A type of thyroid disease, hypothyroidism occurs when your thyroid gland does not produce enough hormones. While it can affect both men and women, women account for as much as 80% of hypothyroidism patients. Millions of Americans are affected by hypothyroidism yet many may not even realize it. This is because the signs of thyroid disease can easily be mistaken for other illnesses and disorders.
What is Hypothyroidism?
Hypothyroidism is a disorder of the thyroid gland. Normally, the thyroid produces, stores and secretes two hormones: thyroxine (T4) and triiodothyronine (T3). These hormones are responsible for your body's metabolism. However, when your thyroid fails to produce enough T4 and T3 to keep your body going, you have what is known as hypothyroidism, underproduction of thyroid hormones.
While the reason for the underproduction of thyroid hormones is almost always caused by a disorder with the thyroid, it is also possible that the disorder may occur as a result of an improperly working pituitary gland. The pituitary gland is located in the brain and normally sends a signal (thyroid stimulating hormone or TSH) to your thyroid. Once your thyroid receives this signal, it knows to start producing T4 and T3.
Causes Behind Hypothyroidism
The most common reason that hypothyroidism occurs is Hashimoto's thyroiditis, or autoimmune thyroid disease. Hashimoto's thyroiditis is a disease where the immune system attacks the thyroid gland. In the vast majority of cases, people diagnosed with hypothyroidism will have this disease. However, because the pituitary gland plays a significant role in the functioning of the thyroid, it is also possible for the problem to originate here.
Other reasons for hypothyroidism include inflammation of the thyroid, surgical removal of the thyroid, congenital defects and previous radioactive iodine treatment for a goiter.
Occasionally, the cause of hypothyroidism will lie not in the thyroid, which is functioning perfectly, but in the pituitary gland. In these rare instances, the pituitary will fail to properly stimulate the thyroid gland. As a result, the thyroid does not realize that it needs to produce more hormones, causing you to develop what is known as secondary hypothyroidism.
Symptoms of Hypothyroidism
Because hypothyroidism slows down your metabolism, it is very likely that you will feel very tired and "sluggish", both mentally and physically. This is because this form of thyroid disease literally slows down your entire body's normal rate of functioning. In addition to fatigue, other common symptoms of hypothyroidism include:
- Unexplained weight gain or troubles losing weight
- Intolerance to cold
- Memory Loss
- Abnormal periods
- Dry, pale skin that flakes or is rough
- Thin, brittle hair and nails
- Pain in muscles or joints
Although some people may be asymptomatic, most people will have a combination of symptoms. If you notice any of these symptoms in yourself, make an appointment with your doctor to be tested for hypothyroidism.
It is also important to note that people who are over 50, overweight, female, have had thyroid surgery or have had their neck exposed to x-rays or radiation treatment are at an increased risk for hypothyroidism.
Testing for Hypothyroidism
Diagnosing hypothyroidism is a fairly simple procedure involving a physical exam and some blood tests for thyroid disease. In addition to any outward hypothyroidism symptoms you may have, such as weight gain and dry hair, your doctor will also take your blood pressure, temperature and heart rate. Often in people with hypothyroidism, blood pressure and body temperature tend to be lowered while the heart rate can slow down.
The two most common blood tests down for hypothyroidism in men and women are a T4 blood test and a serum TSH blood test. A T4 blood test will measure the level of T4 hormones in your blood while a serum TSH test evaluates the levels of thyroid stimulating hormone in your system. If your tests results come back showing that you have lower than normal levels of T4 in your system, but higher than normal levels of TSH, you will be diagnosed with primary hypothyroidism. In this instance, the cause of your hypothyroidism can be traced to your thyroid gland not working properly for whatever reason.
However, tests results that show low T4 levels as well as low TSH levels indicates that the problem lies in your pituitary gland and a diagnosis of secondary hypothyroidism will be made.
The main focus in hypothyroidism treatment is to replace the missing hormones in your body. For this reason, hypothyroidism is always treated with medication, most commonly levothyroxine, which is a synthetic form of T4. Treatment for hypothyroidism is lifelong; you cannot discontinue your medication once you start feeling better. Once you have started treatment, your symptoms should start to improve within a week or two. However, it can take a few months before your metabolism has recovered.
There is no one correct dosage of hypothyroidism medication for everyone. When you first begin treatment, you will need to be closely monitored through regular blood tests until the appropriate dosage for you is determined. It is also important to not receive too much medication as this can cause you to develop hyperthyroidism, another type of thyroid disease. If you feel restless, have quick weight loss or increased sweating, notify your doctor, as these are signs of hyperthyroidism.
It is also important that your thyroid levels do not drop too low as this can cause myxedema coma, a potentially life threatening condition. Signs of myxedema include slowed breathing, low blood pressure and blood sugar levels, and abnormally low body temperature. Treatment of myxedema involves thyroid replacement through IV and steroid therapy. Causes of myxedema include infection, illness, and exposure to cold or certain medications in people with untreated hypothyroidism.
Left untreated, hypothyroidism can cause severe depression, heart failure or coma. Although there is no way to prevent hypothyroidism, it is possible to detect early in children who may have congenital hypothyroidism.
Children who are born without a thyroid gland have congenital hypothyroidism. Although the condition is hereditary, just because you have thyroid problems during pregnancy does not necessarily mean that your child will. As with adults, girls are twice as likely to develop this problem than boys.
Infants who are born without a thyroid gland will have severe mental retardation if the problem is not detected and treatment begun right away Because of this, routine newborn care now requires that all infants be screened for congenital hypothyroidism. Treatment for hypothyroidism in infants is much like adults and involves medications to replace the missing thyroid hormones.
Here are some tips to help you stay fit and healthy when you have hypothyroidism:
- Choose foods from all food groups, but make your servings lower than the recommended range
- Choose low-fat dairy products
- Choose leaner meats
- Prepare food with little or no fat
- Break your meals up throughout the day
To help increase your metabolism, be sure to get 30 minutes of exercise every day. Not only can exercise help you maintain a healthy weight, but it can also the symptoms of depression and anxiety that you may be experiencing.