Hypothyroidism

WHAT IS HYPOTHYROIDISM?

The thyroid gland, one of the hormone-producing organs, is situated at the front of the neck, directly in front of the windpipe. Thyroid regulates all body functions. Hypothyroidism is not a disease, but under activity or hypo functioning of thyroid and since Thyroid regulates all body functions, manifestations are seen all over. It affects both sexes of adults, but more common in women.

SIGNS & SYMPTOMS

Since thyroid regulates the rate of body's metabolism, here every system works in 'go slow' mode.

It is unlikely one patient will have all the following symptoms, but most will have several:

  • Reduced tolerance for cold - you will feel chilly when others are sweating.
  • Decreased sweating.
  • Decreased appetite.
  • Constipation.
  • Chest pain.
  • Coarse or slow-growing hair.
  • Slow, rapid or irregular heartbeat.
  • Weight gain.
  • Placidity or nervousness.
  • Sleepiness or insomnia (Loss of sleep).
  • Mental impairment, including depression, psychosis or poor memory.
  • Fluid retention, especially around the eyes.
  • Dull facial expression and droopy eyelids in severe cases.
  • 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. Following are some of the common causes:

  • Autoimmune disease, in which the body's immune system functions abnormally and attacks the thyroid gland.
  • Iodine deficiency in the diet as iodine is required for formation of thyroid hormones.
  • Decreased activity of the pituitary gland, which controls thyroid by secreting a thyroid-stimulating hormone.
  • Iatrogenic, ie reduced thyroid function by drugs, Radioactive iodine treatment and surgery for hyperthyroidism.

HOW TO PREVENT

  • Use iodized salt.
  • If advised, replacement thyroid drugs take them for life.

DIAGNOSTIC MEASURES

  • Suggestive symptoms.
  • History and physical exam by a doctor.
  • Radioactive Immune Assay to determine blood levels of thyroid hormones. Commonly done are T3, T4 & TSH. For follow up only TSH may be enough. Lab studies can confirm the diagnosis of hypothyroidism, but they cannot indicate how much replacement therapy is needed.

POSSIBLE COMPLICATIONS

Usually curable with careful thyroid-replacement therapy but since most symptoms are vague, chances of missed diagnosis are very high. If untreated, Hypothyroidism is associated with increased risk of Ischemic Heart Disease.

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 and then, recheck of hormone levels once in 6 mths

TREATMENT

GENERAL

No special instructions except those listed under other headings.

SPECIFIC

Your doctor will prescribe thyroid-replacement hormones.

DIET & ACTIVITY

No restrictions

CONTACT YOUR DOCTOR, IF

  • Symptoms don't improve within 3 weeks after treatment begins.
  • New, unexplained symptoms develop. Certain drugs used in treatment may produce side effects. 

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