Hypothyroidism is a condition that has its causes in the thyroid gland. This gland may be small, but it has a grand significance for the proper function of the body. It is producing hormones that reach most of the body’s cells. If it would get out of balance, it could affect your general health and create problems. An underactive thyroid, or hypothyroidism as it is called in the medical sphere, can cause tiredness, weight gain and depression. If the deficit is not treated it can lead to serious complications. In this article, you can read about causes, symptoms and treatment for hypothyroidism.

What’s on this page?

Why does hypothyroidism happen?

The thyroid is a butterfly-shaped organ that is placed in the lower part of the neck, in front of the trachea just under the Adam’s apple. Its main function is to regulate the metabolism in the body, to control the energy the body is spending. This means that it controls the metabolism through two hormones, triiodothyronine (T3) and thyroxine (T4). These are controlling how fast the cells are working. This affects many functions in the body, for example;

  • Breathing
  • Heart rhythm
  • Central and peripheral nervous system
  • Body weight
  • Muscle strength
  • Menstruation cycle
  • Body temperature
  • Cholesterol levels

Low metabolism is also one of the biggest effects of low activity in the thyroid gland. If it produces or release too much or too little of any of the two hormones, it can have a big effect on the rest of the body, since they somewhat control all the cells of the body. The thyroid is in turn controlled by the pituitary gland and the hypothalamus in the brain, who controls and releases signal substances, thyroid stimulating hormone (TSH), to release the substances in the thyroid. Problems with the thyroid can stem from any of these organs.

There are many reasons why the thyroid gland can be acting up. A common reason for low activity in the thyroid gland is Hashimoto’s disease. It is an autoimmune condition where the body is breaking down its own tissue in the thyroid, which inhibits its function. During the onset of the disease, you might have high levels of TSH, so symptoms of hyperthyroidism (the opposite of hypothyroidism) can be experienced to a start. Some other triggering causes can be radiation therapy near the neck area, medications with radioactive iodine, some heart medicines, surgery in the thyroid, pregnancy or if any problems with the thyroid occurred by birth.

In a global perspective, the iodine deficiency is a common reason for the low production. This is unusual in the UK. The only way to prevent this condition is to make sure that you get enough iodine. For example, food salt with added iodine can be purchased in any grocery shop.

What are the symptoms?

The deficit of hormones from the thyroid can develop over time, so you may not discover the symptoms of your condition immediately. If you experience any of the symptoms listed below, you should seek medical care. The symptoms that often arise first is:

  • Tiredness and exhaustion
  • Depression
  • Lack of concentration
  • A sensitivity of low temperatures

In a later stage the following symptoms might appear1:

  • Slower heart rhythm
  • Weight gain
  • Sleep problems
  • Dry hair and skin
  • Frequent and heavy periods
  • Pain in joints and muscles
  • Changes in the menstual cycle
  • Reduced cognition
  • Slow pattern of movement
  • Constipation
  • Swollen thyroid gland
  • Carpal tunnel syndrome
  • Reduced libido
  • Brittle hair and nails

Older persons with an underactive thyroid gland can also experience problems with their memory. Teenagers can enter puberty earlier than normal. Well worth mentioning is that when infants or small children are affected by the disease, it can take on other symptoms such as slowed growth, yellowing skin and eyeballs as well as swelling of the face.

Complications

Extremely low levels of thyroid hormones can give a seriously low body temperature and cause a condition called Myxedema, which is unusual but can be life-threatening and cause the patient to enter a coma. An untreated low activity of the gland can give symptoms such as goitre, heart problems, infertility, joint pain, lower voice pitch, iron deficiency. Obesity is a complication that can lead to cardiovascular complications since cholesterol levels are raised.

If you have hypothyroidism during a pregnancy, both the fetus and the mother can be affected. Complications that can arise is preeclampsia, iron deficiency and premature delivery for the mother, and underactive thyroid and development problems in the child.

When can I be affected by an underactive thyroid?

Everyone can be affected by an underactive thyroid, and the problems can arise in all stages of life. Some groups are more likely to be affected. They include;

  • Elderly people
  • Women
  • People with other autoimmune diseases, or having a family history of autoimmune diseases
  • People with early greying hair
  • People with light or thin eyebrows
  • Bipolarity
  • Downs syndrome
  • Turners syndrome

Diagnosis, tests and medication

To diagnose conditions connected to the thyroid the safest bet is to make more than one test.

Diagnosis for an underactive thyroid if often started with a blood test to measure the levels of hormones in the blood. These test often measure the TSH and T4, but sometimes also T32. To a start, the medics define where the problem has its roots. This can be done by measuring the signal substances from the pituitary gland and hypothalamus. If these are too high or too low, one can presume that this is what the problems are stemming from. If you have high levels of TSH but low levels of T4, it can be an indication that the patient is in an early phase of the disease.

Tests can also be done through physical examination, for example, ultrasound or scans of the thyroid.

Levaxin and other medication

A common medication is a synthetic T4-hormone that is taken daily, a medicine often used is Levaxin with the active ingredient levothyroxine. The medication needs to be taken for the rest of one’s life, but with the right medication, the patient can live a completely normal life. The pills are often to be taken on an empty stomach with water to minimize the risk of the effect being lowered by the food. If you have mild symptoms, the medication might be redundant. If so, you would get medication in case of more serious symptoms.

Regular controls with blood tests can be needed to make sure that your dosage is correct. It can take some tests before you find the exact right dosage for each patient, and it can also take some time before the symptoms of hypothyroidism disappear completely after initiated medication.

References:

  1. More about the condition – NHS
  2. Diagnosis – NHS Inform