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Hypothyroidism: Treatment, symptoms, advice and help

About hypothyroidism

Hypothyroidism is an endocrinal condition in which there is diminished secretion of the thyroid hormone by the thyroid gland. The thyroid gland is located in the neck just below the voice box and secretes the thyroid hormone which is responsible for maintaining the metabolism of the body.

Hypothyroidism: Incidence, age and sex

Hypothyroidism is commonly encountered in the general population. Though it may affect an individual of any age, but individuals above the age of 40 years are more susceptible. Hypothyroidism is four times more frequent in women as compared to men.

Signs and symptoms of hypothyroidism: Diagnosis

Hypothyroidism manifests as vague and non-specific symptoms like brittle nails, dryness of hair and skin, intolerance to cold, constipation, weight gain, persistent exhaustion and lethargy. Psychological symptoms like irritability and depression are also commonly seen in affected individuals. Women may complain of abnormality in menstrual cycles. Longstanding hypothyroidism may exhibit decreased libido, hoarseness of voice, swelling of face and extremities and coarseness of facial features.

If a child is born with hypothyroidism, then he/she may manifest with developmental delay in milestones along with stunted physical and mental growth. Such a condition is called Cretinism and the affected child is called a cretin.

A detailed history and physical examination, including palpation of the thyroid gland leads to suspicion of diagnosis. The suspicion is confirmed by a blood test which assesses the levels of the thyroid stimulating hormone (TSH) and the thyroxine (T4).

Causes and prevention of hypothyroidism

Several causes may lead to hypothyroidism, of which an inflammatory cause afflicting the thyroid gland is the commonest. Autoimmune, Hashimoto’s and post partum (after delivery) thyroiditis are three such inflammatory conditions which damages the thyroid tissue, subsequently resulting in hypothyroidism. Other causes include, damage to the thyroid gland by radioactive iodine or radiation treatment in the neck. Surgical removal of the thyroid gland tissue is also responsible for hypothyroidism. Sometimes, disorder of the pituitary gland causes diminished secretion of the thyroid stimulating hormone (TSH) which subsequently results in decreased secretion of thyroid hormone by thyroid gland.

Hypothyroidism: Complications

Hypothyroidism, if ignored, may progress to critical levels of thyroid hormone in the blood leading to a condition called ‘myxoedema coma’ which is rare but potentially life-threatening. The affected individual may require immediate thyroid hormone replacement in intravenous form along with supportive management. Other complications of hypothyroidism include infertility in women and heart failure.

Hypothyroidism: Treatment

The goal of treatment of hypothyroidism is to replace the deficient thyroid hormone. Levothyroxine is the most common agent used. Periodic monitoring of blood levels of thyroid hormone to assess and adjust the dosage is needed. Hypothyroidism needs lifelong treatment and close monitoring of the dose of medication and the hormone levels in the blood, especially in heart patients.