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Hypothyroidism Symptoms, Causes and Treatment

Hypothyroidism, a condition characterized by an underactive thyroid gland, can significantly impact your health and well-being. This article aims to provide a comprehensive overview of hypothyroidism, including its definition, causes, symptoms, and available treatments.

 

What is Hypothyroidism?

Hypothyroidism, also called underactive thyroid, occurs when the thyroid gland doesn’t produce enough thyroid hormones to meet the body’s needs.

About The Thyroid Gland

The thyroid is a small, butterfly-shaped gland located in the front of the neck, plays a vital role in controlling the body’s energy usage, and affects nearly every organ, including the heart. Insufficient thyroid hormones cause many of the body’s functions to slow down.

Hypothyroidism Symptoms

Hypothyroidism presents a range of symptoms that may differ from one individual to another. Some typical signs include:

• Fatigue
• Weight gain
• Sensitivity to cold temperatures
• Muscle and joint discomfort
• Dry skin or thinning hair
• Irregular menstrual cycles or fertility issues
• Slowed heart rate
• Feelings of depression

Causes of Hypothyroidism

Hypothyroidism has many causes; it can be classified into several categories according to that, as follows:

Primary Hypothyroidism

In primary hypothyroidism, the thyroid gland fails to produce adequate amounts of thyroid hormone. The most common cause globally is iodine deficiency, while autoimmune thyroid diseases are the leading cause in iodine-sufficient regions. Hashimoto thyroiditis is the most prevalent etiology in some countries and has a strong association with lymphoma.

Conditions Leading to Primary Hypothyroidism

• Postpartum Thyroiditis

Affects nearly 10% of women, typically presenting 8 to 20 weeks after delivery. While many women recover without treatment, some are at risk for permanent hypothyroidism or recurrent postpartum thyroiditis in future pregnancies.

• Radioactive Iodine Treatment

Used for managing Graves’ disease, it results in permanent hypothyroidism in about 80% to 90% of patients within 8 to 20 weeks post-treatment.

• Subacute Granulomatous Thyroiditis (de Quervain disease)

A relatively uncommon, self-limiting condition that usually occurs in middle-aged women.

• Autoimmune Polyendocrinopathy

Type-1 condition results from an AIRE gene mutation and includes Addison disease, hypoparathyroidism, and mucocutaneous candidiasis. Type-2 includes hypothyroidism, Addison disease, and type 1 diabetes mellitus.

Other Common Causes of Primary Hypothyroidism

• Medications
• Thyroid Surgery and Radiotherapy

• Secondary and Tertiary Hypothyroidism (Central Hypothyroidism)

Secondary and tertiary hypothyroidism, or central hypothyroidism, result from defects in the hypothalamic-pituitary axis due to various factors:

• Neoplastic, infiltrative, inflammatory, genetic, or iatrogenic disorders
• Pituitary tumors
• Sheehan Syndrome
• Thyroid-Releasing Hormone (TRH) resistance or deficiency
• Lymphocytic Hypophysitis
• Radiation therapy
• Medications

Hypothyroidism Treatment

Hypothyroidism is treated by replacing the hormones that your own thyroid can no longer produce. The standard treatment involves taking a thyroid hormone medication identical to the hormone produced by a healthy thyroid.

These medications are usually prescribed in pill form, but they are also available as liquid and soft gel capsules. These may benefit those with digestive issues affecting hormone absorption. Doctors typically recommend taking this medication in the morning before eating.

Hypothyroidism Diagnosis

Healthcare professionals evaluate and identify the causes of thyroid dysfunction by following a specific procedure as follows:

• Imaging Tests

These may include ultrasound, radioactive iodine uptake tests, or thyroid scans to visualize the thyroid gland and assess any abnormalities.

• Blood Tests

Doctors use a variety of blood tests to assess thyroid function. These tests include Thyroid-Stimulating Hormone TSH, T4, T3, and Thyroid Antibody tests.

1. TSH Test

The Thyroid Stimulating Hormone (TSH) test is often the first step in evaluating thyroid function. TSH is produced by the pituitary gland and stimulates the thyroid to produce T4 and T3 hormones.

• High TSH Levels

Indicate hypothyroidism, suggesting the thyroid isn’t making enough hormones, prompting the pituitary to release more TSH.

• Low TSH Levels

Indicate hyperthyroidism, where the thyroid is producing too much hormones, causing the pituitary to reduce TSH production.

If TSH levels are abnormal, additional tests are required to determine the cause.

        2. T4 Tests

T4, or thyroxine, is a primary hormone produced by the thyroid. T4 tests measure its level in the blood.

• High T4 Levels

Suggest hyperthyroidism.

• Low T4 Levels

Suggest hypothyroidism.

Certain conditions and medications can affect T4 levels. Pregnancy, oral contraceptives, severe illness, or corticosteroid use can alter T4 levels by changing the amount of proteins in the blood that bind to T4. Because these changes don’t affect free T4 levels, many healthcare professionals prefer to measure free T4.

         3. T3 Test

The T3 test measures triiodothyronine levels and is used when hyperthyroidism is suspected despite normal T4 levels. Therefore, high T3 Levels confirm hyperthyroidism even when T4 levels are normal.

          4. Thyroid Antibody Tests

Thyroid antibody tests help diagnose autoimmune thyroid disorders such as Graves’ disease and Hashimoto’s disease. These tests measure the levels of antibodies produced when the immune system mistakenly attacks the thyroid gland.

Understanding hypothyroidism, its causes, and the available treatments is crucial for managing this common endocrine disorder effectively. Proper diagnosis, which includes a range of blood tests to assess thyroid function, can help you receive accurate treatment and improve your overall quality of life.