Hypothyroidism: Overview, Symptoms and Treatment

What is Hypothyroidism?

The thyroid gland is one of the most important endocrine glands of our body as it is important for regulating metabolism. It produces a hormone called thyroxine which acts at various sites of our body to regulate temperature, heart rate, cognitive function, etc.

Hypothyroidism leads to a reduction in thyroxine production and produces consequently various symptoms which impair the patient’s body functionality.

How common is Hypothyroidism?

Hypothyroidism is the most common thyroid disorders in India. Every 1 Indian in 10 suffers from hypothyroidism.

What are the causes of Hypothyroidism?

The most common cause of hypothyroidism is Hashimoto’s thyroiditis. This condition is an autoimmune condition, i.e. body’s own immune system attacks the thyroid gland. This leads to decreased production of the thyroxine hormone.

Other causes are:

Iodine deficiency: Iodine is very important for the production of thyroxine hormone and it’s decreased levels will, in turn, reduce the hormone synthesis.
Thyroid surgery: If there has been any benign or cancerous lesion in the thyroid and the patient has undergone surgery of partial or complete removal of the gland, there is hypothyroidism.
Radioactive Iodine therapy of thyroid: One of the treatments done for hyperthyroidism is radioactive Iodine therapy where with use of radioactive Iodine the gland size and the function is reduced which can as a consequence lead to hypothyroidism.
Radiation to neck: Thyroid gland is located in the neck and any radiation therapy done for any lesion in the neck can affect the gland and can lead to Hypothyroidism.
Medications: Any treatment done for hyperthyroidism or medicines like lithium can lead to hypothyroidism.
Pituitary disorder: pituitary gland controls the thyroxine levels in the body by acting on thyroid gland so any problem with this gland may cause hypothyroidism.

What are the risk factors for Hypothyroidism?

Risk factors for hypothyroidism:

Female gender
Age above 60
Family history of hypothyroidism
Patients with diabetes mellitus type 1
Thyroid surgery
Radiation to neck
Is on medication for hyperthyroidism

What are the symptoms of Hypothyroidism?

Presence of mass in the center of the neck – this is called goiter and it is due to the enlargement of the thyroid gland
Decreased appetite
Weight gain in spite of less appetite
Puffy face
Lethargy
Decreased heart rate
Intolerance to cold environment
Decreased body temperature
Dry skin, redness of skin, vitiligo
Constipation
Menstrual problems – having heavier periods
Mental problems like impaired memory
Weakness, stiffness and aches in muscles
Thinning of hair

What are the complications of Hypothyroidism?

Heart problems: There is increased levels of cholesterol in the body which can lead to narrowing of heart vessels and heart failure in severe untreated cases.
Depression: Depression is one of the mental health issues due to hypothyroidism and it becomes severe as the disease progresses.
Myxoedema: This is a condition characterized by facial puffiness and drowsiness which ultimately leads to unconsciousness and coma. It can also lead to psychosis

Also Read: How Thyroid Disorder and Sexual Dysfunction are Related

How is Hypothyroidism diagnosed?

Complete blood count
Serum TSH levels
Serum T3 and T4 levels
Thyroid antibodies test
Urine iodine levels
BMR (basal metabolic rate)
Radioactive Iodine scan
Ultrasonography of thyroid
CT scan
FNAC

Also Read: Understand Your Thyroid Tests and Reports

What is the treatment for Hypothyroidism?

The treatment is dependent on the cause. The patient should have iodine-rich diet and should consume iodized salt. If the disease is because of hyperthyroidism medications, the dose should be reduced by the treating physician. In case of lithium side effects, either the dose can be reduced or an alternative can be suggested. Basically, the medications should be prescribed after weighing the benefits and risks.

For patients who have an autoimmune disorder or have undergone surgery should be prescribed lifelong synthetic thyroxine.

What are the lifestyle modifications required for preventing Hypothyroidism?

It is important to have a balanced diet rich in iodine.

Also, the symptoms of hypothyroidism like weight gain, lethargy, etc. are overlooked in the beginning but if the weight gain is in spite of decreased appetite and facial puffiness, immediately the doctor should be approached and treatment should be sought.