Hypothyrodism

Overview of Hypothyrodism

Hypothyroidism Meaning in Urdu

یہ ایک ایسی بیماری ہے جس کی وجہ سے تھائی رائڈ مؤثر طریقے سے کام نہیں کر پاتا اور اتنی مقدار میں ہارمونز نہیں بناتا جتنی جسم کو ضرورت ہوتی ہے۔ یہ تھائی رائڈ گردن کے اگلے حصے میں ہوتا ہے اور اس کی شکل تتلی سے ملتی جلتی ہے۔ یہ تھائی رائڈ جسم کے انرجی کو استعمال کرنے کے طریقے کو کنٹرول کرتا ہے اور جسم کے ہر بیرونی اور اندرانی اعضاء پر اثر انداز ہوتا ہے۔ جب یہ تھائی رائڈ ہارمونز نہیں بناتا تو جسمانی کارکردگی متاثر ہوتی ہے۔ اس بیماری کی وجہ سے انیمیا اور دل کے دائمی دورے کا سامنا کرنا پڑ سکتا ہے۔

Hypothyroidism (underactive thyroid) also known as (kenikal halat jo thyroid hormone ki waja se hote hain/ کلینکل حالات جو تھائرائیڈ ہارمونز کیوجہ سے ہوتے ہیں) a medical condition in which less amount of thyroid hormones are produced from thyroid glands.  Over time, if it remains untreated then hypothyroidism can cause multiple health problems such as obesity, joint pain, infertility, and heart disease.

Thyroid function tests are performed to diagnose hypothyroidism. These tests must be done accurately at the right time. Once a person is diagnosed, the most simple and preferable treatment for doctors is synthetic hormone treatment.

Prevalence of Hypothyroidism

The prevalence of hyperthyroidism varies in different countries. According to the study, the prevalence of hypothyroidism and subclinical hypothyroidism in Pakistan was 4.1 and 5.4%, respectively.  The hypothyroidism and subclinical hypothyroidism rate are higher in females than males.

Signs and Symptoms of Hypothyrodism

Hypothyroidism symptoms may elevate other conditions such as

  • Menstrual cycle changes
  • Constipation
  • Depression
  • Dry hair and hair loss
  • Dry skin
  • Elevated cholesterol
  • Fatigue
  • Greater sensitivity to cold
  • Hoarse voice
  • Joint pain, stiffness, and swelling
  • Problems with memory
  • Muscle aches and stiffness
  • Muscle weakness
  • Puffy face
  • Slow heart rate
  • Swelling of the thyroid gland (goitre)
  • Unexplained weight gain or difficulty losing weight
  • Carpal tunnel syndrome

Babies with hypothyroidism may suffer the following symptoms

  • Cold hands and feet
  • Constipation
  • Extreme sleepiness
  • Rough cry
  • Little or no growth
  • Low muscle tone 
  • Persistent jaundice (yellowing of the skin and whiteness of the eyes)
  • Poor feeding habits
  • Puffy face
  • Stomach bloating
  • Swollen tongue
  • Umbilical hernia

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Types of Hypothyrodism

There are three different types of hypothyroidism depending on the inactivation of the thyroid gland.

  • Primary Hypothyroidism: In this type, the thyroid gland doesn't produce enough thyroid hormone.
  • Secondary Hypothyroidism: The pituitary gland doesn't stimulate the thyroid gland to produce enough hormones. This makes the thyroid gland underactive.
  • Tertiary Hypothyroidism: This results from malfunctioning of the hypothalamus (the controller of the endocrine system) that makes the thyroid gland inactive. Due to which, less amount of thyroid hormones are produced.

Causes of Hypothyrodism

There are several causes of hypothyroidism that includes:

  • Among all causes, the most common is Hashimoto's disease. It is an autoimmune disorder where the immune system attacks the thyroid. 
  • Thyroiditis is inflammation of the thyroid
  • Congenital hypothyroidism is present at the time of birth
  • Surgical removal of the thyroid gland either partially or completely
  • Radiation treatment of the thyroid
  • Some medications

Other causes that rarely occur due to hypothyroidism are given below:

  • Pituitary disease
  • Too much or little iodine in the diet
  • Myxedema coma (if hypothyroidism is left untreated)

Pregnant women also experience some complications due to hypothyroidism such as premature birth, high blood pressure in pregnancy, and miscarriage. This leads to slowing the baby's growth and development.

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Risk Factors of Hypothyrodism

Hypothyroidism is a disease that anyone can develop but some factors may increase the risk if individuals: 

  • Are a woman
  • Are age above 60
  • Have a thyroid disease in the family 
  • Have an autoimmune disorder, such as type 1 diabetes, celiac disease, or Hashimoto's disease
  • Have been treated with radioactive iodine or anti-thyroid medications
  • Passes through radiation therapy on the neck or upper chest
  • Have had partial thyroidectomy (thyroid surgery)
  • Have been pregnant or delivered a baby within the past six months

Complications of Hypothyroidism

Hypothyroidism is associated with a number of health problems if a person is not serious about its treatment. Following are the diseases that may increase:

Goiter: In this disease, the thyroid gland becomes hyperactive and releases more hormones than usual. This leads to the enlargement of the gland. However, it is not comfortable and can affect appearance, swallowing, or breathing. 

