Hypothyroidism is a condition in which the thyroid gland does not produce enough thyroid hormone. It is the most common thyroid disorder.
The thyroid is a butterfly-shaped gland in the middle of the neck, located below the larynx (voice box) and above the clavicles (collarbones).
The thyroid produces two hormones, which regulate how the body uses and stores energy (also known as the body’s metabolism).
Thyroid function is controlled by a gland in the brain, known as the pituitary. The pituitary produces a hormone, which stimulates the thyroid to produce these thyroid hormones.
In about 95 per cent of cases, hypothyroidism is due to a problem in the thyroid gland itself. However, certain medications and diseases can also decrease thyroid function. Hypothyroidism can also develop after medical treatments for hyperthyroidism (disease where thyroid produces excessive thyroid hormones), such as thyroidectomy (surgical removal of the thyroid) or radioactive iodine treatment (to destroy thyroid tissue). In some cases, hypothyroidism is a result of decreased production of thyroid-stimulating hormone (TSH) by the pituitary gland in the brain.
Thyroid problems are more common in women, increase with age, and are more common in whites and Mexican Americans than in blacks.
The symptoms of hypothyroidism vary widely; some people have no symptoms while others have dramatic symptoms or, rarely, life-threatening symptoms. The symptoms of hypothyroidism are notorious for being nonspecific and for mimicking many of the normal changes of aging. Usually, symptoms are milder when hypothyroidism develops gradually.
Thyroid hormone normally stimulates the body’s metabolism, and most of the symptoms of hypothyroidism reflect slowing of metabolic processes. Most people with hypothyroidism will feel tired. That can make the condition hard to diagnose, because a lot of conditions can make you tired.
Other symptoms of hypothyroidism include; lack of energy, getting cold easily, weight gain, developing coarse or thin hair and getting constipated a lot (having too few bowel movements).
If it is not treated, hypothyroidism can also weaken and slow your heart. This can make you feel out of breath or tired when you exercise and cause swelling (fluid buildup) in your ankles. Untreated hypothyroidism can also increase your blood pressure and raise your cholesterol—both of which increase the risk of heart trouble.
In women, hypothyroidism can disrupt monthly periods. It can also make it hard to get pregnant. In women who do get pregnant, hypothyroidism can cause problems. For instance, it can increase the chances of having a miscarriage and having a baby with low intelligence.
In the past, hypothyroidism was not diagnosed until symptoms had been present for a long time. However, simple blood tests can now detect hypothyroidism at an early stage. A person may be tested for hypothyroidism if there are signs and symptoms.
In developed settings, newborn babies are routinely screened for thyroid hormone deficiency.
The goal of treatment for hypothyroidism is to return blood levels of these deficient hormones to the normal range and to alleviate symptoms.
The treatment for hypothyroidism is thyroid hormone replacement therapy. This involves taking thyroid hormone pills every day. After taking the pills for about 6 weeks, the doctor will test one’s blood to make sure the levels are where they should be. He or she may adjust the dose depending on the results. Most people with hypothyroidism need to be on thyroid pills for the rest of their life.
In most cases, symptoms of hypothyroidism begin to improve within two weeks of starting thyroid replacement therapy. However, people with more severe symptoms may require several months of treatment before they fully recover.
A person on hypothyroidism needs to consult and discuss with their doctor if planning to get or already pregnant. One can still get pregnant and have a healthy pregnancy. But one’s doctor might need to change their dose of thyroid hormone once the woman is pregnant. He or she will also need to measure the mother’s blood levels of thyroid hormone every four weeks and adjust the dozes accordingly.
Dr. Ian Shyaka
Resident in Surgery,Rwanda Military Hospital,
iangashugi@gmail.com