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Category Archives: Hypothyroidism
What is the thyroid gland?
The thyroid gland is a butterfly-shaped endocrine gland that is normally located in the lower front of the neck. The thyroids job is to make thyroid hormones, which are secreted into the blood and then carried to every tissue in the body. Thyroid hormone helps the body use energy, stay warm and keep the brain, heart, muscles, and other organs working as they should.
Hypothyroidism is an underactive thyroid gland. Hypothyroidism means that the thyroid gland cant make enough thyroid hormone to keep the body running normally. People are hypothyroid if they have too little thyroid hormone in the blood. Common causes are autoimmune disease, surgical removal of the thyroid, and radiation treatment.
When thyroid hormone levels are too low, the bodys cells cant get enough thyroid hormone and the bodys processes start slowing down. As the body slows, you may notice that you feel colder, you tire more easily, your skin is getting drier, youre becoming forgetful and depressed, and youve started getting constipated. Because the symptoms are so variable and non-specific, the only way to know for sure whether you have hypothyroidism is with a simple blood test for TSH.
KEEPING OTHER PEOPLE INFORMED
Tell your family members. Because thyroid disease runs in families, you should explain your hypothyroidism to your relatives and encourage them to get regular TSH tests. Tell your other doctors and your pharmacist about your hypothyroidism and the drug and dose with which it is being treated. If you start seeing a new doctor, tell the doctor that you have hypothyroidism and you need your TSH tested every year. If you are seeing an endocrinologist, ask that copies of your reports be sent to your primary care doctor.
WHAT CAN YOU EXPECT OVER THE LONG TERM?
There is no cure for hypothyroidism, and most patients have it for life. There are exceptions: many patients with viral thyroiditis have their thyroid function return to normal, as do some patients with thyroiditis after pregnancy.
Hypothyroidism may become more or less severe, and your dose of thyroxine may need to change over time. You have to make a lifetime commitment to treatment. But if you take your pills every day and work with your doctor to get and keep your thyroxine dose right, you should be able to keep your hypothyroidism completely controlled throughout your life. Your symptoms should disappear and the serious effects of low thyroid hormone should stop getting worse and should actually improve. If you keep your hypothyroidism well-controlled, it will not shorten your life span.
There can be many reasons why the cells in the thyroid gland cant make enough thyroid hormone. Here are the major causes, from the most to the least common.
Hypothyroidism (//; from hypo- meaning under or reduced, plus thyroid), often called underactive thyroid or low thyroid and sometimes hypothyreosis, is a common endocrine disorder in which the thyroid gland does not produce enough thyroid hormone. It can cause a number of symptoms, such as tiredness, poor ability to tolerate cold, and weight gain. In children, hypothyroidism leads to delays in growth and intellectual development, which is called cretinism in severe cases. The diagnosis of hypothyroidism, when suspected, can be confirmed with blood tests measuring thyroid-stimulating hormone (TSH) and thyroxine levels.
Worldwide, too little iodine in the diet is the most common cause of hypothyroidism. In countries with enough dietary iodine, the most common cause of hypothyroidism is the autoimmune condition Hashimoto's thyroiditis. Less common causes include the following: previous treatment with radioactive iodine, injury to the hypothalamus or the anterior pituitary gland, certain medications, a lack of a functioning thyroid at birth, or previous thyroid surgery.
Hypothyroidism can be treated with manufactured levothyroxine; the dose is adjusted according to symptoms and normalization of the thyroxine and TSH levels. In Western countries, hypothyroidism occurs in 0.30.4% while subclinical hypothyroidism, a milder form of hypothyroidism characterized by normal thyroxine levels and an elevated TSH level, is thought to occur in 4.38.5%. Dogs are also known to develop hypothyroidism and in rare circumstances cats and horses can also have the disorder.
People with hypothyroidism often have no or only mild symptoms. Numerous symptoms and signs are associated with hypothyroidism, and can be related to the underlying cause, or a direct effect of having not enough thyroid hormones. Hashimoto's thyroiditis may present with the mass effect of a goiter (enlarged thyroid gland).
Delayed relaxation after testing the ankle jerk reflex is a characteristic sign in hypothyroidism and is associated with the severity of the hormone deficit.
Man with myxedema or severe hypothyroidism showing an expressionless face, puffiness around the eyes and pallor
Additional finding include swelling of the arms and legs and significant ascites.
