Hypothyroidism occurs when your body fails to produce enough thyroid hormones. It may not cause noticeable symptoms in the early stages. Over time, untreated hypothyroidism can cause a number of health problems, such as obesity, joint pain, infertility, and heart diseases.

Underactive thyroid affects women more frequently than men. Hypothyroidism can be discovered through a routine blood test or after the initiation of symptoms. Accurate thyroid function tests are available to diagnose hypothyroidism. Treatment with synthetic thyroid hormone is usually simple, safe, and effective once you and your doctor find the right dose for you.

Symptoms of Hypothyroidism

Some of the most common symptoms of hypothyroidism:

  • Puffy face
  • Muscle weakness
  • Fatigue
  • Thinning hair
  • Increased sensitivity to cold
  • Constipation
  • Dry skin
  • Weight gain
  • Hoarseness
  • Depression
  • Impaired memory
  • Elevated blood cholesterol level
  • Muscle aches, tenderness and stiffness
  • Pain, stiffness or swelling in your joints
  • Heavier than normal or irregular menstrual periods
  • Slowed heart rate
  • Enlarged thyroid gland (goiter)

Hypothyroidism in infants

When newborns do get affected with hypothyroidism, the problems may include:

  • Jaundice
  • An umbilical hernia
  • A large, protruding tongue
  • Difficulty in breathing
  • Hoarse crying

As the disease progresses, infants are likely to have trouble feeding and may fail to grow and develop normally. They may also have:

  • Excessive drowsiness
  • Constipation
  • Poor muscle tone

Untreated hypothyroidism in infants can lead to severe physical and mental retardation.

Hypothyroidism in children and teens

In general, children and teens with hypothyroidism have the same signs and symptoms as adults do, but they may also experience:

  • Delayed puberty
  • Poor growth, resulting in short stature
  • Delayed development of permanent teeth
  • Poor mental development

Causes of hypothyroidism

Hypothyroidism results when the thyroid gland fails to produce enough hormones. It may occur due to a number of factors, including:

  • Autoimmune disease: The most common cause of hypothyroidism is an autoimmune disorder known as Hashimoto’s thyroiditis.
  • Over-response to hyperthyroidism treatment: People who produce too much thyroid hormone (hyperthyroidism) are often treated with radioactive iodine or anti-thyroid medications. The goal of these treatments is to get thyroid function back to normal. But sometimes, correcting hyperthyroidism can end up lowering thyroid hormone production too much, resulting in permanent hypothyroidism.
  • Radiation therapy: Radiation used to treat cancers of the head and neck can affect your thyroid gland and may lead to hypothyroidism.
  • Thyroid surgery: Removing all or a large portion of your thyroid gland can diminish or halt hormone production. In that case, you’ll need to take thyroid hormone for life.
  • Medications. A number of medications can contribute to hypothyroidism. One such medication is lithium, which is used to treat certain psychiatric disorders.

Less common causes of Hypothyroidism

  • Congenital diseases: Some babies are born with a defective thyroid gland or no thyroid gland. In most cases, the thyroid gland didn’t develop normally for unknown reasons, but some children have an inherited form of the disorder.
  • Pituitary disorder: A relatively rare cause of hypothyroidism is the failure of the pituitary gland to produce enough thyroid-stimulating hormone (TSH) — usually because of a benign tumor of the pituitary gland.
  • Pregnancy: Some women develop hypothyroidism during or after pregnancy. This condition is called as postpartum hypothyroidism and occurs because they produce antibodies against their own thyroid gland. If it is left untreated, it may increase the risk of miscarriage, premature delivery and preeclampsia — a condition that causes a significant rise in a woman’s blood pressure during the last three months of pregnancy. It can also seriously affect the developing fetus.
  • Iodine deficiency: The trace mineral iodine — found primarily in seafood, seaweed, plants grown in iodine-rich soil and iodized salt — is essential for the production of thyroid hormones. Too little iodine can lead to hypothyroidism, and too much iodine can worsen hypothyroidism in people who already have the condition.

