hypothyroidism

hypothyroidism summary

Hypothyroidism is an endocrine disease that affects the thyroid gland and is characterized by insufficient production of thyroid hormones (T3 and T4). These play a key role in metabolism by regulating many vital functions such as heart rate or breathing, fertility or growth.
Hypothyroidism mainly affects women, especially during menopause, at this time in life there is a decrease in the production of thyroid hormones.
Among the different causes of hypothyroidism, one of the most common is thyroiditis (particularly chronic Hashimoto’s thyroiditis), i.e. an inflammation of the thyroid. Other causes may include inadequate iodine intake, the use of certain medications, radioactive iodine therapy, or surgery in the neck area.

Symptoms of hypothyroidism usually appear gradually, that is, over several years. To summarize and simplify, there is a slowdown of various vital functions with symptoms such as weight gain, drowsiness, fatigue or a slow heart rate.

It is important to know that hypothyroidism does not have characteristic symptoms, which makes the diagnosis difficult, however, a simple blood test will assess the levels of thyroid hormones.

Standard treatment is based on daily intake of thyroid hormones, such as the hormone thyroxine or T4 (levothyroxine). However, a study published in April 2017 questioned the use of levothyroxine in certain forms of hypothyroidism in the elderly (more information about the study in the Treatments topic below).

Phytotherapy can help reduce some symptoms of hypothyroidism, such as horsetail in cases of water retention or edema.

In cases of hypothyroidism, it is important to consume a sufficient amount of iodine, usually found in salt (iodized salt), but also in foods rich in iodine such as fish, crustaceans and seaweed rich in natural iodine.

One should consume in moderation certain foods that can interfere with metabolism and increase iodine needs, such as cabbage (which contains a substance that reduces the production of thyroid hormones), Swiss arugula, broccoli or cauliflower.

Definition

Hypothyroidism, also known as thyroid insufficiency or myxedema, is a metabolic disease characterized by insufficient production of thyroid hormones (T3 and T4).

These hormones produced by the thyroid gland have an essential metabolic role in the body, therefore, a reduction in their production can trigger various symptoms throughout the body.

Women are more affected by this disease, it is estimated that there are 4-5 times more women than men with hypothyroidism (some sources speak of up to 10 women for one man).

6% of the world’s population suffer from some degree of hypothyroidism.

Causes

The causes of hypothyroidism can be numerous:

– One of the most common causes is thyroiditis, the most frequent of which is chronic Hashimoto’s thyroiditis, which is an autoimmune disease that destroys the thyroid (this disease has a genetic predisposition). We emphasize that other thyroiditis may also be responsible for hypothyroidism.

– Treatments with radioactive iodine or surgical intervention in the thyroid region can favor hypothyroidism. Radioactive iodine or surgical intervention may be recommended in case of hyperthyroidism.

– In rare cases, the use of certain medications such as lithium (medicine against manic-depressive psychosis) or amiodarone (medicine for the heart).

– An insufficient amount of iodine. In fact, iodine is essential for the formation of thyroid hormones. Deficiencies in iodine still exist in developing countries, but in industrialized countries this does not occur so frequently, since salt is artificially enriched with iodine, and therefore each person has a sufficient daily dose. In children, this deficiency can cause cretinism (short stature, neck enlargement, mental retardation), and in adults, iodine deficiency (leading to goiter and hypothyroidism), is called endemic goiter or myxedema coma.

– In women, menopause can cause hypothyroidism, as the decrease in female hormones favors the aging of the thyroid gland. This is one of the reasons why women suffer more from hypothyroidism than men.

– In rare cases, an insufficient production of TSH by the pituitary gland.

– Hypercarotenaemia, a yellow-orange pigmentation of the skin

– Changes in the menstrual cycle

– goiter

Some severe forms of hypothyroidism can become myxedema, facial swelling caused mainly by an accumulation of fluid in the skin tissues, which in some cases can affect the mouth and even the vocal cords, causing changes in the tone of voice.

Symptoms

There are numerous symptoms of hypothyroidism, as thyroid hormones affect many organs of the human body.

Symptoms usually come on gradually (over months or years), but a sudden onset is possible, here are the most common symptoms:

– fatigue , drowsiness, slowness in carrying out movements

– loss or lack of energy, which can even trigger depression

– weight gain (although the weight gain is a maximum of 2-3kg, it is mainly a weight gain due to water retention).

– dry hair and possible hair loss, dry skin

– constipation

– memory disorders

– infertility

– cold intolerance

– cramps

– swollen eyelids

– hoarseness (due to an action on the vocal cords)

– hypercholesterolemia, the slow metabolism can cause an increase in bad cholesterol levels (LDL)

– muscle weakness and muscle pain, joint swelling and stiffness

– shortness of breathe

– decrease in heart rate

Groups of risk

People at risk are those who have a family history of hypothyroidism, especially women.

