Hypothyroidism: Here’s everything you need to know

Hypothyroidism is a life-changing chronic hormone deficiency. The debilitating exhaustion caused by this condition can greatly hamper productivity, not to mention the accompanying mood swings and weight gain. Read on to discover more about hypothyroidism, including its causes, symptoms, and treatments.

What is hypothyroidism?

Hypothyroidism is a condition in which your body is not able to produce sufficient quantities of thyroid hormone. Your thyroid gland produces thyroid hormones, which help in regulating the body’s metabolism. In other words, it tells each cell how much energy it should use. Thus, a deficiency of thyroid hormones can lead to an overall slowing down of the body’s functioning.

What causes hypothyroidism?

Hypothyroidism can be caused by various factors such as –

Iodine deficiency
Surgery to remove the thyroid gland
Radioactive iodine treatment
Radiation therapy involving your thyroid, neck or chest
Hashimoto’s thyroiditis
Congenital hypothyroidism (partial or complete absence of the thyroid gland at birth)
Viral infections (sometimes viral infections cause inflammation of the thyroid gland, making it underactive)
Medicines such as lithium, thalidomide, rifampin, phenytoin, carbamazepine, phenobarbital interferon-alpha, interleukin-2, amiodarone etc.
An underactive pituitary gland

What are the symptoms of hypothyroidism?

Symptoms of hypothyroidism include –

Fatigue
Weakness
Weight gain
Enlarged thyroid
gland
Dry skin
Dry hair and hair loss
Increased sensitivity to cold
Joint pain and muscle cramps
Decreased heart rate
Menstrual problems
Fertility problems
Decreased libido
Irritability and depression

Hypothyroidism in infants can present with the following symptoms –

Dull puffy face
Jaundice
A big tongue that protrudes or sticks out
Bouts of poor feeding and choking
Poor muscle tone resulting in floppiness
Stunted growth
Constipation
Sluggishness
Hoarse crying

Hypothyroidism in children results in –

Delayed or stunted growth
Delayed onset of puberty
Thick lips
Delayed eruption of teeth and malalignment of teeth

What is subclinical hypothyroidism?

Subclinical hypothyroidism or mild thyroid failure is a condition in which your thyroid hormone levels are normal but your thyroid stimulating hormone (TSH) is elevated. If you have subclinical hypothyroidism, you may not have any symptoms. Subclinical hypothyroidism can progress to hypothyroidism.

What is myxedema?

Severely advanced hypothyroidism is also called myxedema. Myxedema occurs in cases of undiagnosed and untreated hypothyroidism. It can be life-threatening in its more advanced phases and demands urgent medical care.

What is cretinism?

Cretinism is a condition caused due to deficiency of thyroid hormone during the foetal stage, infancy or early childhood. Thyroid hormone is essential for the proper development of a child’s brain as well as overall growth. Cretinism results in severe mental retardation and stunted growth in children.

What is Hashimoto's disease?

Hashimoto’s disease or Hashimoto’s thyroiditis is a disease of the immune system in which your body’s cells are targeted and destroyed by your own defence cells. This means that your body’s immune cells fail to recognize cells of your thyroid gland as its own and hence attack them. It is also called autoimmune thyroiditis. Due to the immune response, there is inflammation and death of the thyroid gland cells, leading to a deficiency of thyroid hormone.

What are the complications of hypothyroidism?

Some complications include –

Goitre (enlarged thyroid gland – it can lead to hoarseness of voice, trouble in breathing and swallowing)
Myxedema coma (features include decreased rate of breathing, decreased body temperature, seizures and shock; this requires emergency medical care)
Heart disease
Infertility
Mental health problems
Stunted growth and mental deficiency in babies and young children

How is hypothyroidism diagnosed?

If you report to your doctor with symptoms of hypothyroidism, you may be advised to take certain blood tests. These include

Thyroid stimulating hormone (TSH)
T3 and T4 tests
Anti-thyroid antibody testing

Additionally, you may be advised to undergo radioactive iodine uptake, ultrasound, CT, MRI or a biopsy if your doctor suspects a greater problem.

How is hypothyroidism treated?

Hypothyroidism is treated with synthetic thyroxine (Levothyroxine). Your physician will calculate the dose of your medication based on your body weight and your hormone levels.

Is my hypothyroidism curable?

Hypothyroidism is a very treatable condition. Timely and proper medical treatment will help you get back to a normal healthy life. However, you may have to continue taking medications for your thyroid disease for a long period of time.

Do I have to take thyroid hormone supplements for the rest of my life?

Your thyroid gland may remain underactive for your entire life. This means that you may have to be under medication for your lifetime. However, your doctor may adjust your dose periodically based on your hormone levels.

I missed a dose of my thyroid medicine. What should I do now?

If you miss a dose, take the dose when you remember it. If you remember your missed dose only at a time close to your next dose, then take only that dose. Don’t take a second dose to make up for the one you missed.

What if I take an extra dose of my thyroid medication by mistake?

If you take an extra dose of your thyroid medication by mistake, do not panic. Accidental consumption of one additional dose of thyroid medicine is unlikely to harm you. You may experience heart pounding, feeling very hot, sweating, increased hunger, nervousness, anxiety and in some cases, even diarrhoea and sleeplessness. You may start experiencing these symptoms several days after the accident which may resolve gradually over the next couple of days. Consult your doctor and report the incident if your symptoms are persistent.

To avoid making a mistake, keep a checklist or a pillbox that contains tablets dispensed for each day separately.

Are there any side effects to thyroid hormone medicines?

There are some side effects to thyroid hormone medicines. These include –

Rapid heartbeat (palpitations)
Excessive hunger, in spite of eating normally
Nervousness and anxiety
Intolerance to heat
Hairfall
Abnormalities in the
menstrual cycle
Changes in appetite
Nausea and vomiting
Joint pain
Cramps

If your symptoms are severe, contact your doctor.

How is hypothyroidism and its treatment going to impact my pregnancy?

Untreated hypothyroidism can interfere with the development of the embryo and lead to a miscarriage. It can also lead to premature delivery, low birth weight and decreased mental capacity of the baby.

Levothyroxine, the medicine used for treating hypothyroidism, is safe to take during pregnancy. However, talk to your doctor and confirm if you need to make any adjustments to your dosage during pregnancy.

I have hypothyroidism. What lifestyle modifications should I adopt now?

Some measures include –

Sleeping for at least 8 hours every day
Exercising and maintaining a healthy weight
Consuming a healthy balanced diet: Add foods with iodine to your diet (seafood, iodized salt, dairy, meat, eggs etc.)
Getting treated for your hypothyroidism and ensuring regular follow-ups with your doctor