Risk factors

Despite the fact that anyone can develop hypothyroidism, you might be at an increased risk if you:

  • Are a female
  • Are older than 60 years
  • Have an autoimmune disease, such as type 1 diabetes or celiac disease
  • Have a family history of thyroid diseases
  • Have had thyroid surgery (partial thyroidectomy)
  • Have been treated with radioactive iodine or anti-thyroid medications
  • Received radiation to your neck or upper chest
  • Have been pregnant or delivered a baby within the past six months

Diagnosing hypothyroidism

Two primary tools are used to diagnose hypothyroidism

1-    Physical examination

Your doctor will complete a thorough physical exam and medical history. He’ll check for physical signs of hypothyroidism, including:

  • Swelling
  • Dry skin
  • Slowed reflexes
  • A slower heart rate

In addition, your doctor will ask you to report any symptoms you’ve been experiencing, such as

  • Fatigue
  • Depression
  • Constipation
  • Cold

2-    Blood tests

Blood tests are the only way to reliably confirm a diagnosis of hypothyroidism.

  • A thyroid-stimulating hormone (TSH) test measures how much TSH your pituitary gland is creating:
  • High TSH levels show that your body is trying to stimulate more thyroid hormone activity.
  • Low TSH levels show that your body is trying to stop excessive thyroid hormone production.
  • A thyroxin (T4) level test is also useful in diagnosing hypothyroidism. T4 is one of the hormones directly produced by your thyroid. Used together, T4 and TSH tests help evaluate thyroid function.

Generally, if you have a low level of T4 along with a high level of TSH, you have hypothyroidism. However, there is a spectrum of thyroid disease, and other thyroid function tests may be necessary to properly diagnose your condition.

Medications for Hypothyroidism

Hypothyroidism is best treated by using levothyroxine (Levothroid, Levoxyl). This synthetic version of the T4 hormone copies the action of the thyroid hormone your body would normally produce. Once hormone levels are restored, symptoms of the condition are likely to disappear or at least become much more manageable.

In most cases, people with hypothyroidism must remain on this medication their entire lives. However, it’s unlikely you’ll continue to take the same dose. To make sure your medication is still working properly, your doctor should test your TSH levels yearly. If blood levels indicate the medicine isn’t working as well as it should, your doctor will adjust the dose until a balance is achieved.

Alternative treatment for hypothyroidism

Animal extracts that contain thyroid hormones are available. These extracts come from the thyroid glands of pigs (So, definitely not Halal). They contain both T4 and triiodothyronine (T3).

If you take levothyroxine, you’re only receiving T4. But that’s all you need because your body is capable of producing T3 from the synthetic T4. It is noteworthy that these alternative animal extracts are often unreliable in dosing and haven’t been shown in studies to be better than levothyroxine. For these reasons, they aren’t routinely recommended.

People with hypothyroidism should follow the following recommendations to keep their thyroid hormones in balance:

  • Eat a balanced diet (with adequate amounts of iodine) but you don’t need to take an iodine supplement in order for that to happen. A balanced diet of whole grains, beans, lean proteins, and colorful fruits and vegetables should provide enough iodine.
  • Monitor soy intake: Soy may hinder the absorption of thyroid hormones. If you drink or eat too many soy products, you may not be able to properly absorb your medication. This can be especially important in infants needing treatment for hypothyroidism who also drink soy formula.

Some common soy products are:

  • Tofu
  • Vegan cheese and meat products
  • Soy milk
  • Soybeans
  • Soy sauce
  • Smart intake of fiber: Fiber may also interfere with hormone absorption. Too much dietary fiber may prevent your body from getting the hormones it needs. Fiber is important, so don’t avoid it entirely. Instead, avoid taking your medicine within several hours of eating high-fiber foods.
  • Avoid taking thyroid medicine with other supplements: Other medications can interfere with absorption, so it’s best to take your thyroid medicine on an empty stomach and without other medicines. Plus, if you take supplements or medications in addition to thyroid medicine, try to take these medicines at different times for avoiding any hindrance.