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Sheela Nayak came to my clinic with complaints of extreme tiredness, breathlessness, swelling of legs and feet, dryness and itching of skin and extreme hair loss. What was this due to? I then advised her to do a few blood tests. One of them was Thyroid profile [T3, T4, TSH]. These were the findings-
- Hemoglobin level- 8.6g%;
- Blood sugar fasting- 100 mg/dl;
- TSH- 13.9 [normal range0.3 to 5.5].
There you are- it was the raised TSH that showed she suffered from Hypothyroidism.
Hypothyroidism is a condition caused by insufficient levels of thyroxine (T4) and triiodothyronine (T3). It can lead to a number of different complications.
The symptoms of hypothyroidism include fatigue, increased weight, hair loss, dry skin and depression.
Left untreated, the disease may cause serious consequences. It may even lead to death. Here’s what you need to know about hypothyroidism and its treatment options:
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What is Hypothyroidism?
Hypothyroidism is a condition caused by insufficient production of thyroid hormone by the thyroid gland. This hormone regulates metabolism in the body.
About 60% of the world’s population will have some degree of hypothyroidism at some point in their lives. It can be caused by Hashimoto’s disease, which leads to the destruction of the thyroid gland.
It can also be caused due to other conditions, such as autoimmune diseases such as certain types of cancer, radiation therapy, surgery, pituitary disorders.
Signs and Symptoms
The signs and symptoms of include-
- fatigue,
- weight gain,
- hair loss,
- dry skin,
- constipation, and
- feeling depressed
- decreased heart beats, known as bradycardia
- rise in blood pressure
Other common signs and symptoms include-
- Having difficulty concentrating or remembering things,
- Feeling cold all the time,
- Trouble sleeping,
- Feeling restless,
- Having trouble losing weight,
- Puffiness in the face and around the eyes,
- Muscle cramps,
- Joint pain,
- Hoarseness of voice
- Swelling in the fingers or around the eyes, and
- Menstrual irregularities in women.
A majority of people who have this condition have no idea that they have it. In fact, about 60% of those diagnosed don’t know that they have it.
Investigations in hypothyroidism
A thyroid stimulating hormone (TSH) blood test is used to diagnose this disease. In addition to this, other tests may be performed to rule out other conditions that can cause symptoms similar to this illness.
These tests include an ultrasound of the thyroid gland and tests for autoimmune disorders such as anti-TPO and anti-TG antibodies.
Learn all about investigations of hypothyroidism and their interpretations here-
Possible Complications of Hypothyroidism
Although most people with this disease do not have any complications, some people may experience complications. These include: –
- Complications during Pregnancy: Untreated hypothyroidism can pose health risks to both the mother and the fetus. It can increase the risk of an early delivery, miscarriage, low birth weight, and low IQ in infants. –
- Cardiovascular disease: People with this disease have a higher risk of developing cardiovascular disease. –
- Obesity: Untreated hypothyroidism can lead to weight gain. –
- Osteoporosis: It can reduce bone mineral density, increasing the risk of osteoporosis.
- Increased risk of depression and anxiety: People with hypothyroidism are at an increased risk of developing depression and anxiety. –
- Impaired cognitive function: People may experience impaired cognitive function.
- Sleep problems: Some people may experience sleep problems. –
- Skin problems: Some may experience skin problems such as splinter hemorrhages, dry skin, and brittle nails.
What is sub-clinical hypothyroidism?
This is a condition wherein the TSH is just above the higher limit and early signs of hypothyroidism like weight gain, dry skin, lethargy is visible. It is somewhat similar to conditions like pre-diabetes and pre-hypertension. Here the treatment consists of lifestyle changes like avoiding some foods that may trigger or cause hypothyroidism.
Why is it important to treat hypothyroidism?
Untreated hypothyroidism can have long-term consequences that affect both health and quality of life. It can increase the risk of major health problems such as cardiovascular disease, osteoporosis, and developmental problems in children born to mothers with hypothyroidism. It can also negatively impact mental health and well-being. With early diagnosis and treatment, most people can lead a normal life without any complications.
Treatments for Hypothyroidism
Treatment depends on the severity of the condition. Mild forms of hypothyroidism can be treated with lifestyle changes and medications. People with moderate or severe forms may require lifelong treatment with thyroid hormone replacement. Lifestyle changes that can help reduce the symptoms include increasing physical activity and eating a healthy diet. Patients with this disease should avoid consuming high amounts of caffeine and alcohol, as these substances can exacerbate symptoms.
Medication for hypothyroidism
The medicines for this disease should be had only after consultation with your family Physican or an endocrinologist. The table below is a list of some medicines that I prescribe to my patients. Please read the effects and side-effects.
Table 1.
| Brand name | Content | Strength [in mcg] | Side effects |
|---|---|---|---|
| ELTROXIN | Thyroxine Sodium | 12.5, 25, 50, 75, 88 100, 112.5. 125, 150 |
None in hypothyroid treatment. May lead to hyperthyroidism if dosage not regulated |
| THYRONORM | Same as above | Same as above | Same as above |
| THYROX | same as above | Same as above | Same as above |
How do I initiate treatment of my hypothyroid patients?
After proper evaluation of the patient clinically as well as with proper investigation, I initiate treatment for the patient in the following way-
Those having slightly raised TSH, I usually do not prescribe any medicines if the sign- symptoms are mild. The patient is again reevaluated after 3 months and if the reports for TSH is high, a low dose thyroxine of 25mcg is given. Again after 3 months, if there has been significant improvement, the dosage is maintained as it is.
If the TSH value is way too high, an initial dose of 50mcg thyroxine is given. After 3 months, if there is no improvement or the improvement is marginal, the dose is increased by 25mcg and repeated every 3 months till TSH comes to normal levels.
Final Words
Hypothyroidism is a condition caused by insufficient levels of thyroid hormone. It can lead to a number of different complications.
The symptoms include fatigue, increased weight, hair loss, dry skin, and depression. Early diagnosis and treatment can prevent complications such as cardiovascular disease, developmental problems in children, obesity, and impaired cognitive function.
If you or a loved one experience some or all of these symptoms, it is important to see your doctor for an evaluation.
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Useful resources – Hypothyroidism signs and symptoms
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