What Is Hypothyroidism?

What Is Hypothyroidism?

Hypothyroidism is the insufficient secretion of thyroid hormones due to an underactive thyroid gland. Because these hormones regulate our metabolism, the low secretion of hormones into the blood can cause fatigue, tiredness, dry skin and hair loss, and, in untreated cases, enlargement of the tongue and hoarseness of the voice.

In blood tests, TSH is high and free T4 is low; if TSH is high but free T4 is normal, this is called subclinical hypothyroidism. Unless the disease is brought under control, the patient first starts gaining weight, then body temperature drops over time and consciousness becomes clouded. Constipation is added to these.

When these symptoms are seen together, the patient should consult a specialist and have thyroid function measured. When thyroid hormones are insufficient, treatment can be given by replacing the hormones with daily tablets.

Causes of Hypothyroidism

Hypothyroidism is not a preventable disease and mostly results from the immune system attacking and destroying the thyroid gland. The best known of these is Hashimoto’s thyroiditis, a chronic inflammation of the thyroid gland.

In Hashimoto’s disease, the immune system recognizes the thyroid gland as foreign and sometimes does nothing for a lifetime, while at other times it attacks and destroys it, rendering it non-functional. Whether due to Hashimoto’s disease or another disease, when hypothyroidism develops, the thyroid hormones that regulate the body’s metabolism decrease, and various complaints result.

Hypothyroidism may develop after surgery or radioactive iodine treatment for toxic goiter or thyroid cancer.

Other causes are as follows;

1. People with another autoimmune disease, such as type 1 diabetes or vitiligo
2. People who have undergone thyroid surgery or radioactive iodine therapy
3. Cases in which the baby’s thyroid gland did not develop from birth (congenital hypothyroidism)
4. Problems of the pituitary gland in the brain
5. People living in iodine-deficient regions and those who consume little iodine
6. Exposure to radiation
7. People using medications such as amiodarone, lithium and interferon
8. People with a family history of thyroid disorders.

Women are at a 4-8 times higher risk of developing this disease than men. Although it is suspected that the female hormones estrogen and progesterone may play a role, there is no definite evidence as to why this disease is seen more often in women.

Symptoms of Hypothyroidism

The Symptoms of Hypothyroidism, in Which Thyroid Hormones Are Underactive, Are as Follows:

1. Fatigue, tiring easily, slowness of movement,
2. Depressed mood and unhappiness,
3. Intolerance to cold environments,
4. Edema in the hands and feet,
5. Decreased sweating,
6. Hoarseness,
7. Constipation,
8. Abnormal weight gain, increased appetite,
9. Forgetfulness, decreased concentration,
10. Delayed puberty in boys,
11. Decreased or absent menstruation in women.

Diagnostic Methods for Hypothyroidism

The diagnosis can be made by checking hormone levels with a blood test called the thyroid function test.

In this test, the TSH hormone and the thyroid hormone T4 are checked. A high TSH and a very low level of the thyroid hormone T4 in the blood mean hypothyroidism.

If TSH is high but the T4 level is normal, there is a risk of developing hypothyroidism in the future.

Your doctor prepares a treatment plan to replace the hormones with medication and monitors your thyroid levels with regular blood checks during this time.

In addition to hormone levels, if there are other findings such as any swelling on manual examination, a family history of thyroid disease, difficulty swallowing or bulging of the eyes, the size and structure of the gland are examined with a thyroid ultrasound.

The detection of a nodule does not always mean that there is a malignant nodule. Further investigations are made with thyroid scintigraphy and, if necessary, fine-needle aspiration biopsy.

Treatment Methods for Hypothyroidism

When the T4 hormone is insufficient in the body, this deficiency is corrected with externally administered medication. However, hypothyroidism is not temporary; it is a disease that needs to be treated for life.

Complaints begin to improve 2 weeks after starting thyroid medication. The medication is started at low doses and increased at short intervals, generally every 5-6 weeks, and the dose is adjusted until the TSH hormone returns to normal. Afterwards, whether the thyroid hormone level in your blood is normal is usually checked with six-monthly or yearly check-ups.

If hypothyroidism is present in pregnant women, the elderly and people with coronary heart disease, more frequent monitoring is required. The reason is that medications containing thyroid hormone make the heart work faster. Therefore, the medication must be adjusted carefully.

If lifelong hypothyroidism is not treated, the metabolic problems resulting from thyroid deficiency continue, and life-threatening conditions such as enlargement of the heart, heart failure, clot formation, hypertension and atherosclerosis can occur.

If TSH is mildly elevated and free T4 is normal, the doctor may choose to monitor; if free T4 is low or TSH is above 10 mU/L, treatment is recommended. In these cases, your doctor usually monitors your hormone level every few months.