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The Call-On-Doc Guide to Hypothyroidism

Published on Apr 14, 2023 | 10:46 AM

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The thyroid is, on average, the size of a monarch butterfly, even though relatively small, your thyroid has a big impact on your entire body. Not only responsible for creating the hormones that affect your metabolism, but it also plays a part in how your bones, heart, nervous system, and other organs work.

If your thyroid is underperforming, you might have a condition called hypothyroidism, where your thyroid does not produce enough hormones. While that might sound frightening, it is relatively common. According to the National Institute of Diabetes and Digestive and Kidney Diseases, around 5 out of every 100 Americans have the condition, with the majority of cases being mild or difficult to notice. 

Like kidney disease or type 2 diabetes, many hypothyroidism symptoms in women and men are rarely noticed. That is because many of the symptoms often come naturally or are assumed to be a part of a common disease.  

What are the warning signs of hypothyroidism?

According to the United Kingdom’s National Health Service (NHS), many Hypothyroidism symptoms in women and men are seldom noticed early on. Additionally, the symptoms can be confused with those of other conditions as it progresses. When worrying about the condition, some hypothyroidism symptoms to look out for can include the following:

  • Increased cold sensitivity: Hypothyroidism can increase sensitivity to cold because the thyroid hormone helps regulate body temperature. When the thyroid gland doesn't produce enough thyroid hormone, it can slow the body's metabolism, decreasing heat production. As a result, people with hypothyroidism may feel colder than usual, even in relatively warm temperatures.
  • Depression: Hypothyroidism can cause depression because the thyroid hormone plays a role in regulating mood and brain function. When the thyroid gland doesn't produce enough thyroid hormone, it can slow down many bodily functions, including those in the brain. As a result, people with hypothyroidism may experience symptoms of depression, such as sadness, low energy, and difficulty concentrating.
  • Difficulty thinking clearly: The thyroid hormone is vital for the growth and development of the brain and for maintaining cognitive function throughout life. When thyroid hormone levels are low, it can lead to various cognitive symptoms, including difficulty concentrating, forgetfulness, and confusion.
  • Hair loss: Your thyroid hormone affects the growth and development of hair follicles. A reduction of production in the thyroid hormone can cause hair follicles to enter a resting phase, leading to hair thinning and eventual hair loss. In addition, hypothyroidism can also affect the health of the scalp, leading to dryness, itchiness, and inflammation, which can further contribute to hair loss, often through scratching.
  • Exhaustion: The thyroid hormone helps to regulate the body's metabolism, which is the process by which the body converts food into energy. When there is a deficiency in thyroid hormone, the body's metabolism slows down, leading to a decrease in energy production. This can result in fatigue and exhaustion, even with adequate rest and sleep.
  • Weight gain: Hypothyroidism can cause weight gain because the thyroid hormone plays a crucial role in regulating your metabolism, which is how the body converts food into energy. When the thyroid gland doesn't produce enough thyroid hormone, it can slow the body's metabolism, decreasing energy production.
  • Muscle Cramps: The thyroid hormone is essential for maintaining the proper balance of calcium in the body, which is needed for muscle contraction and relaxation. When there is a problem with the thyroid hormone, it can lead to imbalances in calcium levels, which can result in muscle cramps and spasms. In addition, hypothyroidism can also cause changes in the levels of other electrolytes, such as sodium, potassium, and magnesium, which can further contribute to muscle cramps.
  • Physical weakness: When the body gets less thyroid hormones, the body's metabolism slows down, leading to a decrease in energy production. This can result in feelings of physical weakness, even with adequate rest and sleep. In addition, hypothyroidism can cause muscle weakness and atrophy (degeneration of cells), which can further contribute to physical weakness. This is because the muscles require thyroid hormones to function properly, and getting fewer can cause the muscles to weaken and lose mass.
  • Dry skin: The thyroid hormone reduced by hypothyroidism affects the function of the sweat and oil glands, which help moisturize and protect the skin. When there is reduced production of thyroid hormones, these glands may not function properly, leading to a decrease in the production of sweat and oil. This can result in dry, itchy, and flaky skin.
  • Brittle nails: Hypothyroidism can also cause a decrease in blood flow to the nail bed, which can contribute to brittle nails. Furthermore, when there is a deficiency in thyroid hormone, the nail matrix may not function properly, leading to a decrease in the production of new nail cells. This can result in fragile, thin, and easily breakable nails.
  • Carpal tunnel syndrome: Hypothyroidism can contribute to the development of carpal tunnel syndrome in multiple ways. One example can be seen in the swelling or inflammation in the tissues around the carpal tunnel, which can pressure the median nerve. It can also lead to nerve function and blood flow changes, which can further contribute to nerve compression.
  • Constipation: When fewer thyroid hormones are produced, it can cause the muscle cells to contract more slowly, which can lead to slower movement of stool through the intestines and ultimately cause constipation. In addition, hypothyroidism can also cause a decrease in the secretion of digestive juices and enzymes that help break down food. Which can further contribute to the hypothyroid symptom in women and men.
  • Loss of libido: When there is a deficiency in thyroid hormone, it can cause a decrease in blood flow to the genitals, which can make it difficult to achieve or maintain an erection in men and decrease sexual desire or arousal in both men and women. 
  • Irregular or heavy periods: Hormones affected by hypothyroidism affect the levels of estrogen and progesterone in the body, the same hormones responsible for regulating the menstrual cycle. When the thyroid hormone is deficient, it can cause an imbalance in these hormones, leading to irregular or heavy periods.
what-are-the-warning-signs-of-hypothyroidism

What causes hypothyroidism?

