What is hypothyroidism?
Hypothyroidism is a condition where the thyroid gland does not produce enough thyroid hormones. The thyroid is a small, butterfly-shaped gland in the front of your neck that releases hormones that control the speed of your metabolism. When your thyroid makes fewer hormones, it causes the metabolism to slow down.
Some common symptoms of hypothyroidism include:
- Fatigue
- Increased sensitivity to cold
- Constipation
- Dry skin
- Unexplained weight gain
- Puffy face
- Hoarseness
- Muscle weakness
- Elevated blood cholesterol level
- Muscle aches, tenderness and stiffness
- Pain, stiffness or swelling in your joints
- Heavier than normal or irregular menstrual periods
- Thinning hair
- Slowed heart rate
- Depression
- Impaired memory
However, the symptoms and their severity can vary. Many people with mild hypothyroidism may not notice any symptoms.
What causes hypothyroidism?
There are several potential causes of hypothyroidism, including:
– Hashimoto’s thyroiditis: This is an autoimmune disorder and the most common cause of hypothyroidism. The body’s immune system attacks the thyroid gland, leading to inflammation and damage that reduces thyroid hormone production.
– Thyroid surgery: Removing all or part of the thyroid gland can cause hypothyroidism if the remaining gland can’t produce enough hormones.
– Radiation therapy: Radiation treatment of cancers in the neck can damage the thyroid and lower its hormone production.
– Medications: Drugs like amiodarone, lithium, interferon alpha, and interleukin-2 can prevent the thyroid gland from producing its hormones normally.
– Congenital hypothyroidism: Some babies are born with an underdeveloped, malformed, or missing thyroid gland.
– Pituitary disorder: The pituitary gland produces a hormone called thyroid-stimulating hormone (TSH) that signals the thyroid to make its hormones. If the pituitary is damaged or diseased, it may not produce enough TSH.
– Pregnancy: The immune system sometimes attacks the thyroid during or after pregnancy, causing temporary or permanent hypothyroidism.
How is hypothyroidism diagnosed?
Doctors will usually diagnose hypothyroidism with a simple blood test that measures the level of thyroid-stimulating hormone (TSH) and sometimes the levels of T3 and T4 hormones.
Some key points about diagnosis:
– Elevated TSH level indicates hypothyroidism. TSH is produced by the pituitary gland to stimulate the thyroid to release its hormones. When thyroid hormone levels are low, the pituitary releases more TSH to try to spur the thyroid into action.
– Low T3 and T4 levels can confirm the diagnosis but aren’t always necessary. These are the actual thyroid hormones, so low levels verify that the thyroid isn’t producing enough.
– Subclinical hypothyroidism is when TSH is mildly elevated but T3 and T4 are still normal. This indicates mild or early thyroid failure.
– Antibody testing may be done to confirm autoimmune Hashimoto’s thyroiditis. About 90% of hypothyroidism cases are caused by Hashimoto’s.
– Symptoms and family history can help guide testing. If a patient has symptoms or family members with thyroid problems, a doctor may test for hypothyroidism.
What are the treatment options for hypothyroidism?
1. Thyroid hormone replacement medication
Taking daily thyroid hormone pills is the standard treatment for hypothyroidism. This oral medication provides the thyroid hormones (T3 and/or T4) that your thyroid can no longer produce on its own. Some examples are levothyroxine (Synthroid, Levoxyl, Levothroid) and liothyronine (Cytomel).
Benefits:
– Relieves symptoms of hypothyroidism.
– Restores normal metabolism and energy levels.
– Prevents complications of untreated hypothyroidism.
– Inexpensive and well-tolerated by most people.
2. Changing your diet
Although medication is necessary, some dietary changes can help minimize symptoms:
– Eat more seafood, eggs, dairy, and other good sources of iodine to support thyroid function.
– Avoid foods like soy, cruciferous vegetables, and processed foods that may interfere with thyroid hormone synthesis.
– Reduce sugar intake, which can cause inflammation and worsen symptoms.
– Increase fiber to prevent constipation.
– Stay well hydrated and drink warm liquids to prevent fluid retention.
3. supplements
Some supplements that may help include:
– Selenium – an antioxidant that may help convert T4 to active T3 thyroid hormone.
