The thyroid is a butterfly-shaped gland of the endocrine system, located in the front part of the neck, above the trachea. Its function is to produce thyroid hormones (T4 and T3).
T4 and T3 reach all the body cells through the bloodstream to control and regulate their metabolism; they carry out the rhythm with which the various bodily processes and reactions. For example, thyroid hormones help the body use and consume energy, maintain body temperature, and help muscles and organs such as the brain and heart function properly.
What Is Hypothyroidism?
‘Hypothyroidism‘ is a body dysfunction that causes the thyroid gland not to produce enough ‘Thyroid Hormones .’ Therefore, the body cannot function normally, and organic activity decreases or slows down.
Another consequence of the decrease in T3 and T4, in the case of primary thyroid insufficient, is an increased secretion of TSH, the thyroid-stimulating hormone. Its production we notice in the pituitary gland. The production of TSH is the body’s way of up-regulating or down-regulating the production of thyroid hormones. It works like the one in charge of an “assembly chain.” Suppose the production of these hormones is excessive. In that case, the TSH concentration decreases, and the thyroid cells work less in the production of T4 and T3. On the contrary, we observe if the levels of T4 and T3 decrease, TSH increases its presence. Thus the performance of the thyroid gland does not decrease.
In this way, the doctor will consider the levels of T4 and the level of TSH, since, for example, this indirectly allows -indirectly- to detect that the thyroid gland is not working within the appropriate limits. Even if the levels of T3 and T4 remain stable, we will see what happens in cases of mild thyroid failure.
Although there is no cure, it is commonly an easy-to-control disease. Only if it is not diagnosed and treatment is not given, the symptoms derived from hypothyroidism intensify in extreme situations. It can progress to generalized swelling, heart failure, and respiratory failure.
What Types Are There?
There are two main types of thyroid insufficient, depending on whether the problem is in the thyroid gland itself or the production of thyrotropin. TSH, produced in the pituitary gland and TRH, produced in the hypothalamus and which in turn regulates the production of TSH in the pituitary:
It is the most common, representing approximately 95% of cases, due to some damage or alteration in the thyroid. Also, it even damages the cells that produce the thyroid hormone itself in the gland. Various diseases, lack of Iodine in food and water, excessive intake, taking medications, and other conditions can work.
It represents 5% of cases of hypothyroidism. The decreased secretion of TSH is due to alterations in secondary hypothyroidism or tertiary thyroid insufficient.
Occasionally, we can diagnose mild thyroid failure as a mild thyroid gland failure. Also, we define it as the situation that occurs with elevated TSH but with normal circulating T4. In these cases, it maintains an attitude of observation. Although previously thought to be symptom-free, it currently only considers hormone levels, regardless of whether or not there are symptoms. It is not usually necessary to supplement with external thyroid hormone. Still, periodic monitoring by the doctor is necessary, who will decide when it is convenient to start the medication.
Who Gets Hypothyroidism?
According to data from the reports, it is a disease that most frequently affects the female sex, as 2% of adult women suffer from it, compared to 0.1-0.2% of men. It usually develops after 40 or 50, especially when its cause is autoimmune.
What Are The Causes?
Various causes can cause hypothyroidism:
The universal characteristic is a condition called ‘Hashimoto’s thyroiditis.’ It causes the immune system. The immune system defends the body against foreign infections to mistake the thyroid cells and their enzymes from invaders and attack them. Another autoimmune disease that can cause hypothyroidism is atrophic thyroiditis.
A condition caused by a problem in the immune system or by a viral infection causes thyroid inflammation and, consequently, the thyroid hormones are released suddenly. It causes short-term hyperthyroidism, which then leads to hypothyroidism.
Although it is not common, it is the most frequent endocrine disorder in newborns. Its causes are iodine deficiency. In those places with sufficient Iodine, the most common is to be born without a thyroid gland or only partially formed or in the wrong place.