Other risk groups are the elderly who suffer from diseases such as type 1 diabetes, hypercholesterolemia and women, especially in the first month after giving birth and in the menopause .

Diagnosis

You should know that many of the symptoms of hypothyroidism are generally non-specific for this disease (weight gain, drowsiness, fatigue, abnormal menstrual cycle, etc.). As a result, the risk is that the disease may be misdiagnosed and not treated properly, which increases the likelihood of being affected by other diseases such as cardiovascular disease and may reduce life expectancy. See also: hypothyroidism complications

A good diagnosis of this disease is essential.

The diagnosis of hypothyroidism, in addition to anamnesis, is based on a simple blood test to analyze thyroid function. To do this, the doctor will ask for the dosage of some hormones related to the activity of the thyroid gland, for example, researching TSH and T4 (two thyroid hormones).

A specialist (endocrinologist) can deepen the diagnosis, using more specific tests.

For an accurate diagnosis and more complete information, always ask your doctor, preferably an endocrinologist.

Complications

Long-term hypothyroidism, in the absence of treatment, can lead to:

– heart problems such as atherosclerosis (cholesterol), heart failure or heart attack .

– gastrointestinal problems

– breathing problems

– in newborns: mental retardation, impaired growth.

– myxedema coma, a rare and serious complication of hypothyroidism, characterized by a comatose state (breathing problems, reduced body temperature, seizures). This disease can lead to death.

Treatments

Hypothyroidism is treated through the daily use of thyroid hormones such as thyroxine or T4, sold under the name of the active ingredient levothyroxine, which must be taken in pill form.

There are numerous dosages of this medicine and only a doctor will be able to prescribe and monitor the therapy in the best way (with blood tests, for example).

The maximum daily dose should be up to 200µg and it is important not to exceed this dose. In most cases, the daily dosage should remain between 50 and 200 µg of levothyroxine.
It is possible to see an improvement in symptoms about 3 weeks after starting treatment.

We emphasize that it is not always easy to quickly find the correct dosage and the best dosage, which is why tests will be carried out at the beginning with medical supervision, in order to find the most adequate dosage. It will also be necessary to periodically reassess (every 6 months, for example) the dose of thyroxine.

At the beginning of therapy, the doctor generally tends to prescribe a low dose of hormones, then gradually increase it until reaching the appropriate maintenance dose for each case.

Reconsideration regarding the use of levothyroxine in certain situations:
A study published in April 2017 in the well-known scientific journal The New England Journal of Medicine showed that the use of levothyroxine in certain forms of hypothyroidism (subclinical hypothyroidism or subclinical hypothyroidism in English ) did not present no benefit in elderly people. In other words, elderly people who took levothyroxine did not have less symptoms of hypothyroidism.

If hypothyroidism is caused due to an iodine deficiency , then iodine will be prescribed. Iodine deficiency remains very rare in the West and more frequent in developing countries.

Herbal medicine

Herbal treatment can complement the treatment and help alleviate the symptoms associated with hypothyroidism, for example, in case of swelling and water retention (a very common symptom in patients with hypothyroidism) like horsetail, this plant has mainly an effect diuretic.

Some food supplements can also be useful, such as Kelp seaweed, this seaweed is particularly rich in natural iodine, an essential mineral for thyroid activity.

In addition, taking B vitamins and vitamins A, C and E can complete the treatment of hypothyroidism, talk to your doctor or nutritionist.

Tips

In case of hypothyroidism, take your medications (thyroid hormones) regularly and consult your doctor periodically. In fact, this is a curable disease, and for that to happen, the treatment has to be taken seriously (it is important to take the medication correctly and make sure you are taking the correct dosage).

– Make sure you are ingesting a sufficient amount of iodine (eg use iodized salt). You can also eat foods that are naturally rich in iodine, such as fish and seafood.

– If hypothyroidism is caused by iodine deficiency , it is not always necessary to use iodine supplementation, as it does not cure hypothyroidism and can even have a harmful effect. You should know that iodine deficiency is becoming less common, as salt is iodized in many countries, people consume iodine without realizing it.

– Certain foods can harm the metabolism and increase the demand for iodine, such as cabbage, this vegetable contains a substance that acts on the thyroid and reduces the production of thyroid hormones. Other vegetables such as arugula (Swiss arugula), broccoli, cauliflower and soybeans also appear to limit thyroxine production, especially if eaten raw. These vegetables should be eaten in moderation. Try to eat foods rich in dietary fiber.

Jeanne Kenney
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I’m a stylist trainer, a content creator, and an entrepreneur passion. Virgo sign and Pisces ascendant, I move easily between my dreams, the crazy world I want, and my feet on the ground to carry out my projects.

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