Hypothyroidism
Basic Information
Description
Underactive thyroid gland which causes underproduction of thyroid hormone. The thyroid is a small butterfly-shape gland in the neck. Virtually all metabolic processes are affected by the thyroid hormone. It affects both sexes of adults, but is more common in women.
Frequent Signs and Symptoms
It is unlikely one person will have all the following symptoms, but most will have several:
- Decreased tolerance for cold
- Decreased sweating
- Decreased appetite
- Constipation
- Chest pain
- Coarse or slow-growing hair
- Slow, rapid or irregular heartbeat
- Weight gain or extreme thinness
- Placidity or nervousness
- Sleepiness or Insomnia
- Mental impairment, including depression, psychosis or poor memory
- Fluid retention, especially around the eyes
- Dull facial expression and droopy eyelids
- Coarse skin
- Decreased tolerance for medication
- Decreased sex drive and infertility
- Menstrual disorders
- Anemia
- Numbness and tingling of the hands and feet
- Deepened or hoarse voice
Causes
Sometimes unknown. Most common causes include:
- Autoimmune disease, in which the body’s immune system functions abnormally and attacks the thyroid gland
- Radioactive iodine treatment
- Surgery for hyperthyroidism
- Iodine deficiency in the diet
- Decreased activity of the pituitary gland, which secretes a thyroid-stimulating hormone
- Use of drugs, such as lithium, that may depress thyroid function
Risk Increases With
- Adults of 60
- Obesity
- Surgery for hyperthyroidism
- X-ray treatments
Preventative Measures
- No known medication to prevent primary hypothyroidism
- Take replacement thyroid for life after thyroid surgery or destruction of the thyroid gland by radiation treatment
Expected Outcome
Usually curable with careful thyroid-replacement therapy. The goal of treatment is to provide the body with enough thyroid substance for efficient body function. Medical evaluation may be necessary for several months to establish the correct dose of thyroid replacement. Relapses will occur if treatment is interrupted.
Possible Complication
- Myxedema coma- life threatening complication of hypothyroidism
- Increased susceptibility to infection
- Adrenal crisis with vigorous treatment of hypothyroidism
- Infertility
- Over treatment over long periods can lead to bone demineralization
Treatment
General Measures
- Laboratory blood studies of thyroid hormones. Lab studies can confirm the diagnosis of hypothyroidism, but they cannot indicate how much replacement therapy is needed.
- Goals of treatment are long-term thyroid replacement and recognition of symptoms to avoid over or under-dosing
- You may require hospitalization if complicating emergencies occur, such as myxedema coma (extremely rare in warm climates, more common in cold climates)
Medication
Thyroid replacement hormones will be prescribed. Dosage requirements will depend on age, weight, sex, capacity of thyroid function, other drugs you take, and intestinal function.
Activity
No restrictions. Stay as active as possible.
Diet
- No special diet for hypothyroidism. Avoid constipation by eating a high fiber diet
- Weight loss diet recommended if you are overweight
Notify Our Office If:
- You or a family member has symptoms of hypothyroidism
- Symptoms don’t improve within 3 weeks after treatment begins
- New, unexplained symptoms develop. Drugs used in treatment may produce side effects
- Coma or seizures occur. Get emergency help immediately!