Heart Problems: Hypothyroidism may also contribute to a heart disease that ultimately leads to heart failure. High levels of low-density lipoprotein (LDL) cholesterol (the "bad" cholesterol) can affect people with an underactive thyroid.

Mental Health Problems: Like depression is more likely to occur in people with early hypothyroidism and become more severe over time. It can also slow mental abilities.

Peripheral Neuropathy: It has been diagnosed in people with long-term uncontrolled hypothyroidism. Because it can damage the peripheral nerves of the brain that carry information from the brain to the spinal cord such as arms and legs. Also may cause pain, numbness, and tingling in affected areas.

Myxedema: It is a rare life-threatening condition that results from long-term, undiagnosed hypothyroidism. The following signs and symptoms include 

  • Severe cold intolerance 
  • Drowsiness 
  • Feeling Lethargic or unconsciousness

A myxedema coma may be triggered by sedatives, infection, or other stress on the body. If you have signs or symptoms of myxedema, you need immediate emergency medical treatment.

Infertility:  Reduced levels of thyroid hormone can affect ovulation, which impairs fertility. 

Birth Defects:  Pregnant women with untreated thyroid disease may have a high risk of delivering babies with birth defects. The newborn babies of affected women have serious mental, physical and social development. If it is diagnosed during early pregnancy then there may be a possibility to treat them.

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Prevention

There are no known ways to prevent hypothyroidism, especially if you are taking enough iodine in your diet. You can only avoid complications with early diagnosis of the disease.

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Diagnosis

The accurate diagnosis of hypothyroidism depends on its symptoms, any underlying medical condition associated with it or the medical and family history of the patients.

A doctor may ask for the following details from the patients to diagnose hypothyroidism.

  • Ask about changes in health, for example, the body is slowing down
  • Had thyroid surgery
  • Had radiation treatment to neck for cancer treatment cancer
  • Taking any of the medicines that can cause hypothyroidism
  • Amiodarone
  • Lithium
  • Interferon alpha
  • Interleukin-2
  • Thalidomide
  • Had a family history of thyroid disease

After these questions, a doctor will do a physical examination to check the thyroid gland. Also observe the changes in hypothyroidism patients such as dry skin, swelling, slower reflexes, and a slower heart rate.

When the physical examination has been done completely the following tests may recommend:

Blood Tests

Two blood tests are used for the diagnosis of hypothyroidism.

  • TSH (Thyroid-stimulating Hormone) Test: TSH test is used for the measurement of how much thyroid hormone thyroxine (T4) is produced. An abnormally high TSH means hypothyroidism, the thyroid gland releases more T4 but there isn’t enough T4 in the blood.

  • T4 Tests: T4 is bound to a protein thyroxine-binding globulin. The “bound” T4 can’t enter the body cells. Only about 1%–2% of unattached (free) T4 presents in the blood and can get into cells. This blood test is used to determine the free T4 and the free T4 index and provide it into the cells. 

 

Treatment of Hypothyrodism | When to Consult a Doctor

Along with medical treatment, people usually change their diet or take supplements in order to reduce the symptoms of hypothyroidism.

  • Selenium contains food such as tuna, turkey, Brazil nuts or grass-fed beef etc.
  • Vitamin B
  • Probiotics
  • Gluten-free diet

The standard treatment for hypothyroidism is the use of the synthetic thyroid hormone levothyroxine (Levo-T, Synthroid, and others) on a daily basis. This oral medication controls hormone levels and reduces the signs and symptoms of hypothyroidism.

After taking it, a person feels better and lowers cholesterol levels which ultimately reduces weight gain. Treatment with levothyroxine dose will likely be lifelong, but because the dosage is adjusted according to the level of TSH. A doctor will check the TSH level firstly after 6 to 8 weeks, depending on the associated condition along with hypothyroidism such as 

If an individual has coronary artery disease or severe hypothyroidism, a doctor may prescribe levothyroxine in a smaller amount and increase the dosage gradually. Progressive hormone replacement helps to increase metabolism.

Important note: There are no side effects of levothyroxine if doses are adjusted accurately. The right dosage is important in this disease. Also with it, do not skip doses or stop taking the drug, because of more chances of recurring hypothyroidism.

Levothyroxine Absorption

Certain medications, supplements, and even some foods may affect the absorption of levothyroxine. Consult the doctors if you are using soya products or high fiber diet or the medications such as

  • Iron supplements or multivitamins containing iron
  • Aluminum hydroxide, mostly in antacids
  • Calcium supplements

Levothyroxine gives the best result by taking it on an empty stomach on a daily basis. Generally, a person can take the hormone in the morning before eating and wait for an hour.  If a person is taking any other medications then can take them at bedtime but a four hours gap is required after the evening meal.

Take levothyroxine with a doctor's consultation.

Subclinical Hypothyroidism

If a person is suffering from subclinical hypothyroidism, discuss the treatment strategy with a competent doctor. For the significant increase of TSH, the treatment of subclinical hypothyroidism can be complicated. Special precautionary measures are needed.

 

Hypothyroidism is a preventable disease but if a person is diagnosed earlier and takes proper treatment on time. ISo, if you exhibit any concerning signs and symptoms of hypothyroidism, consult a medical professional as soon as possible.

 

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Last updated on Monday 21/11/2022

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