What is Hypothyroidism
It is an illness characterised by abnormally low thyroid hormone production.
This can be due to the problem with thyroid gland itself wherein it cannot produce sufficient hormones due to certain reasons or due to a problem with the pituitary gland wherein the basic stimulus for the hormone secretion is lacking.The incidence being much higher in women.
If not treated in time, it can effect:
•Heart and nervous system functions
- Causes of Hypothyroidism
- Symptoms of Hypothyroidism
- Diagnosis of Hypothyroidism
- Treatment of Hypothyroidism
1.Hashimoto’s thyroiditis -In this thyroid gland is usually enlarged and has a decreased ability to make thyroid hormones.It is an autoimmune disease in which the body’s immune system inappropriately attacks the thyroid tissue.
2.Lymphocytic thyroiditis -In this inflammation is caused by a particular type of white blood cells.This condition is common after pregnancy.in these cases there is usually a hyperthyroid phase followed by a hypothyroid phase.
3.Thyroid destruction secondary to radioactive iodine or surgery- Patient who have been treated for a hyperthyroid condition and received radioactive iodine may be left with little or no functioning thyroid issue after treatment. Removal of thyroid gland during surgery will be followed by hypothyroidism.
4.Pituitary or hypothalamic disease-If for some reason the pituitary gland or hypothalamus are unable to signal the thyroid and instruct it to produce thyroid hormones , a decreased level of circulating T4 and T3 may result,even if the thyroid gland itself is normal.This is called “Secondary hypothyroidism”.If the disease is due to hypothalamic disease,it is called “tertiary hypothyroidism”.
5.Pituitary injury-It may result after brain surgery or if there has been a decrease of blood supply to the area.In these cases TSH hormone is become low and hypothyroidism results because thyroid gland is no longer stimulated by pituitary TSH.
6.Medications-Medicines that are used to an overactive thyroid may cause hypothyroidism.These include Methimazol, Propylthiouracil etc. 7.Severe iodine deficiency-In areas of world where there is an iodine deficiency in the diet severe hypothyroidism can be seen.
•Easily getting tired
•Increased sensitivity to cold
•Unexplained weight gain
•Elevated blood cholesterol level
•Muscle aches ,tenderness and stiffness
•Pain,stiffness and swelling in joints
•Heavier than normal or irregular menstrual periods
•Slowed heart rate
Your consultant usually will diagnose hypothyroidism by a thorough physical examination followed by a blood test. A medical history will probably be taken as well.
The most common blood test used is the TSH test. If the TSH report is above normal then you may be diagnosed as having hypothyroidism.Additional blood tests used to confirm the diagnosis or determine the cause of hypothyroidism are the free T3 & free T4 test and the thyroid auto-antibody test.
For all of the aforementioned tests a 12 hours fasting blood sample is required.As many of the symptoms of hypothyroidism are the same as other conditions, the doctor will not be able to make a diagnosis based solely on symptoms.The health care provider may also perform tests to check cholesterol levels, liver enzymes, prolactin, sodium or perform a full blood count. The severity of symptoms and blood tests reports may not always match due to various reason and hence before doing any tests, its better to talk to your specialist at Welling Clinic.
For long, the conventional treatment involves synthetic hormones to replace your body hormones.
Courses of treatment for hypothyroidism aim to give the body the amount of thyroid hormone that it is lacking. This is achieved through synthetic thyroxine, a medication that is identical to the T4 hormone.
Dosage is determined by the patient & history, symptoms and current TSH level. Health care providers will regularly monitor the patient & blood to ensure that their dosage does not need to be adjusted. Monitoring will remain regular but gradually become less frequent over time.
Adverse reactions associated with levothyroxine therapy are primarily those of hyperthyroidism due to therapeutic overdosage & long term medication. They include the following:
•GI: diarrhea, vomiting, abdominal cramps;
•Dermatologic: hair loss, flushing;
•Reproductive: menstrual irregularities, impaired fertility.
•Hypersensitivity reactions to inactive ingredients have occurred in patients treated with thyroid hormone products. These include urticaria, pruritus, skin rash, flushing, angioedema, various GI symptoms (abdominal pain, nausea, vomiting and diarrhoea), fever, arthralgia, serum sickness and wheezing.