Myxedema coma is a rare but life-threatening state of extreme hypothyroidism. It may occur in those who are known to have hypothyroidism when they develop another illness, but it can be the first presentation of hypothyroidism. The illness is characterized by very low body temperature without shivering, confusion, a slow heart rate and reduced breathing effort. There may be physical signs suggestive of hypothyroidism, such as skin changes or enlargement of the tongue.
Even mild or subclinical hypothyroidism has been associated with impaired fertility and an increased risk of miscarriage. Hypothyroidism in early pregnancy, even with limited or no symptoms, may increase the risk of pre-eclampsia, offspring with lower intelligence, and the risk of infant death around the time of birth.Women are affected by hypothyroidism in 0.30.5% of pregnancies. Subclinical hypothyroidism during pregnancy has also been associated with gestational diabetes and birth of the baby before 37 weeks of pregnancy.
Newborn children with hypothyroidism may have normal birth weight and height (although the head may be larger than expected and the posterior fontanelle may be open). Some may have drowsiness, decreased muscle tone, a hoarse-sounding cry, feeding difficulties, constipation, an enlarged tongue, umbilical hernia, dry skin, a decreased body temperature and jaundice. A goiter is rare, although it may develop later in children who have a thyroid gland that does not produce functioning thyroid hormone. A goiter may also develop in children growing up in areas with iodine deficiency. Normal growth and development may be delayed, and not treating infants may lead to an intellectual impairment (IQ 615 points lower in severe cases). Other problems include the following: large scale and fine motor skills and coordination, reduced muscle tone, squinting, decreased attention span, and delayed speaking.Tooth eruption may be delayed.
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Hypothyroidism - Wikipedia, the free encyclopedia
Hypothyroidism is a condition in which the body lacks sufficient thyroid hormone. Since the main purpose of thyroid hormone is to "run the body's metabolism," it is understandable that people with this condition will have symptoms associated with a slow metabolism. The estimates vary, but approximately 10 million Americans have this common medical condition. In fact, as many as 10% of women may have some degree of thyroid hormone deficiency. Hypothyroidism is more common than you would believe, and millions of people are currently hypothyroid and don't know it. For an overview of how thyroid hormone is produced and how its production is regulated, check out our thyroid hormone production page.
There are two fairly common causes of hypothyroidism. The first is a result of previous (or currently ongoing) inflammation of the thyroid gland, which leaves a large percentage of the cells of the thyroid damaged (or dead) and incapable of producing sufficient hormone. The most common cause of thyroid gland failure is called autoimmune thyroiditis (also called Hashimoto's thyroiditis), a form of thyroid inflammation caused by the patient's own immune system.
The second major cause is the broad category of "medical treatments." The treatment of many thyroid conditions warrants surgical removal of a portion or all of the thyroid gland. If the total mass of thyroid producing cells left within the body are not enough to meet the needs of the body, the patient will develop hypothyroidism. Remember, this is often the goal of the surgery for thyroid cancer.
But at other times, the surgery will be to remove a worrisome nodule, leaving half of the thyroid in the neck undisturbed. Sometimes, this remaining thyroid lobe and isthmus will produce enough hormone to meet the demands of the body. For other patients, however, it may become apparent years later that the remaining thyroid just can't quite keep up with demand.
Similarly, goiters and some other thyroid conditions can be treated with radioactive iodine therapy. The aim of the radioactive iodine therapy (for benign conditions) is to kill a portion of the thyroid to prevent goiters from growing larger or producing too much hormone (hyperthyroidism).
Occasionally, the result of radioactive iodine treatment will be that too many cells are damaged so the patient often becomes hypothyroid within a year or two. However, this is usually greatly preferred over the original problem.
There are several other rare causes of hypothyroidism, one of them being a completely "normal" thyroid gland that is not making enough hormone because of a problem in the pituitary gland. If the pituitary does not produce enough thyroid stimulating hormone (TSH) then the thyroid simply does not have the "signal" to make hormone. So it doesn't.
Each individual patient may have any number of these symptoms, and they will vary with the severity of the thyroid hormone deficiency and the length of time the body has been deprived of the proper amount of hormone.
You may have one of these symptoms as your main complaint, while another will not have that problem at all and will be suffering from an entirely different symptom. Most people will have a combination of these symptoms. Occasionally, some patients with hypothyroidism have no symptoms at all, or they are just so subtle that they go unnoticed.
If you have these symptoms, you need to discuss them with your doctor. Additionally, you may need to seek the skills of an endocrinologist. If you have already been diagnosed and treated for hypothyroidism and continue to have any or all of these symptoms, you need to discuss it with your physician.
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