Transient includes postpartum thyroiditis, silent thyroiditis, and giant cell thyroiditis. Commonly, some women develop hypothyroidism ‘during or after pregnancy’ since their body produces antibodies that attack the thyroid gland. Therefore, they require special control and monitoring by the endocrinologist for the proper development of the pregnancy.
For example, lithium and interleukin-2 can trigger hypothyroidism, though usually only in those with genetic susceptibility. Also, some cough suppressants, syrups, contrast media containing Iodine, and some antiseptics can antibiotics it.
Inflammation Of The Pituitary Gland
Hypophysis is a disorder in this gland that prevents enough TSH hormones.
Too Much Or Too Little Iodine
The body uses Iodine, a mineral, to make thyroid hormones. For this reason, and although it is important to include iodized salt in our diet, we should take it in moderation.
Surgical Reduction Of Part Or All of The Thyroid Gland
This intervention may be necessary in the case of thyroid nodules, thyroid cancer, or Graves’ disease.
It can be radioactive Iodine -administered to treat diseases mentioned in the previous point- or radiation -used to treat Hodgkin’s disease, lymphoma, or head or neck cancers.
And diseases that occur with the appearance of deposits of substances in the thyroid prevent it from performing its function correctly.
What Symptoms Does Hypothyroidism Produce?
The symptoms of hypothyroidism usually appear gradually and tend to develop progressively. Among the most common are:
- Apathy, indifference, or, sometimes, depression.
- Weight gain: because the cells burn less energy.
- Dry skin and hair, with fragile and brittle hair and nails.
- Finding “bad” cholesterol levels in a general analysis.
- Tiredness and/or drowsiness.
- Reduced ability to concentrate, memory failures, and forgetfulness.
- Greater sensitivity to cold.
- Hoarse voice and swollen face.
- Muscle pain and/or cramps.
- Stiffness or swelling in the joints.
- In women, menstrual disorders.
All the above symptoms can go unnoticed since they are non-specific. They can be common to other pathologies and are often a reflection of a “slowing down” of the body’s functioning.
Can Complications Occur?
If treatment is not given, hypothyroidism can present various complications:
- Goiter is an enlarged thyroid. Externally, a tumor may appear in the lower front part of the neck, below the larynx. Sometimes this lump can press on the trachea and cause problems with swallowing or breathing.
- Increased cholesterol in the blood increases the risk of coronary heart disease and arteriosclerosis.
- It can lead to heart failure in advanced stages.
- If we cannot treat depression or apathy sufficiently, we cannot treat mental health problems well.
- In women, it can cause lower fertility or even sterility.
- In poorly controlled pregnant women, hypothyroidism increases the risk of miscarriage or increased mortality in babies. It is also so with an increased risk of hypertension in pregnant women. Babies of hypothyroid mothers, whom we do not treat, can have congenital disabilities.
- Myxedema arises Rarely. Its characteristic elements are ‘Generalized Swelling,’ great sensitivity to cold, hypothermia-drowsiness, ‘slow heart rate,’ depression, and ‘respiratory failure.’ Sometimes it may also lead to a state of ‘coma,’ and it may be fatal.
Although it is a chronic disease, hypothyroidism is controllable with treatment along with medication for life.
Pharmacological treatment for hypothyroidism is available on substituting the T4 hormone that the thyroid cannot produce by T4 through taking a daily dose. In this case, instead of being produced within us, it is administered in the form of medication. This treatment is the most important pillar for the different organs and devices to continue performing their functions, encouraged by the thyroid hormone. This way, it regulates the hormone levels, and the metabolism returns to normal. Likewise, it reduces cholesterol, and if there has been weight gain, we find its usual reversal.
It is a permanent treatment for hypothyroidism that must be controlled periodically by a doctor. Still, it allows hypothyroidism to lead a completely normal life in most cases.
To keep your thyroid hormone levels stable, it is important never to skip your daily medication intake. It will also help inform the doctor if you ingest drugs or supplements that can interfere with the body’s ability to assimilate thyroxine, such as soy or fiber ingested in large quantities, iron or calcium supplements, or aluminum hydroxide we find in some antacids.