Hypothyroidism: symptoms, causes and treatment

Hypothyroidism is a disorder of the endocrine system., specifically of the thyroid gland, which is less active than normal, hindering the correct development of different functions of the human body.

There are multiple causes that can lead to hypothyroidism, giving rise to different symptoms and signs that you have to know how to detect as soon as possible to go to health professionals as soon as possible.

In this article we will see what hypothyroidism is, what this pathology consists of, what causes generate it, what risk factors increase the probability of its appearance and what treatment is the most appropriate.

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What is the thyroid?

The thyroid is a gland of the endocrine system, that is, it produces hormones, specifically, thyroid hormones. It is located in the neck, just above the clavicle and is responsible for controlling many of the body's functions such as metabolism, sexual development, growth, heart rate, and even, in young children, brain development.

Given all the functions in which it participates, the affectations that can occur if its functioning is altered are many: appearance of goiter due to enlargement of the gland; hyperthyroidism, when more thyroid hormone is produced than is necessary; hypothyroidism if less thyroid hormone is produced than the body needs; thyroid cancer; nodules when we see lumps in the thyroid and thyroiditis when the thyroid swells.

For this reason it will be necessary to evaluate and control possible dysregulations to avoid alterations in the subject. There are different ways to proceed depending on the affectation. So let's see what exactly hypothyroidism consists of.

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What is hypothyroidism?

As we have already advanced, hypothyroidism is a health disorder based on an insufficient production of thyroid hormones, linked to a reduction in the activity of the thyroid gland.

In these circumstances, the thyroid-stimulating hormone (TSH) produced by the anterior pituitary gland and responsible for regulating the levels of thyroxine (a type of thyroid hormone) in the blood, begins to increase in concentration to try to get the thyroid gland to increase its exercise. In the case of hypothyroidism we will see how this regulation attempt made by the body does not achieve the desired effect.

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Causes of hypothyroidism

There are several causes that can lead to a lower performance of the thyroid gland or a deficiency of this hormone. One of the most frequent is the appearance of Hashimoto's disease., which is an autoimmune condition where the immune system attacks and destroys the thyroid.

Other causes are: thyroiditis (which produces a swelling of the thyroid gland); removal of the thyroid gland; congenital hypothyroidism, which is observed from birth; radiation treatments; thyroid cancer; side effects of taking some medications; a deficiency of the hormone TSH; and on some less frequent occasions we can also observe a dysregulation of the iodine consumed.

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Factors that increase the risk of hypothyroidism

Hypothyroidism, as well as other conditions linked to the thyroid, it is observed more in women, especially after 50-60 years. Frequently related to Hashimoto's disease. You're also more likely to develop hypothyroidism if you've previously had thyroid problems or had thyroid surgery or radiation therapy.

As with other pathologies, having a family history of this affectation increases the risk of presenting it. In addition, being pregnant or having recently given birth is also more likely to develop the condition.

Finally, there are some pathologies or alterations that are related to a higher risk of showing hypothyroidism: autoimmune conditions such as rheumatoid arthritis or lupus; genetic alterations such as Turner syndrome where the lack of an X chromosome is detected in women; type 1 diabetes or insulin dependent, related to difficulties for glucose to enter the cells or anemia due to lack of red blood cells.

Symptoms of hypothyroidism

There are multiple and diverse symptoms that a subject with hypothyroidism can show; As we already know, this hormone participates in different functions, many of them essential. The development of the affectation is progressive; In this way, we may not see serious problems at first, but it is possible that they lead to greater damage if left untreated.

In the first stage of the pathology it is usual to observe that the subject feels more tired and that his weight increases inexplicably. It may be that when these symptoms begin we do not give them importance, since we tend to link them to other causes such as leading a stressful life, which makes us feel tired, or simply age.

Other symptoms or signs that we can identify in patients with low thyroid activation are: increased feeling of cold, constipation, pain and stiffness in the joints and muscles, more puffy face, breathing problems when we sleep (snoring), increased cholesterol level in the blood, menstrual irregularities or heavier bleeding, hair thinning and hair loss, dry skin, sweating less, fertility problems in women, slow heart rate, depression, memory problems or goiter, enlargement of the gland thyroid.

Another affectation that hypothyroidism can also cause and that we must bear in mind is the alteration of the growth and development of the baby. It has been seen that mothers who do not treat their thyroid problem may have children who show retardation and psychomotor problems during childhood.

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How is the diagnosis of hypothyroidism made?

To make a correct diagnosis of hypothyroidism and know what the cause is in order to proceed to treat it appropriately; the doctor will take into account different variables. In the same way, what happens with any other pathology, First, the professional usually asks the subject different questions to find out what their medical history is., if you have a family history of hypothyroidism, if you have had problems with your thyroid before or if you take any type of medication or have undergone any surgery.

Apart from the clinical history, it is also common to ask about the current state of the patient, about whether they notice any type of symptom or have any sensations that are different from the usual ones. For example, if you feel more tired, you notice that you have gained weight or that your hair is falling out more, as we have already seen, are usually the first consequences that are detected from this affectation. In women, a sign that is also easy to identify is the irregularity of menstruation or the increase in the amount of bleeding.

Another procedure that can help the evaluation consists of performing a physical examination where the doctor palpates the patient's neckwhere the thyroid gland is located. The purpose is to know the size of the gland, its consistency, the sensitivity it shows, as well as to detect irregularities, asymmetries or nodules that it may present. For the exploration to be correct, it is necessary to palpate gently and carefully, since if we press excessively it will be more difficult to appreciate the alterations.

Likewise, another useful medical test to contrast the information already obtained and to know if the patient's symptoms or signs are due to hypothyroidism is the blood test. As we already mentioned before a decrease in thyroxine (T4) there is an increase in TSH hormone. In this way, if we detect a lower concentration of T4 or an increase in the level of TSH in the blood, it is probably due to a decrease in the activation of the gland.

We can also check the level of antibodies in the blood, specifically the antithyroglobulin and the thyroid antiperoxidase, which are increased when the immune system attacks the gland thyroid.

Finally, an ultrasound of the thyroid gland may be done to identify any type of irregularity or a reactive iodine absorption test, to check the operation of the thyroid.

Treatment

The main treatment of hypothyroidism consists of take a medication that has the function of compensating for the deficiency of thyroid hormone. According to the results obtained in the evaluation, the professional will set the dose and will adjust it depending on the levels of the hormone that are observed in the following blood tests. Once the dose is established, the subject's condition will normally be monitored with a blood test every year in case the dose needs to be changed.

Normally, the affectation is chronic, thus requiring medication for life, although if the doctor's instructions are followed correctly, the symptoms can be controlled without any problem. It is especially important that we adjust and control the dose at the time of pregnancy, since low levels of the hormone can affect the baby. In case of observing hypothyroidism in newborns, it is essential to start treatment as soon as possible to avoid developmental problems.