What is Hypothyroidism?
Hypothyroidism is the term used when the thyroid gland becomes underactive and fails to produce enough hormones. This can trigger an array of symptoms.
The prevalence of this condition is greater in women than men. Furthermore, those who already have certain illnesses including: type 1 diabetes, rheumatoid arthritis and lupus have a higher chance of developing hypothyroidism. (1)
This condition affects almost five percent of the US population aged 12 or above. (2)
Symptoms
The thyroid gland is a very small organ which sits just above the collarbone in the front of the neck. It has a butterfly shape and produces thyroid hormones.
These hormones are essential for the body, they assist with human growth from the brain to the muscles. A certain amount is constantly released into the blood to help the body make use of energy.
During specific events, such as pregnancy, growth spurts and external temperature fluctuations, production can increase to help the body cope.
It is possible to be born with an underactive thyroid, this is called congenital hypothyroidism. This could be caused by an undeveloped thyroid gland, a defect or a malfunction.
This can affect intellectual development, however, it’s generally avoided with the help of early detection and treatment. (3)
In rare cases hypothyroidism is caused by a lack of iodine (commonly found in food and iodized salt) which is fundamental for the production of thyroid hormones. (4)
If the body doesn’t get sufficient levels of thyroid hormones, its functions will slow down causing the following symptoms: (5)
Fatigue
Fatigue can be explained as an extreme feeling of mental and/or physical exhaustion. In contrast to normal weariness, fatigue is hard to overcome. (6)
People affected by hypothyroidism will feel overly exhausted and very weak most of the time, even after rest. When the body has a low metabolism it doesn’t produce enough energy, resulting in this symptom. (7, 8)
Low Pulse
The pulse is wave-like motions created when blood circulates around the body. A low pulse means the heart is beating at a slower pace than what you would consider normal.
A change in the number of thyroid hormones can have various effects on the heart. If levels are lacking, the muscle (heart) controlling heartbeat may be weakened and can slow down the pulse. (9)
Cold Intolerance
One of the many functions of thyroid hormones is to keep the body at a tolerable temperature. When the thyroid isn’t as effective as it should be, core body temperature will fall which may result in intolerance to cold and reduced sweating. (10)
This is why people suffering from hypothyroidism often report feeling colder than normal.
Weight Gain
A person might experience a slight to moderate weight gain when the thyroid is compromised. This is primarily due to changes in how the body uses energy.
Hypothyroidism causes energy spent at rest (BMR – basal metabolic rate) to be lower. Therefore fewer calories are burned which could, lead to weight gain. (11)
Neurological Symptoms
The hormones produced from the thyroid gland play an important role in the nervous system. This also means when there’s a problem in the thyroid it can affect the person on a neurological level.
Signs could include forgetfulness or difficulty concentrating. Neurological symptoms can also include depression or anxiety, headaches and muscle weakness. In severe cases, hypothyroidism can lead to seizures or coma. (12)
Dry Skin and Thin Hair
Thyroid hormones are present in skin tissue. When the thyroid is not working at a normal pace, it’s common to see changes in the texture of the skin and hair.
The skin will generally thicken and may look swollen and pale. It might feel dry and scaly due to a lack of moisture from sweat glands.
Hair will typically lose some of its keratin, causing it to appear thin and dry. The holes where hair strands sit (follicles) can also suffer from reduced functions of sweat glands and may dry up, resulting in hair loss. (13)
Constipation
Constipation is when a person has fewer bowel movements than usual. When they finally do occur the stool can be hard and dry and might be difficult to pass.
Hypothyroidism will slow down most body functions, including the intestines, which leads to constipation. (14)
Problems in Menstrual Cycle
When a woman suffers from hypothyroidism she will generally start to experience heavier bleeding during her menstrual cycles. Some women can also become less fertile, making it harder to become pregnant. (15)
Erectile Dysfunction
Hypothyroidism has a significant effect on the reproductive abilities of men. The condition can cause erectile dysfunction and low sperm count. (16)
Stages
Hypothyroidism can be classified as subclinical (mild) or clinical (severe) depending upon severity. (17)
Doctors will measure levels of two different hormones to determine the category. The hormones in question are “free T4” (FT4) and “thyroid-stimulating hormone” (TSH).
