Hypothyroidism
Hypothyroidism is a condition that results from an underactive thyroid gland that causes your body to not produce enough quantities of some crucial hormones (T3 and T4).
Although hypothyroidism is most common in middle aged and older women, it can affect people of all ages including infants and adolescents.
The thyroid gland is located in the neck and is responsible for providing energy to most organs of your body. Without the right levels of hormones from the thyroid, your body’s natural functions begin to slow down. Hypothyroidism is generally a lifelong condition.
What are the causes of hypothyroidism?
Hypothyroidism is an autoimmune disease. Our body’s immune system is designed to protect us against viruses and invading bacteria and sends “fighter” cells out to destroy unknown foreign cells. In some instances, our body gets confused and mistakes normal healthy cells for invading foreign cells. This is called the autoimmune response, and if this goes untreated the immune system can attack healthy tissue. The result can cause serious medical conditions such as hypothyroidism.
Hashimoto’s disease is an autoimmune condition and is most often the cause of hypothyroidism. It attacks the thyroid gland causing chronic inflammation which can result in reduced thyroid function. It’s common for multiple family members to have Hashimoto’s disease.
Who is most at risk of hypothyroidism?
Common causes of hypothyroidism include:
- A family history of autoimmune disease.
- Treatment for hyperthyroidism (when the body produces too much thyroid hormone). Particularly the use of radioactive iodine which can leave thyroid hormone levels permanently low.
- When the thyroid has been surgically removed due to thyroid problems.
- Radiation therapy when used as a conjunction treatment for cancer of the head or neck, lymphoma or leukemia may slow or halt thyroid hormone production resulting in hypothyroidism.
- Some medications may lower thyroid hormone production; particularly those used to treat psychological conditions, cancer and heart disease.
- Older women and pregnant women.
What are the symptoms?
In the early stages, hypothyroidism may not cause any noticeable systems, but over time if untreated it can cause numerous health problems including obesity, joint pain, infertility and heart disease. Symptoms will vary depending upon the level of hormone deficiency, but generally problems tend to develop slowly over a number of years. Sometimes signs symptoms such as fatigue and weight gain are attributed to the ageing process, but as your metabolism continues to slow, some more obvious signs may develop.
Adult Symptoms vary and can include:
- Fatigue
- An increased sensitivity to cold
- Constipation
- Dry skin
- Weight gain
- Puffy face
- Hoarseness
- Muscle weakness, aches, tenderness and stiffness
- Pain stiffness and swelling of the joints
- Irregular period
- Heavier than usual period
- Thinning hair
- Higher blood cholesterol levels
- A slowed heart rate
- Feeling depressed
- Memory impairment
- An enlarged thyroid or “goiter”
Hypothyroidism in infants, children and teens
Although most commonly affecting adults, hypothyroidism can affect people of all ages.
Babies can be born without a thyroid gland, or a thyroid gland that doesn’t function properly. If a newborn has a problem with hypothyroidism, the symptoms can include:
- Yellowing of the skin and whites of the eyes (jaundice)
- A large and protruding tongue
- Breathing difficulties
- A hoarse cry
- Umbilical hernia
As the hypothyroidism progresses it can result in infants not thriving and failing to develop normally. Other symptoms might include:
- Constipation
- Poor muscle tone
- Excessive sleepiness
If left untreated in infants, hypothyroidism may lead to severe mental and physical retardation.
If children and teens develop hypothyroidism they will have the same signs and symptoms as adults but might also have:
- Poor growth which results in short stature
- Delays in the development of their permanent teeth
- Delayed puberty
- Poor mental development
Pregnancy and hypothyroidism
For those women who have hypothyroidism and want to become pregnant, there a number of challenges. Pregnancy with hypothyroidism can cause:
- Anemia
- Miscarriage
- Preeclampsia
- Stillbirth
- Low birth weight
- Brain development problems
- Birth defects
Women can also develop hypothyroidism during pregnancy and your obstetrician will regularly check your thyroid levels during your pregnancy. Post-partum hypothyroidism can also occur, but this generally resolves after one year and medication is no longer required.
Dr Nandi has undertaken extensive training and has a vast amount of experience in the management and treatment of pregnant women with thyroid conditions including hypothyroidism. If you have this condition and wish to discuss your options, please ask your GP for a referral for a consultation with Dr Nandi.
How do we diagnose hypothyroidism?
There are accurate thyroid function tests used to diagnose hypothyroidism.
How can hypothyroidism be prevented or reversed?
Unfortunately hypothyroidism cannot be prevented. In some rare instances, hypothyroidism will resolve without treatment, but this is unusual. The best defence is to ensure you watch for symptoms and undertake to engage a specialist endocrinologist for treatment and management.
Dietary considerations for hypothyroidism
The thyroid needs iodine to properly function. Eating a balanced diet that includes whole grains, beans, lean proteins and colourful fruits and vegetables is best. It is also believed that soy may inhibit the production of thyroid hormones. Ensure you monitor your soy intake and limit soy products.
Treatment and management of hypothyroidism
Hypothyroidism can be controlled in most cases through the supplementation of low T4 hormone levels with synthetic hormones. The synthetic version is levothyroxine which copies the action of your body’s natural thyroid hormone. Once thorough testing and evaluations have been completed, Dr Nandi will be able to determine what dosage is required to restore your normal hormone levels.
To arrange for a consultation with Dr Nandi regarding your hypothyroidism, please ask your GP for a referral.