– Zinc and iron – important minerals for thyroid function that are sometimes deficient in hypothyroid people.
– B vitamins like B12 and folate – help convert inactive thyroid hormone to the active form.
– Probiotics – support gut health, which is important for proper thyroid hormone activation.
However, always consult your doctor before trying supplements, as safety and effectiveness vary.
What lifestyle changes can help with hypothyroid symptoms?
Exercise and activity
Regular exercise helps counteract fatigue, muscle weakness, weight gain, and mood issues associated with hypothyroidism. Aim for 30 minutes of moderate activity most days. Walking, swimming, yoga, and light strength training are great options.
Stress management
Chronic stress exacerbates hypothyroidism symptoms. Set aside time for relaxation through meditation, deep breathing, massage, etc. Simplify your schedule and cut out unnecessary responsibilities. Get good sleep and rest.
Staying warm
Feeling cold all the time is a classic hypothyroid symptom. Wear layered clothing, thick socks, and gloves. Crank up the heat in your home and use blankets. Drink warm beverages like tea. Take warm baths and showers.
Healthy sleep routine
Hypothyroidism often causes sleep problems. Develop good sleep habits like sticking to a schedule, limiting electronics use before bedtime, and making your bedroom comfortable and dark. Addressing fatigue, anxiety, and hormone imbalances can also improve sleep.
What foods should you eat or avoid with hypothyroidism?
Recommended foods
- Seafood high in omega-3s like salmon. This helps reduce inflammation that can impact thyroid function.
- Nuts and seeds are a good source of selenium and zinc for thyroid health.
- Eggs contain iodine, essential for making thyroid hormones.
- Dairy like yogurt and cheese also provides iodine.
- Fruits and veggies high in antioxidants like berries, oranges, tomatoes, and spinach help the thyroid work efficiently.
- Whole grains like oats and brown rice offer B vitamins for thyroid hormone synthesis.
Foods to avoid
- Soy foods like tofu, edamame, and soy protein – soy isoflavones can suppress thyroid function.
- Cruciferous vegetables like broccoli, cabbage, and Brussels sprouts – contain compounds that may suppress thyroid hormone synthesis in some people.
- Certain foods can impact thyroid hormone absorption and should be avoided for around 4 hours after taking medication, including calcium-rich foods like milk and iron-containing products like cereals and supplements.
- Avoid added sugars, refined carbs, and junk food. These trigger inflammation and worsen symptoms.
Focus on a balanced diet rich in essential nutrients for thyroid function. But speak to your doctor about any major diet changes to ensure it won’t affect your medication.
How can you manage symptoms and feel better day-to-day?
Here are some tips to help manage common hypothyroidism symptoms:
Fatigue
– Stick to a regular sleep schedule.
– Reduce stress through relaxation techniques.
– Exercise daily as you are able to boost energy.
– Ask about medication dose adjustments if fatigue persists.
– Rely on productivity hacks like timers, alarms, and breaks.
– Schedule demanding tasks for when you have peak energy.
Brain fog and memory issues
– Make lists and reminders on your phone to reduce mental effort.
– Focus on one task at a time and eliminate distractions.
– Do activities that engage your brain like puzzles or learning a new skill.
– Reduce multitasking which requires extra mental energy.
– Ask loved ones to remind you of important events and appointments.
Weight gain
– Have your dose adjusted if weight gain persists despite lifestyle changes.
– Reduce calorie intake moderately while still eating nutrient-dense foods.
– Incorporate more activity into daily routines like taking the stairs.
– Find an exercise routine you enjoy and can stick to consistently.
– Set reasonable goals for weekly weight loss, like 1 pound per week.
Constipation
– Eat more high fiber foods like fruits, vegetables, beans and whole grains.
– Stay well hydrated by drinking plenty of water.
– Limit dairy products which may worsen constipation.
– Exercise regularly to stimulate bowel movements.
– Consider a fiber supplement like psyllium husk if diet changes aren’t enough.
Joint pain and muscle cramps
– Apply heat pads and take warm baths to soothe muscle pain and relax joints.
– Try over-the-counter pain relievers like acetaminophen as needed.
– Ask your doctor about prescription anti-inflammatories.
– Do light stretching and range of motion exercises.
– Consider glucosamine supplements to support joint cartilage.
– Use topical pain relief creams containing menthol or capsaicin.
