Definition

Hypothyroidism is a condition characterised by insufficient production of thyroid hormone by the thyroid gland. The thyroid is a little, butterfly-shaped gland situated at the anterior part of your neck. The thyroid hormone controls energy utilization and metabolism, exerting influence on nearly all organs in the body, including heart rate. Insufficient thyroid hormone can lead to a decrease in several bodily processes.

Causes

There are numerous causes of hypothyroidism, including:

• Hashimoto's disease. This is an autoimmune disorder that is the primary cause of hypothyroidism. This condition involves the immune system targeting the thyroid. Inflammation of the thyroid gland leads to decreased production of thyroid hormone.
• Thyroiditis is the inflammation of the thyroid gland, leading to the leakage of stored thyroid hormone. At first, this leak causes an elevation in thyroid hormone levels in your bloodstream, resulting in thyrotoxicosis, a state of too-high thyroid hormone levels. Thyrotoxicosis might persist for several months. Subsequently, your thyroid gland may decrease in activity, leading to a potentially permanent disease that needs thyroid hormone replacement medication. Following hypothyroidism, three types of thyroiditis can cause hyperthyroidism:

• • Subacute thyroiditis is defined by a painful, inflamed, and swollen thyroid gland.
  • Postpartum thyroiditis occurs following childbirth in women.
  • Silent thyroiditis is asymptomatic, yet it may lead to thyroid enlargement. Experts speculate that this could be an autoimmune disorder.

• Congenital hypothyroidism. Some infants are born with an underdeveloped or dysfunctional thyroid gland. Untreated congenital hypothyroidism can lead to intellectual impairment and developmental failure. Early intervention can mitigate these difficulties.
• Thyroidectomy: surgical removal of part or all of the thyroid gland. After partial thyroidectomy, the residual portion of the thyroid gland is capable of producing adequate levels of thyroid hormone. Nevertheless, hypothyroidism may develop in certain individuals following this procedure. Complete removal of the thyroid gland invariably results in hypothyroidism. The surgeon can perform a partial or whole thyroidectomy as a treatment for:

• • Hyperthyroidism
  • Large goiter
  • Thyroid nodules, which are noncancerous lumps or tumors on the thyroid, can produce too much thyroid hormone
  • Small thyroid cancer

• Medications. Certain medications can impact the synthesis of thyroid hormones, leading to hypothyroidism. This includes specific cardiac, psychiatric, and cancer medications. Newly emerging anticancer medications can impact the thyroid either directly or indirectly through harm to the pituitary gland.

Risk factor

Women have a higher risk of developing hypothyroidism compared to men. This condition is more prevalent in individuals aged 60 and above. You are at a higher risk of developing hypothyroidism if you:

• Have a history of thyroid diseases, including goiter
• Undergone surgery or received radioactive iodine for thyroid issues
• Have undergone radiation therapy to the thyroid, neck, or chest
• Family history of thyroid disease
• Pregnant within the past 6 months
• Experiencing Turner syndrome, a hereditary condition commonly found in females

You have an increased risk of thyroid weakness if you also have the following additional health conditions:

• Celiac disease
• Sjörgen's syndrome, a disease that causes dry eyes and mouth

• A condition called pernicious anemia that results from a lack of vitamin B12
• Diabetes mellitus, type 1 or type 2,
• Rheumatoid arthritis is an autoimmune disease involving the joints
• Lupus is a chronic (long-term) autoimmune inflammatory condition.

Symptoms

Hypothyroidism presents a range of symptoms that differ among individuals. Common signs of hypothyroidism include the following:

• Fatigue
• Weight gain
• Cold intolerance
• Articular and musculoskeletal pain
• Dehydrated skin or parched, fine hair
• Heavy or irregular menstrual cycles, or infertility
• Bradycardia
• Depression

Due to the gradual progression of hypothyroidism, the onset of symptoms may elude the affected individual for months or even years. Numerous of these symptoms, weight gain and fatigue in particular are common and do not necessarily indicate that you have a thyroid disorder.

Diagnosis

The doctor will inquire about your medical history and conduct a physical examination. Diagnosing hypothyroidism based solely on symptoms is not possible due to the similarity of its symptoms with those of other disorders. Your doctor can use several thyroid blood tests and radiographic studies to verify the diagnosis and determine the underlying cause. Women experiencing infertility frequently undergo thyroid condition screenings due to the potential impact of hypothyroidism on fertility.

Management

Hypothyroidism is managed by administering hormones that the thyroid gland is unable to generate. You will receive a prescription for levothyroxine, a synthetic thyroid hormone that resembles the hormone that a healthy thyroid gland naturally produces. The medicine is typically administered in pill form, although it can also be found in liquid form and soft gel capsules. This updated recipe could assist those with digestive issues in absorbing thyroid hormones. Your physician will advise taking this medication in the morning on an empty stomach.

Your doctor will advise you to get a blood test 6 to 8 weeks after starting the medication and may change the dosage if needed. Whenever your dosage is adjusted, you will have a blood test. After determining an effective dosage, your doctor will probably conduct blood tests every 6 months initially and subsequently once a year.

Thyroid hormone therapy can effectively manage hypothyroidism when used at the proper dose as directed. Always see a doctor before discontinuing this medication. Excessive intake of thyroid hormone therapy might lead to severe issues like atrial fibrillation or osteoporosis.

Complications

Hypothyroidism may lead to elevated cholesterol levels. Individuals with elevated cholesterol levels should undergo screening for hypothyroidism. Untreated severe hypothyroidism can result in myxedema coma, an extreme form of hypothyroidism where bodily systems slow down to a life-threatening level. Immediate medical care is necessary for myxedema coma.

Untreated hypothyroidism during pregnancy can impact both the mother and the fetus. Thyroid medicine helps prevent problems and is safe for use during pregnancy. Women with hypothyroidism may need increased doses of thyroid hormones during pregnancy. It is important to promptly visit a doctor if you are pregnant and have this condition.

Prevention

Preventing hypothyroidism is not possible. To avoid severe hypothyroidism or symptoms that significantly impact your daily life, it is crucial to recognize the indicators of hypothyroidism. If you encounter these symptoms, it is advisable to get advice from a medical professional. Early detection and treatment of hypothyroidism are highly effective.

When to see a doctor?

If you experience unexplained fatigue or other signs of hypothyroidism, it is advisable to seek medical advice from a doctor. Adhere to your doctor's instructions for managing hypothyroidism with thyroid hormone therapy.

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