According to the American Thyroid Association, a handful of hypothyroidism causes exist. They primarily have to do with the following:

  • Congenital hypothyroidism: Congenital hypothyroidism occurs when the thyroid gland fails to develop properly or is completely absent. Genetic factors, problems with the formation of the thyroid gland during fetal development, or exposure to certain medications or substances during pregnancy can cause this. Typically, the condition is screened for at birth.
  • Radiation: Radiation can damage the thyroid gland in several ways, including exposure to radiation therapy (such as chemo) and exposure to radiation from environmental disasters (such as nuclear accidents).
  • Thyroid gland removal: Thyroid removal is typically conducted to treat thyroid cancer, severe hyperthyroidism, or other thyroid disorders that do not respond to other treatments. In some cases, only a portion of the thyroid gland (part of or one of the two lobes) is removed, while in other cases, the entire gland (both lobes) is removed. This can lead to hypothyroidism if the remaining gland cannot provide enough thyroid hormones. 
  • Complications from autoimmune diseases: Autoimmune diseases can cause hypothyroidism through Hashimoto's thyroiditis. Hashimoto's thyroiditis is an autoimmune disease in which the body's immune system attacks the thyroid gland, causing inflammation and damage. Over time, this damage can lead to a decrease in the thyroid gland's ability to produce thyroid hormone, resulting in hypothyroidism.
  • Pituitary gland damage: The pituitary gland is located at the base of the brain and produces hormones that regulate various body functions, including the thyroid gland's production of thyroid hormone. If the pituitary gland is damaged, it may not produce enough thyroid-stimulating hormone (TSH), which is needed to stimulate the thyroid gland to produce thyroid hormone. This can lead to a decrease in the thyroid gland's function, resulting in hypothyroidism.
  • Lack of or too much iodine: Iodine is a mineral that is essential for the production of thyroid hormones. The thyroid gland uses iodine to produce the two main thyroid hormones, thyroxine (T4) and triiodothyronine (T3). These hormones help regulate many of the body's functions, including metabolism, growth, and development. Too much iodine causes the gland to be hyperactive, and too little reduces its production. 
  • Medication complications: Certain medications can interfere with the production or absorption of thyroid hormones, leading to hypothyroidism. For example, lithium, a medication commonly used to treat bipolar disorder, can damage the thyroid gland and cause hypothyroidism in some people. In addition, some medicines used to treat cancer, such as radioactive iodine and some chemotherapy drugs, can also damage the thyroid gland and lead to hypothyroidism. Additionally, some supplements like iron, calcium, and more interfere with the absorption of thyroid hormones. 
  • Thyroiditis: Thyroiditis is an inflammation of the thyroid gland that can cause hypothyroidism.
what-causes-hypothyroidism

What is the most common cause of hypothyroidism?

According to the National Institute of Diabetes and Digestive and Kidney Diseases, the most common cause of hypothyroidism is Hashimoto's thyroiditis, which is an autoimmune disease that causes inflammation and damage to the thyroid gland. In Hashimoto's thyroiditis, the immune system mistakenly attacks the thyroid gland, leading to a gradual loss of thyroid function and a decrease in thyroid hormone production.

Who usually gets hypothyroidism?

Hypothyroidism can affect people of any age, gender, or ethnicity, but some groups may be more likely to develop the condition than others. For example, women are more likely than men to develop hypothyroidism, particularly as they get older.

Hypothyroidism can also run in families, so so anyone with a family history of thyroid disease may be at increased risk. Additionally, people with autoimmune diseases, such as type 1 diabetes, rheumatoid arthritis, or lupus, may have a higher risk of developing hypothyroidism.

Other risk factors for hypothyroidism include previous thyroid surgery or radiation treatment, iodine deficiency, certain medications (such as lithium), and pregnancy. In rare cases, hypothyroidism may be present at birth (congenital hypothyroidism).

Diagnosis: How do you diagnose hypothyroidism?

The diagnosis of hypothyroidism typically involves a combination of blood tests and physical exams. The most common blood test used to diagnose hypothyroidism measures the levels of thyroid-stimulating hormone (TSH) and thyroxine (T4) in the blood.

TSH levels are often elevated in people with hypothyroidism, while T4 levels are decreased. Additional blood tests may also be performed to check for other thyroid hormones, such as triiodothyronine (T3), and thyroid antibodies. Such a test can help identify autoimmune causes of hypothyroidism. Not sure if you have hypothyroidism? You can get tested easily with Call-On-Doc here.

