HYPOTHYROIDISM

Hypothyroidism (under-active thyroid) is a condition in which your thyroid gland doesn't produce enough of certain important hormones. Hypothyroidism upsets the normal balance of chemical reactions in your body.

RISK FACTORS [3]

  • Women have been seen to have a higher risk than men.

  • Risk increases with age especially if you are over sixty years of age.

  • Having a family history of any thyroid disease increases your risk as well as having a first-degree family member who has hypothyroidism.

  • Autoimmune diseases such as type 1 diabetes or celiac disease has been seen to increase the risk.

    • NOTE: Celiac disease is an autoimmune disease that is inherited. An inflammatory reaction occurs after eating gluten activates the immune system. This immune response attacks the small intestine and as a results causes damage to it. [6]

  • Receiving radiation therapy to your neck or upper chest increase the risk.

  • Being treated with radioactive iodine or anti-thyroid medications may cause hypothyroidism if the dosage is exceeded.

  • Surgery to the thyroid may cause hypothyroidism.

  • Pregnancy of six months postpartum may cause hypothyroidism.

CAUSES [4;5]

  • Thyroiditis: which is inflammation of the thyroid gland, which leaves some of the cells of the gland damaged or dead and unable to produce sufficient hormone.

  • Certain medications such as those needed to treat heart problems, psychiatric conditions and cancer may have an effect on the production of the thyroid hormone.

  • Having too little iodine in the diet, as the body does not produce it and it is necessary for the production of the thyroid hormone.

  • Born with a thyroid gland that did not develop properly and thus it is unable to perform its function properly.

  • Having a pituitary disease or damage to the pituitary can cause hypothyroidism as the pituitary releases a hormone which stimulates the production of the thyroid hormone.

  • A rare cause would be a disease of the hypothalamus which releases a hormone that stimulates the pituitary and thus the production of the thyroid hormone.

  • Other factors that cause hypothyroidism are those mentioned in risk factors such as an over -response to hyperthyroidism treatment, thyroid surgery, radiation therapy and pregnancy.

SIGNS AND SYMPTOMS

  • Fatigue

  • Increased sensitivity to cold

  • Constipation

  • Dry skin

  • Weight gain

  • Puffy face

  • Hoarseness

  • Muscle weakness

  • Elevated blood cholesterol level

  • Muscle aches, tenderness and stiffness

  • Pain, stiffness or swelling in your joints

  • Heavier than normal or irregular menstrual periods

  • Thinning hair

  • Slowed heart rate

  • Depression

  • Impaired memory

 

COMPLICATIONS OF UNTREATED HYPOTHYROIDISM

  • Goiter - constant stimulation of your thyroid to release more hormones may cause the gland to become larger.

  • Heart problems - increased risk of heart disease, primarily because high levels of low-density lipoprotein (LDL) cholesterol — the "bad" cholesterol - Hypothyroidism can also lead to an enlarged heart and heart failure.

  • Mental health issues - depression and slowed mental functioning.

  • Peripheral neuropathy - damage to the nerves that carry information from your brain and spinal cord to the rest of your body, for example, your arms and legs. Signs and symptoms of peripheral neuropathy may include pain, numbness and tingling in the area affected by the nerve damage. It may also cause muscle weakness or loss of muscle control.

  • Myxoedema - rare, life-threatening condition is the result of long-term, undiagnosed hypothyroidism. Its signs and symptoms include: low blood pressure, decreased breathing, decreased body temperature, unresponsiveness and even coma.

  • Infertility - Low levels of thyroid hormone can interfere with ovulation

  • Birth defects - babies born to women with untreated thyroid disease have a higher risk of birth defects - intellectual and developmental problems

LIFESTYLE CHANGES [1;2]

  • Eating healthy and small regular meals that will give you energy throughout the day is essential. There isn’t a specific diet for hypothyroidism, but emphasis is put on having meals around veggies, fruits, whole grains, lean protein and healthy fats.

  • Talk to your doctor about foods such as high fibre foods and supplements such as iron or calcium that can affect absorption of levothyroxine, before you attempt to take them.

  • Talk to your doctor about taking iodine supplements. Iodine is required to produce the thyroid hormone and a deficiency in it can cause hypothyroidism. Iodine is usually found in iodized salts and other foods such as cheese, soy sauce, saltwater fish, eggs, etc. Iodine supplements in the form of potassium iodide or sodium iodide or those containing kelp or spirulina are a good source of iodine.

  • Regular exercise is important to maintain a healthy weight, boost energy and decrease stress. Focus on aerobic exercises, strengthening and flexibility. Try to exercise for about 30 minutes a day, five times a week.

  • Manage your stress with meditation, deep breathing exercises, massages, yoga, etc.

  • Hypothyroidism can make you feel tired and drained throughout the day. Having a sleep schedule and sticking to it may help. Try to sleep for about seven to nine hours everyday regardless of the time you go to sleep.

  • Take medications as prescribed by the doctor. Do not miss dosages and make sure you have regular visits to the doctor for proper management.

REFERENCES

  1. Gentile, J.M. [Internet]. 4 Lifestyle Tips for Hypothyroidism. America: Remedy Health Media LLC; [updated 2019; cited 2019 Aug 15]. Available from: https://www.endocrineweb.com/conditions/hypothyroidism/4-lifestyle-tips-hypothyroidism.

  2. Rodriguez, D. [Internet]. 8 Ways to live better when Diagnosed with Hypothyroidism. New York, US; [updated 2017 Oct 27; cited 2019 Aug 15]. Available from: https://www.everydayhealth.com/hs/healthy-living-with-hypothyroidism/live-better-pictures.

  3. Mayo Clinic Staff [Internet]. Hypothyroidism underactive thyroid). America: Mayo Clinic; [updated 2018 Dec 04; cited 2019 Aug 23]. Available from: https://www.mayoclinic.org/diseases-conditions/hypothyroidism/symptoms-causes/syc-20350284.

  4. Norman, J. [Internet]. Hypothyroidism: Overview. Causes and Symptoms. New Jersey: endocrineWeb; [updated 2019 Jul 10; cited 2019 Aug 23]. Available from: https://www.endocrineweb.com/conditions/thyroid/hypothyroidism-too-little-thyroid-hormone.

  5. WebMD [Internet]. Hypothyroidism. America: WebMD LLC; [updated 2019 Aug 16; cited 2019 Aug 23]. Available from: https://www.webmd.com/women/hypothyroidism-underactive-thyroid-symptoms-causes-treatments#1.

  6. Celiac Disease Foundation [Internet]. What is Celiac Disease?. America: Celiac Disease Foundation; [cited 2019 Aug 26]. Available from: https://celiac.org/about-celiac-disease/what-is-celiac-disease/.

  7. Leonard, J. [Internet]. 12 signs and symptoms of hypothyroidism. United Kingdom: Healthline Media; [updated 2019 Feb 25; cited 2019 Sep 12]. Available from: https://www.medicalnewstoday.com/articles/324535.php.

  8. Shamon, M. [Internet]. Diet and Weight Loss Tips for Thyroid Patients. America: verywell health; [updated 2019 Sep 04; cited 2019 Sep 12]. Available from: https://www.verywellhealth.com/diet-and-weight-loss-tips-for-thyroid-patients-3233060.

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