Since we have talked about hyperthyroidism before, this week we shift the focus to hypothyroidism. This condition is characterized by under-active thyroid gland in which case, the thyroid gland is unable to make sufficient thyroid to keep the body running normally. If left untreated, hypothyroidism can lead to life-threatening complications like myxedema, a rare condition that causes swelling of tissues, increased fluid in body cavities (e.g heart and lungs), diminishing muscle reflexes and thinking ability. Mild hypothyroidism though, can be treated without any complication. So, lets get to know more about this condition.

Ever felt like your body is slowing down too much?

As elaborated in the previous article on hyperthyroidism, thyroid gland is responsible for metabolism in our body. So, if you are thyroid gland is being under-active, the metabolism is affected and consequently our body slows down. Some of the common symptoms are:

• Intolerance to cold
• Fatigue
• Forgetfulness and depression
• Constipation
• Drier skin
• Decreased appetite, increased weight
• Reduced concentration
• Depression
• Slow heart rate
• Hair fall

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What could possibly lead to hypothyroidism?

There are a number of causes, which could lead to hypothyroidism. Some of the common causes of this condition are:

• Autoimmune disease: In some people, immune system identifies thyroid glands as invaders and starts attacking them. This leads to inadequacy of thyroid cells to make thyroid hormone that meets body’s need. Women are more susceptible to this condition than men. The most common forms are Hashimoto’s thyroiditis and atropic thyroiditis.
• Surgical procedure: People with their thyroid gland removed entirely due to certain disease states might be hypothyroid, while someone with their gland partially removed will still be able to produce normal level of thyroid in their blood.
• Radiation treatment: People with certain conditions like Grave’s disease, nodular goiter, lymphomas or cancers need to undergo radiation treatment. Such radiation treatment sometimes can either affect the function of the thyroid gland entirely or partially. Hypothyroidism in this case develops gradually and might not be noticeable for a few years.
• Congenital hypothyroidism: Some babies are born with dysfunctional thyroid glands, in which the thyroid can be only partly formed or completely absent. Certain babies are born with ectopic thyroid, a condition in which part of or the whole thyroid will be in wrong place.
• Thyroiditis: Inflammation of the thyroid caused by viral infection.
• Medicines: Certain medicines have the potential to trigger hypothyroidism especially in people who have genetic predisposition to autoimmune disease.
• Iodine deficiency/over-consumption: Iodine is very important for the thyroid glands to make thyroid hormone. Having too little or too much iodine in diet can lead to hypothyroidism.
• Disorder of pituitary gland/hypothalamus: Pituitary gland and hypothalamus produce hormones that control production of thyroid hormone by thyroid gland. Any damage to either of these major glands can cause underactive thyroid.

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How do I find out if I am suffering from hypothyroidism?

It is very important to realize that the symptoms presented by people suffering from hypothyroidism can also occur in people with other conditions. Hypothyroidism does not have a characteristic symptom associated to it hence diagnosis for hypothyroidism includes consideration of the factors/tests as listed below:

• Medical and family history
• Physical examination: Doctors will check if there are any changes to thyroid gland, skin and for slower heart rate and reflexes.
• Blood tests: There are two types of blood tests to diagnose hypothyroidism. One tests for Thyroid Stimulating Hormone (TSH) while another one tests for free thyroxine level (FT4) in our blood. High levels of TSH or low levels of FT4 can be indicative of hypothyroidism. However, it is important to know that someone does not conclusively suffer from underactive thyroid if their TSH level is high. There could be other reasons contributing to fluctuating hormone levels in our body.

Can we prevent hypothyroidism?

Given that most cases of hypothyroidism are due to Hashimoto’s disease (autoimmune), it is not possible to completely prevent this condition. Nevertheless, hypothyroidism that stems from insufficient iodine intake can be definitely managed by altering our diet appropriately. Adults need approximately 200-500 microgram* of iodine a day, children need less than 200 microgram* while pregnant and breastfeeding women need a little more than normal adults. Taking too much iodine however can be detrimental in long term and lead to overactive thyroid. So, beware when you are taking iodine supplements and it is a good idea to consult your doctor and get your blood checked before starting on one. American Thyroid Association suggests adults over 35 to be tested for thyroid disease every five years. Apart from that, older women (over the age of 60), those with family history hypothyroidism and those who suffer from Addison’s disease, rheumatoid arthritis, pernicious anaemia and type 1 diabetes are recommended to get their blood tested as these groups of people are at higher risk of developing hypothyroidism compared to others. A healthy physical lifestyle can also help prevent the condition to some extent.

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*Be informed that the amount suggested can differ (within a small range) from one reference to another.

Is there a cure?

There is no cure for hypothyroidism, however in most circumstances this condition can be completely controlled. Hypothyroidism is mainly treated using thyroxine (T4) replacement therapy, which aims to bring one’s TSH and T4 to normal level. By doing so, body’s normal function is restored.

Hopefully the write-up this week had shed some light on hypothyroidism if you have not known much about the condition before. Get yourself screened (especially if you are in high risk group) and knock your hypo on its face and keep dancing through your life! Wondering how? Check this!

 References:

Pubmed

American Thyroid Association

Webmd

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• hypothyroidism
• less thyroxine
• thyroid
• thyroxine
• TSH