In addition to blood tests, a physical exam may also be used to diagnose hypothyroidism. During a physical exam, a healthcare provider may check for symptoms of hypothyroidism, such as dry skin, hair loss, and weight gain. They may also check for an enlarged thyroid gland or other abnormalities.

In some cases, imaging tests, such as an ultrasound or a radioactive iodine uptake test, may also help diagnose hypothyroidism or identify the condition's underlying cause.

What is the primary treatment for hypothyroidism?

Blood tests are the primary tool used to diagnose hypothyroidism. The most common tests used are:

  • Thyroid-stimulating hormone test: This test measures the level of TSH in the blood. High levels of TSH may indicate an underactive thyroid gland.
  • Thyroid hormone tests: These tests measure the levels of the thyroid hormones T3 (triiodothyronine) and T4 (thyroxine) in the blood. Low levels of these hormones may indicate an underactive thyroid gland.
  • Antibody tests: If a doctor suspects that an autoimmune disorder may cause hypothyroidism, they may order tests to measure levels of antibodies that attack the thyroid gland.

Once a diagnosis of hypothyroidism is confirmed, the doctor may perform additional tests to determine the condition's underlying cause. This may involve imaging tests like an ultrasound, CT scan, or thyroid gland biopsy.

At what TSH level should hypothyroidism be treated?

The American Thyroid Association recommends that treatment for hypothyroidism should be considered in adults with a TSH level above the upper limit of the reference range and who have symptoms of hypothyroidism or a TSH level above 10 mIU/L regardless of symptoms. The reference range for TSH can vary slightly between different labs but is typically around 0.4 to 4.0 mIU/L.

Can hypothyroidism be cured?

In most cases, hypothyroidism cannot be cured. However, it can be effectively managed with lifelong treatment, typically taking a daily dose of synthetic thyroid hormone. The goal of treatment is to restore normal levels of thyroid hormone in the body, which can alleviate symptoms and prevent complications associated with hypothyroidism.

What helps prevent hypothyroidism?

Unfortunately, there is yet to be a surefire way to prevent hypothyroidism in all cases. According to MedicalNewsToday, things you can monitor are not necessarily conducive to preventing hypothyroidism, with the best examples being diet control as well as checking the medications you take.

According to the American Thyroid Association, a way to reduce your chances of hypothyroidism or to reduce the condition’s severity before it develops is to maintain a healthy diet that avoids heavy intakes of fat and sodium. Additionally, the hypothyroidism diet is the same as one recommended ordinarily, but to be clear, it would include the following:

  • The daily recommended amount of water
    • One gallon minimum for men
    • 2.7 liters minimum for women
  • Dairy alternatives
    • Almond milk 
    • Soy milk
  • Healthy proteins
    • Beef
    • Chicken
    • Eggs
    • Venison
  • High-fiber starchy foods
    • Apples
    • Beans
    • Carrots
    • Corn
    • Bread
    • Cereal
    • Oats
  • Plenty of fruits and vegetables daily
    • Blackberries
    • Blueberries
    • Broccoli
    • Cranberries
    • Oranges
    • Kale
    • Raspberries
  • Unsaturated oils and spreads in small amounts
    • Coconut oil
    • Olive oil
what-helps-prevent-hypothyroidism

How can I boost my thyroid naturally?

While there is no guaranteed way to prevent hypothyroidism, there are some natural strategies that may help support thyroid function and promote overall health. Here are some tips:

  • Moderate caffeine: An overabundance of caffeine can negatively affect the thyroid gland, but consuming it in low to moderate amounts can alleviate early symptoms of hypothyroidism or when the thyroid gland is underperforming. 
  • Eat a balanced diet: Eating a diet that is rich in nutrients, especially iodine, selenium, and zinc, can help support thyroid function. While not a direct way to avoid the condition, a hypothyroidism diet is one of the best ways to improve your thyroid and overall health. 
  • Manage stress: Stress can negatively impact the thyroid gland and lead to hormonal imbalances. Finding ways to manage stress, such as through meditation, yoga, or other relaxation techniques, may help support thyroid function.
  • Regular exercise: Regular exercise can help promote healthy thyroid function and improve overall health. Doing so helps the body circulate hormones created by the thyroid gland and allows it to function at a sustainable level. 
  • Get enough sleep: Getting adequate sleep is important for overall health and will support thyroid function. On a daily basis, a person should get at least seven hours of sleep. 
  • Avoid exposure to toxins: The thyroid is an extremely sensitive part of the body that will be affected by what's consumed. While fluoride and chloride are not necessarily toxins, they play a huge role in agitating the gland. Other toxins to watch out for include lead, mercury, cadmium, and aluminum. 

Hypothyroidism can be difficult to self-diagnose but can have a huge impact on your body. If you think you or a loved one might be at risk for hypothyroidism, getting tested and appropriate treatment will help your overall day-to-day health and demeanor.

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Wayne C. Hahne,

English graduate and Call-On-Doc’s medical resource guide, Wayne C. Hahne is an experienced and passionate medical education content expert. Through diligent research, provider interviews and utilizing the industry's leading resources for wellness information, it is Mr. Hahne’s personal mission to educate the general public on medical conditions with in-depth and easy-to-understand written guides.

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