What is hypothyroidism?

Hypothyroidism, also referred to as underactive thyroid, or low thyroid, is a common endocrine disorder whereby the thyroid gland fails to produce enough thyroid hormone to regulate many important processes, including metabolism. This hormonal deficit slows the body down, affecting appetite, body temperature, energy level, cognitive function, and reproductive cycles (in women of childbearing age).

Many types of hypothyroidism exist, but Hashimoto’s thyroiditis is the most common thyroid disorder, when the body’s own immune system attacks the thyroid gland by mistake.

Signs and Symptoms of Hypothyroidism

• Slow pulse
• Fatigue
• Hoarse voice
• Slower speech
• Goiter, due to swollen thyroid gland
• Sensitivity to cold
• Weight gain
• Constipation
• Shortness of breath
• Chest tightness
• Aching joints
• Need for more sleep
• Fingers and toes cold
• Dry, scaly, thick, or coarse hair
• Thinning hair
• Outside third of eyebrows thinning
• Numbness in fingers or hands
• Confusion, memory difficulties
• Depression
• Dementia
• Headaches
• Menstrual irregularities

In children, possible symptoms may include:

Delayed growth, delayed teething, and slow mental development^[1]

Who gets hypothyroidism and why?

Women are five to eight times more likely to get hypothyroidism than men, as well as individuals over the age of 50.

The number one cause of hypothyroidism is iodine deficiency worldwide. In developed countries such as the U.S. however, iodine is plentiful in the diet and not considered a major contributing factor to the disease. Instead, thyroiditis, or swelling and inflammation indicating damage to cells within the thyroid gland may be caused from:

• Immune system attacks on the thyroid gland
• Viral infections, such as cold and respiratory infections

Other reasons for hypothyroid may be:

• Pregnancy or postpartum thyroiditis
• Medications, including lithium and amiodarone
• Congenital defects
• Radiation treatments for cancer to areas surrounding the neck or brain
• Surgical removal of part or all of the thyroid gland
• Sheehan syndrome, (heavy bleeding during pregnancy/childbirth) destroys pituitary gland
• Tumor on the pituitary gland or pituitary surgery^[5][4]

What methods are used to treat hypothyroidism?

The standard form of treatment for hypothyroidism is daily oral administration of levothyroxine (LT4). This is the generic form of “Synthroid”, “Levothroid”, “Tirosint”, “Unithroid”, “Levoxyl”, and “Novothyrox”. Levothyroxine is a synthetic hormone that may take up to six weeks (for the full effect of the drug) to be felt.^[6][3]

Although hypothyroidism cannot be cured, it can be controlled, as long as replacement thyroid hormone, (T4) is taken regularly for the remainder of an individual’s life. In certain cases of extreme life-threatening hypothyroidism, as with severe myxedema, patients must be admitted for in-patient hospital treatment. Synthetic thyroid is identical to that of natural thyroxine produced by the thyroid gland.^[7]

Self-check for Hypothyroidism

Before discussing signs and symptoms of hypothyroidism with your healthcare provider, there are a few things you can do at home to check for underactive thyroid.

1. Place a pencil vertically at the outside corner of your eye. If your eyebrow does not extend naturally beyond the pencil tip over the eye, then you may have hair loss due to hypothyroidism.
2. Before getting out of bed in the morning, and with minimal movement, take your axillary (under the armpit) temperature for 5 consecutive days. If the average is not greater than 97 degrees Fahrenheit AND you are experiencing some of the symptoms listed above, you may be suffering from hypothyroidism.
3. Check elbows, knees and (for women) under the breasts, for dry, or flakey skin that has a doughy consistency. If skin cannot be treated with a skin moisturizer, this could be a sign of hypothyroidism.

Although more than half of an estimated 20 million Americans with hypothyroidism never seek treatment, symptoms can become life threatening.^[2] Hypothyroidism can lead to higher than normal bad cholesterol, increasing the risk of stroke or heart attack. It can also cause pericardial effusion, or fluid build-up around the heart, making it more difficult for the heart to pump blood. Another rare, but serious condition referred to as, “myxedema” occurs when metabolism slows to the point that an individual falls into a coma. The key to avoiding more serious complications from hypothyroidism is early detection through blood tests and thyroid screenings.