May 10, 2022

A Basic Guide to Hypothyroidism

Hypothyroidism is the most common type of thyroid disease, affecting around 10 million Americans

Also referred to as underactive thyroid, this disease occurs when the thyroid doesn't produce and release enough thyroid hormone into the bloodstream. The thyroid hormone's main job is to run and manage the metabolism. The lack of this hormone causes your metabolism to slow down, creating issues throughout the body.

Signs and symptoms of hypothyroidism

Symptoms of hypothyroidism can vary from person to person based on the severity of the hormone deficiency. 

Common signs and symptoms of hypothyroidism include:

  • Fatigue

  • Unable to tolerate the cold

  • Constipation

  • Dry skin and hair

  • Weight gain

  • Puffy face

  • Voice becomes hoarse 

  • Muscle weakness

  • Numbness and tingling in hands

  • Increased blood cholesterol level

  • Muscle aches and stiffness

  • Joint pain/stiffness/swelling 

  • Heavier, irregular menstrual periods

  • Thinning hair

  • Decreased heart rate

  • Depression

  • Brain fog/ memory trouble

The American Thyroid Association reports that around 60% of people are unaware that they have a thyroid disease. That's because symptoms can develop slowly over several years. Many people don't notice or attribute symptoms, like weight gain and fatigue, to getting older. 

How does hypothyroidism affect infants

Most states in the US perform a thyroid blood test on newborns 1-3 days to detect congenital hypothyroidism.

Some babies may not show any signs of hypothyroidism, but some symptoms include:

  • Jaundice (yellowing of the skin and whites of the eyes)

  • A large, protruding tongue

  • Difficulty breathing

  • Hoarse crying

  • An umbilical hernia

  • Constipation

  • Poor muscle tone

  • Excessive sleepiness

Left untreated, congenital hypothyroidism can cause heart failure, permanent mental disabilities, lack of growth development, and anemia. 

Most children will need to take synthetic thyroid hormones to help ensure that they manage their thyroid correctly. However, there are some cases in which a child’s thyroid may start working properly again. 

Causes of Hypothyroidism

There can be many reasons why the thyroid gland can't produce enough thyroid hormone, including:

Who is at risk for hypothyroidism?

An underactive thyroid can affect anyone at any age. However, some people are more at risk of developing it.

Risk factors for hypothyroidism include:

  • Pregnancy

  • History of other autoimmune diseases like rheumatoid arthritis or Type 1 diabetes 

  • Age - the disease is more common in people over 50 years old

  • Gender - women are more prone to develop it than men

  • Family history of thyroid or autoimmune diseases

  • Taking certain medicines like antithyroid medications, Lithium, amiodarone, interferons, tyrosine kinase inhibitors (TKIs), alemtuzumab, and Iodine-containing medications.

  • Thyroid surgery 

  • Exposure to radiation on the neck or upper chest area

Hypothyroidism and pregnancy 

Women with undiagnosed or unmanaged hypothyroidism may experience trouble conceiving. It's important to talk to your doctor if you are diagnosed with hypothyroidism before becoming pregnant, so they can adequately monitor your hormone levels and adjust your thyroid medication as needed. 

Several hypothyroidism symptoms are similar to pregnancy symptoms, like weight gain and extreme fatigue. Therefore, you should always consult your doctor about all symptoms you are experiencing and any changes you notice as your progress through pregnancy. 

If hypothyroidism is not managed during pregnancy, women can experience:

  • high blood pressure in late pregnancy

  • anemia

  • miscarriage

  • giving birth to a baby with low birth weight or stillbirth

How is hypothyroidism diagnosed?

Since signs of underactive thyroid are often mistaken for other medical conditions or diseases, it's important to see your doctor, especially if these are newer symptoms. 

You should provide your medical history to your healthcare provider at your appointment. This includes any and all medications you have or are taking, recent changes in your health, any surgeries or radiation therapies you've had on your thyroid, and family history of thyroid disease. 

Your doctor will perform a physical exam as well. 

Diagnosis of hypothyroidism is based on your symptoms and the results of thyroid function tests:

Your physician may also order thyroid antibodies and thyroglobulin (Tg) tests to assess your thyroid function further. 

Treatment for Hypothyroidism

Unfortunately, hypothyroidism is a lifelong condition for most people. However, current medications for hypothyroidism are effective, safe, and can improve symptoms and quality of life. 

Underactive thyroid medications replace the hormone the body is missing due to the disease. The most common medicine prescribed is the synthetic thyroid hormone levothyroxine sodium (Levoxyl/Synthroid)

Although it may take some time for your doctor to find the correct dosage, you should start to feel better shortly after you start treatment for hypothroidism. It's also very common to have your dosage levels fluctuate over time. 

Before making any diet or medication changes, always talk to your doctor first because some foods, supplements, and medicines can affect your hypothyroidism prescription. 

What happens if hypothyroidism is left untreated?

Unmanaged hypothyroidism can lead to serious and life-threatening conditions such as:

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