What medications treat hypothyroidism?
| Medication | Mechanism | Dosage Forms | Additional Info |
|---|---|---|---|
| Levothyroxine (Synthroid, Levoxyl) | Synthetic T4 hormone replacement | Oral tablets, capsules | Standard first-line treatment, once-daily dose |
| Liothyronine (Cytomel) | Synthetic T3 hormone replacement | Oral tablets | May be combined with T4 drugs for tailored therapy |
| Thyroid desiccated (Armour Thyroid) | Natural thyroid extract, T4 + T3 | Oral tablets | Alternative to synthetic hormones |
| Methimazole (Tapazole) | Thyroid hormone production inhibitor | Oral tablets | Treats hyperthyroidism and Graves’ disease |
Key points about medications:
– Levothyroxine (T4) is usually preferred as the initial therapy.
– Liothyronine or Desiccated thyroid (T3/T4 combo) may be used if T4 alone is not effective.
– Exact dosing is tailored to the individual based on symptoms, lab work, age, and other factors.
– Regular monitoring of TSH levels is important to ensure optimal dosing.
– Most patients require life-long thyroid replacement medication.
– Medications are very safe with few side effects when dosed appropriately.
What are the potential complications of uncontrolled hypothyroidism?
Left untreated or inadequately treated, hypothyroidism can lead to a number of health problems:
Cardiovascular disease
Hypothyroidism raises “bad” LDL cholesterol and inflammation, increasing the risk of atherosclerosis, heart attack and stroke.
Mental health issues
The thyroid helps regulate chemicals like serotonin and dopamine that control mood. Hypothyroidism may contribute to depression and anxiety.
Myxedema coma
This rare, life-threatening condition is caused by long-term, undiagnosed hypothyroidism. It requires immediate medical treatment.
Birth defects
Untreated hypothyroidism in pregnant women can result in poor fetal development and birth defects.
Peripheral neuropathy
Delayed nerve signals due to thyroid hormone deficiency can cause numbness and tingling in the arms, legs, hands, and feet.
Carpal tunnel syndrome
Fluid accumulation in the wrist joint compresses the median nerve, causing numbness, wrist pain, and impaired hand function.
Goiter
A noncancerous enlargement of the thyroid gland. As the thyroid tries to compensate for inadequate hormone production, it grows in size.
Infertility
Thyroid hormones imbalance in women can disrupt the menstrual cycle and cause infertility.
That covers the major potential complications, but there are various other effects hypothyroidism can have if not properly managed, underscoring the importance of treatment.
When should you see a doctor about hypothyroidism symptoms?
You should make an appointment with your doctor if you experience any persistent symptoms of hypothyroidism including:
– Fatigue, lethargy, muscle weakness
– Weight gain or difficulty losing weight
– Sensitivity to cold temperatures
– Constipation
– Dry skin, thinning hair
– Irregular or heavy menstruation
– Swelling in neck or hoarse voice
– Elevated blood cholesterol
– Pain, stiffness or swelling in joints
– Impaired memory or concentration
– Depression, mood changes
Don’t write off these kinds of symptoms as normal or unavoidable results of aging or stress. Bring a thorough list of all symptoms you’ve noticed, how long they’ve been present, and how they impact your daily life.
Your doctor can run blood tests to measure your thyroid hormone levels and diagnose a potential thyroid disorder. The sooner it’s caught, the sooner treatment can begin and prevent complications.
Even mild or subclinical hypothyroidism warrants evaluation to determine if you need treatment or more frequent monitoring. Thyroid issues tend to be progressive.
Women especially should have periodic thyroid testing done during pregnancy and after age 50 when thyroid problems become more common.
Conclusion
Hypothyroidism can significantly impact your quality of life with its wide-ranging symptoms. But taking thyroid replacement medication as prescribed and making supportive lifestyle changes enables most people to effectively manage hypothyroidism.
With proper treatment, you can relieve troublesome symptoms and avoid the more serious health consequences of inadequate thyroid hormone levels. Work closely with your doctor to find the optimal treatment regimen tailored to your needs.
Be patient with the process. It can take some time to get your thyroid levels stabilized and start feeling like your usual self. But sticking with it and monitoring your progress will pay off as you learn to live well with hypothyroidism.
