Hypothyroidism is one of the most common endocrine diseases and is characterized by low thyroid activity, which leads to the production of fewer hormones than necessary for the optimal functioning of all bodily functions, resulting in the appearance of certain symptoms with excessive fatigue, decreased heart rate, weight gain, hair loss and dry skin.
This change is most common in women over age 40, who have close relatives with hypothyroidism, who have already removed some or all of the thyroid, or who have received some type of radiation to the head or neck. Treatment of hypothyroidism aims to regulate thyroid hormone levels and thus relieve symptoms, and the use of synthetic hormones, such as levothyroxine, for example, is generally indicated by the endocrinologist.
- Signs and symptoms that may indicate low thyroid function may appear slowly over time as thyroid hormone.
- T3 and T4 levels decrease.
- The main signs and symptoms of hypothyroidism are:.
In addition, in some cases, the person may experience personality changes, depression and dementia, but these symptoms occur in people with very low levels of T3 and T4.
For children, hypothyroidism can also interfere with development, so in adolescence puberty can be delayed and small, for example. In addition, in the case of congenital hypothyroidism, if the child is not detected in the first week after birth, the child may develop neurological changes, with the risk of developing mental retardation. Learn more about congenital hypothyroidism.
The most common cause of hypothyroidism is Hashimoto’s thyroiditis, which is an autoimmune disease, in which antibodies begin to attack the thyroid gland, as if it were harmful to the body. In addition, hypothyroidism can occur due to iodine deficiency, a condition known as goiter, in which there is an increase in thyroid size, but less T3 and T4 due to decreased iodine concentration.
Treatment of hyperthyroidism or the use of medicines such as lithium carbonate, amiodarone, propyliouracil and metimazole can also cause hypothyroidism, so it is important to consult the endocrinologist if any of the symptoms are identified for the drug to be discontinued or replaced. .
People who have taken thyroid medications for weight loss may also develop hypothyroidism because once these hormones are already present in the blood, the thyroid can stop or decrease their natural production.
In addition to these causes, hypothyroidism may also occur during pregnancy or postpartum, which tends to return to normal shortly thereafter. In addition, it is important to remember that this disease decreases the fertility of the woman, which causes problems getting pregnant. Learn more about hypothyroidism and pregnancy.
To find out if this is hypothyroidism, the endocrinologist evaluates the signs and symptoms that the person presents and indicates that blood tests are performed to check the amount of circulating thyroid hormones.
Therefore, the dose of T3 and T4, which are usually decreased in hypothyroidism, and the dose of TSH, which is increased, is indicated. In the case of subclinical hypothyroidism, normal T4 levels and an increase in TSH may be observed. Learn more about thyroid tests.
In addition, your doctor may recommend research on antibodies, thyroid mapping, and thyroid ultrasound when nodules are detected during thyroid palpation. It is also possible for the person to self-examine the thyroid to identify any changes, especially the nodules. Learn how to do a thyroid self-exam.
In addition to people with signs and symptoms that may indicate hypothyroidism, these tests should also be performed by:
Hypothyroidism, if not adequately controlled, can interfere with the possibility of becoming pregnant and affect the mother and baby. It can also occur in the postpartum, a few months after the birth of the baby, transiently and also requires treatment.
Thus, it is normal for your doctor to order T3, T4, and TSH tests during prenatal screening to evaluate thyroid function and continue to monitor postpartum what thyroid hormone values are like and whether medications are needed. to get back to normal. Learn about the risks of hypothyroidism during pregnancy.
Treatment of hypothyroidism is relatively simple and should be done by hormonal replacement with the intake of synthetic hormones, levothyroxine, which contains the hormone T4, and should be taken with an empty eye, at least 30 minutes before breakfast. the digestion of food does not decrease its effectiveness. The dose of the drug should be prescribed by the endocrinologist and may vary during treatment depending on the levels of T3 and T4 circulating in the blood.
6 weeks after starting the medicine, your doctor may check the person’s symptoms and order a TSH test to see if the dose of the medicine needs to be adjusted until the amount of free T4 is normalized. Tests should then be done to evaluate the thyroid once or twice a year to see if the dose adjustment of the medicine needs to be adjusted.
In addition to using medications, it is important for the person to monitor blood cholesterol levels, avoid fat intake, adopt a diet that helps liver function, and avoids excessive stress by altering thyroid hormone secretion. . In some cases, a consultation with a nutritionist may also be recommended so that nutritional treatment with iodine supplements can help reduce symptoms of hypothyroidism.
In the case of subclinical hypothyroidism, in the absence of symptoms, your doctor may recommend medications, as they may help reduce the risk of cardiovascular problems, which may be important for people who are overweight or with high cholesterol or diabetes.
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Signs of improvement in hypothyroidism appear about 2 weeks after initiation of treatment, with decreased fatigue and improved mood. In addition, long-term treatment of hypothyroidism also helps control weight and reduce blood cholesterol levels.
Signs of worsening appear when treatment is not done correctly or when the dose of levothyroxine is not adequate, with insomnia, increased appetite, palpitations and tremors, for example.