Hypothyroidism (underactive Thyroid) - Symptoms, Causes and Treatment
Written By: Dr. Yasmeen Ajaz
Updated On:January 30, 2025
What is Hypothyroidism?
The thyroid, a tiny gland that resembles a butterfly, sits at the base of the neck, directly below the Adam's apple. Thyroxine (T-4) and triiodothyronine (T-3) are the two primary hormones produced by the thyroid gland. All of the body's cells are impacted by these hormones. They facilitate the body's use of lipids and carbs at different rates, they aid in regulating body temperature, and they impact heart rate. Also, the hormones aid in regulating the body's production of protein. Hypothyroidism occurs when the thyroid gland does not make enough of these necessary hormones.
Causes of Hypothyroidism
Below is a list of conditions that can result in hypothyroidism.
- Autoimmune Diseases: The thyroid gland may be involved in autoimmune diseases, impacting the gland's hormone-producing capacity.
- Thyroid surgery: Thyroid hormone production can be reduced or stopped entirely via surgery that removes all or part of the gland.
- Radiation treatment: Treatment for head and neck tumors with radiation might damage the thyroid gland and cause hypothyroidism.
- Thyroiditis: An inflammation in the thyroid gland might lead the thyroid to release all of the thyroid hormones it has accumulated, leading to hypothyroidism.
- Medication: Many medications, such as lithium, may have the potential to cause hypothyroidism.
Less often, hypothyroidism may be caused by problems present at birth, pituitary disorder, pregnancy, and lack of iodine.
Symptoms of Hypothyroidism
Hypothyroidism symptoms may include the following:
- Dull skin and hair
- Indigestion
- Depression
- Dry skin
- Hoarseness in voice
- Memory problems
- An irregular or heavier-than-normal menstrual period
- Increased sensitivity to cold
- Tenderness, soreness, and stiffness in the muscles
- Weakness in the muscles
- Swollen face
- Bradycardia, or a slowed heart rate
- Hair thinning
- Fatigue
- Gain in weight
When to see a doctor for Hypothyroidism?
If you are experiencing fatigue without any apparent cause or if you exhibit further signs of hypothyroidism, consult your physician.
When using thyroid hormone medication for hypothyroidism, heed the advice of your healthcare professional regarding the frequency of your check-ups. To ensure you're getting the proper dosage of medication, you might first need to schedule routine visits. You could require examinations in the future so that your physician can keep an eye on your condition and prescriptions.
Hypothyroidism Risk Factors
Though hypothyroidism may happen to anyone, the following factors put you at higher risk:
- are a female
- possess a family medical history of thyroid issues
- possess an autoimmune condition, such as celiac disease or type 1 diabetes.
- have had hyperthyroidism therapy
- radiation treatment to the upper chest or neck
- have undergone thyroid surgery
Hypothyroidism Complications
Left untreated, hypothyroidism may lead to the following:
- The thyroid gland may enlarge as a result of hypothyroidism, a condition referred to as a goiter.
- An increased risk of heart disease and heart failure can result from hypothyroidism. This is mostly because individuals who have an underactive thyroid often have elevated levels of low-density lipoprotein.
- Peripheral nerve injury can occur from long-term untreated hypothyroidism. In the arms and legs, peripheral neuropathy can result in pain, tingling, and numbness.
- Insufficient thyroid hormone can cause ovulation to be impeded, hence reducing fertility.
- Newborns born to adults with untreated thyroid disease may be more likely to develop birth abnormalities. Untreated hypothyroidism at birth puts infants at risk for severe issues with their physical and mental development.
- Long-term hypothyroidism medication without improvement can result in this uncommon but potentially fatal illness, myxedema.
Hypothyroidism Diagnosis
Individual differences may exist in the symptoms of hypothyroidism. Moreover, they frequently resemble the signs of other medical conditions. As a result, symptoms alone are not sufficient for diagnosing hypothyroidism. Usually, it is determined by the outcomes of blood tests.
TSH levels are measured in the blood as part of the initial blood test usually performed to identify hypothyroidism. The test is repeated and a blood test for the thyroid hormone T-4 is performed if the result is high. Hypothyroidism is the diagnosis if the test results reveal a high TSH and a low T-4. There are instances where measuring the thyroid hormone T-3 is also possible.
Subclinical hypothyroidism is the diagnosis made if the second test reveals elevated TSH but normal T-4 and T-3 levels. Usually, it has no discernible symptoms.
TSH levels are crucial for long-term management of hypothyroidism. They assist your healthcare professional in determining and keeping you on the appropriate drug dosage.
Hypothyroidism Treatment
Taking the thyroid hormone medication levothyroxine (Levo-T, Synthroid, among others) daily is the standard treatment for hypothyroidism. You take this medication orally. It ends the signs and symptoms of hypothyroidism by bringing hormone levels back to a normal range. Within a week or two of starting treatment, you should start to feel better. Levothyroxine therapy is probably going to last a lifetime. Every year, your healthcare professional may check your TSH level since the dosage of levothyroxine you require may fluctuate.
Hypothyroidism Prevention
Hypothyroidism is unavoidable. Watching for signs of hypothyroidism is the best approach to avoid getting a bad case of the ailment or having the symptoms seriously interfere with your life. The best course of action is to consult your healthcare physician if you encounter any of the symptoms associated with hypothyroidism.
References
Chiovato, L., Magri, F., & Carlé, A. (2019). Hypothyroidism in context: where we’ve been and where we’re going. Advances in therapy, 36, 47-58.
Dunn, D., & Turner, C. (2016). Hypothyroidism in women. Nursing for women's health, 20(1), 93-98.
McAninch, E. A., & Bianco, A. C. (2016). The history and future of treatment of hypothyroidism. Annals of Internal Medicine, 164(1), 50-56.
Vaidya, B., & Pearce, S. H. (2008). Management of hypothyroidism in adults. Bmj, 337.
Wilson, S. A., Stem, L. A., & Bruehlman, R. D. (2021). Hypothyroidism: Diagnosis and treatment. American Family Physician, 103(10), 605-613.
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