When levels are either too high or low this indicates a problem with the thyroid gland.
Subclinical (Mild)
Hypothyroidism is classified as mild when the balance of TSH is just above the normal limit, despite an average amount of FT4 hormones.
Symptoms experienced will be mild in nature and some people might not experience any signs at all.
Clinical (Severe)
When the level of TSH increases and FT4 begins to decrease, the condition will be classified as severe.
The person can expect to experience serious symptoms and in some cases it could lead to neurological damage or even a coma.
Treatment
Treatment of hypothyroidism is considered straightforward, yet it’s important to be consistent and keep track of hormone levels within the blood. This ensures appropriate treatment is administered. (18)
Levothyroxine
This is a drug which will replace hormones not being produced by the thyroid. It’s a hormone substitute, therefore with the proper dose it can successfully control the condition and minimize symptoms.
Doctors will base the level of treatment depending on how serious the condition is. They will also take into consideration any other health concerns or if there is a possibility of interference with other medications.
The patient will be under close watch to make sure the dose is correct, and every six to eight months the TSH levels will be measured. The dosage may have to be adjusted over time. (19)
Diet
After hypothyroidism is diagnosed, consulting your healthcare provider for guidance on what to eat can help the condition.
Iodine is an important substance for the thyroid. However, if the condition is caused by an autoimmune thyroid disorder such as hashimoto’s disease, it can trigger serious complications. Be sure to consult your doctor regarding diet and salt intake. (20)
Pregnancy
Women who are pregnant have a significantly higher risk of developing hypothyroidism.
Iodine is important for the development of the baby. However, if a woman is lacking adequate levels this could lead to severe outcomes such as mental or physical disabilities, miscarriage or stillbirth. (21)
FAQ
What is hypothyroidism? Hypothyroidism is a condition of the thyroid gland whereby it’s not producing enough hormones to keep the body working efficiently.
What are the signs of hypothyroidism? A range of different symptoms can indicate an underactive thyroid. People can experience fatigue, constipation, slow heart rate, depression and forgetfulness, dry skin and hair, sensitivity to cold temperatures, weight gain and low fertility.
How do you develop hypothyroidism? There are different ways to develop this condition. Most common is an autoimmune disease which causes inflammation in the thyroid gland. Other causes can include a partially removed thyroid. This could be as a result of an illness such as cancer, radiation treatments, certain medication or damage to the pituitary gland. (22)
How are you diagnosed for hypothyroidism? Doctors will diagnose the condition by checking the levels of thyroid hormones and TSH with a blood sample. Prior to this, they will ask you about the symptoms you are experiencing. A physical exam will also be performed to check for any signs around the location of the thyroid and on the skin. (23)
What is the best treatment for hypothyroidism? The best treatment is a hormone replacement called levothyroxine. This will help compensate for the missing hormones. Symptoms will usually subside once this treatment has taken effect. If not, the dose may need to be adjusted accordingly. (24)
What are the long term complications of hypothyroidism? Long term complications can include dysfunctions of different vital organs such as the heart. Others may involve side effects from treatment. (25)
Is hypothyroidism considered a disability? Yes, if a child is born with congenital hypothyroidism and remains untreated it can interfere with mental development. (26)
Is there any cure for hypothyroidism? No, but it can be controlled with treatment and symptoms can subside.
Is hypothyroidism life-threatening? Yes if its not treated. In this case the body’s functions, including vital organs, will continue to slow down which may cause the person to drift into a life-threatening coma. (27)
Summary
Hypothyroidism is the term used when the thyroid is not functioning at full working capacity. It can also be described as an underactive thyroid.
Diagnosis can sometimes be a challenge, this is because a number of symptoms are common signs of everyday pressures or other illnesses. However, if you are constantly lacking energy to the point it’s affecting your daily life, consult your doctor with any concerns.
This condition can be serious and in severe cases, life-threatening. However, most people will be able to manage it and keep symptoms at bay with the help of treatment.