Synthroid, others) each day. This medicine is taken by mouth. Returns the hormone levels to a healthy range, eliminating the symptoms of hypothyroidism.

You'll likely start to feel better a week or two after treatment begins. Treatment with levothyroxine likely going to be for a lifetime. Because the dosage you need may change, your doctor may check the level of TSH every year.

Find the correct dosage

To find the right dosage of levothyroxine for you, your health care provider checks your level of TSH approximately 6 to 8 weeks after you start taking the medication. You may need another blood test to check the TSH again six months later. Too much levothyroxine can cause side effects, such as:

  • Fatigue.
  • Increased appetite.
  • Sleep problems.
  • The tremors.
  • Palpitation of the heart, sometimes called heart palpitations.

Levothyroxine usually does not cause side effects when used in the correct dose. If you change the brand of the medicine, tell your health care provider, as the dose may need to be changed.

If you have coronary artery disease or severe hypothyroidism, your doctor may start treatment with a smaller amount of the medicine, and then slowly increase the dose. This allows your heart to adjust to the rise in the metabolism of your body.

To take levothyroxine correctly

Levothyroxine is best taken with an empty stomach at the same time each day. It is ideal to take the hormone in the morning, and then wait 30 to 60 minutes before eating or taking other medication. If you take the medicine at bedtime, expected to take until at least four hours after the last meal or snack.

Do not skip doses or stop taking the medication because you feel better. If it does, it is likely that the symptoms of hypothyroidism are slowly return. If you miss a dose of levothyroxine, take two pills the next day.

Some medications, supplements and even some foods can affect the body's ability to absorb levothyroxine. Talk with your health care provider if you eat large amounts of soy products, or if you often eat a diet high in fiber. Also, tell your doctor if you take other medicines, especially:

  • Iron supplements or multivitamins that contain iron.
  • Aluminum hydroxide, which is found in some antacids.
  • The calcium supplements.

Subclinical hypothyroidism

If you are diagnosed with subclinical hypothyroidism, discuss treatment with your health care provider. By a slight increase in TSH , thyroid hormone may not be useful. If the level of TSH is increased, but in the subclinical range of thyroid hormones, it can improve some of the symptoms.

Alternative medicine

Most health care providers recommend taking the medicine levothyroxine to treat hypothyroidism. But an extract that contains the thyroid hormone derived from the thyroid glands of pigs is available. It is sometimes called desiccated thyroid extract. However, this treatment is not recommended due to the amount of the T-4 and T-3 she may not be consistent. It is not safe for pregnant women, people taking desiccated thyroid extract because it can harm a developing fetus.

Preparing for your appointment

It is likely to start by seeing your primary health care provider. Or you may be referred to a specialist in disorders of the hormone, called an endocrinologist. Babies with hypothyroidism may need to see a pediatric endocrinologist immediately. Children or adolescents may start with your primary health care provider. But they need to see a pediatric endocrinologist if there is any question about levothyroxine or on the correct dose of medication.

Here is the information to help you prepare for your appointment and know what to expect from your health care provider.

What you can do

  • Be aware of any pre-appointment restrictions. When you make the appointment, ask if there is something that you need to do before you arrive.
  • Write down any symptoms you're experiencing, including any that may seem unrelated to the reason for which you scheduled the appointment.
  • Write down key personal information, including any major stresses or recent life changes.
  • Make a list of all medications, vitamins or supplements you are taking.
  • Have a family member or friend along, if possible. Someone who goes with you may remember something that you missed or forgot.
  • Write questions to ask their health care provider.

Have a list of questions will help you make the most of your time with your health care provider. For hypothyroidism, some basic questions to ask include:

  • What is the most likely cause of my symptoms?
  • What tests do I need?
  • Is my condition likely temporary or long-term?
  • What treatments are available, and which do you recommend?
  • I have other health conditions. How can I best manage them together?
  • There are restrictions that must be followed?
  • You should see a specialist?
  • Is there a generic alternative to the medicine you're prescribing?
  • Are there brochures or other printed material that I can take with me? What sites do you recommend?

Do not hesitate to ask other questions.

What to expect from your doctor

Your health care provider is likely to ask a series of questions, including:

  • When did you begin experiencing symptoms?
  • The symptoms been continuous or occasional?
  • How severe are the symptoms?
  • What, if anything, seems to improve your symptoms?
  • What, in any case, it makes your symptoms worse?
  • Do you have a family history of thyroid disease?
Symptoms and treatment of Hypothyroidism (underactive thyroid)