Hypothyroidism is a condition that happens when the thyroid does not make enough hormone. The thyroid gland is in the front of the neck just below the voice box. It releases hormones that regulate metabolism.
The most prevalent cause of hypothyroidism is inflammation of the thyroid gland, which damages glands cells. Hashimoto's thyroiditis, when the immune system attacks the thyroid gland, is the most common example of this inflammation. Some women can develop hypothyroidism after pregnancy (known as postpartum thyroiditis).
Common causes of hypothyroidism include:
- Congenital (birth) defects
- Radiation treatments to the neck to treat different cancers, which may also damage the thyroid gland
- Radioactive iodine used to treat an overactive thyroid (hyperthyroidism)
- Surgical removal of part or all of the thyroid gland, done to treat other thyroid problems
- Viral thyroiditis, which may cause hyperthyroidism and is often followed by temporary or permanent hypothyroidism
Early symptoms include:
- Being more sensitive to cold
- Fatigue or feeling slowed down
- Heavier menstrual periods
- Joint or muscle pain
- Paleness or dry skin
- Thin, brittle hair or fingernails
- Weight gain (unintentional)
Later symptoms include if left untreated:
- Decreased taste and smell
- Puffy face, hands, and feet
- Slow speech
- Thickening of the skin
- Thinning of eyebrows
A physical examination may reveal a smaller than normal thyroid gland, although sometimes the gland is normal size or even enlarged (goiter). The examination may also reveal:
- Brittle nails
- Coarse facial features
- Pale or dry skin, which may be cool to the touch
- Swelling of the arms and legs
- Thin and brittle hair
Your family doctor can order specific lab tests to check for thyroid disorder.
Lab tests to determine thyroid function include:
- TSH test
- T4 test
Lab tests may also reveal:
- Anemia on a complete blood count (CBC)
- Increased cholesterol levels
- Increased liver enzymes
- Increased prolactin
- Low sodium
The goal of treatment is to replace the thyroid hormone that is lacking. Levothyroxine is the most commonly used medication. Doctors will prescribe the lowest dose possible that effectively relieves symptoms and brings your TSH level to a normal range. If you have heart disease or you are older, your family doctor may start with a very small dose.
Lifelong therapy is required unless you have a condition called transient viral thyroiditis.
You must continue taking your medication even when your symptoms go away. When starting your medication, your doctor may check your hormone levels every 2 - 3 months. After that, your thyroid hormone levels should be monitored at least every year.
Very Important things to remember when you are taking thyroid hormone are:
Do NOT stop taking the medication when you feel better. Continue taking the medication exactly as directed by your family doctor.
If you change brands of thyroid medicine, let your doctor know. Your levels may need to be checked.
Thyroid medicine works best on an empty stomach and when taken 1 hour before any other medications.
Do NOT take thyroid hormone with fiber supplements, calcium, iron, multivitamins, aluminum hydroxide antacids, colestipol, or medicines that bind bile acids.
In most cases, thyroid levels return to normal with proper treatment. However, thyroid hormone replacement must be taken for the rest of your life.
If you are being treated for hypothyroidism, call your family doctor if you:
- develop chest pain or rapid heartbeat
- have an infection
- symptoms get worse or do not improve with treatment
- develop new symptoms
Be sure to sit down and have an in-depth discussion with your family doctor about your specific symptoms.
At Leavitt Family Medicine, we are there for you, for all of your medical needs. We welcome your questions and comments; Please let us know how we can help you today!