What is Underactive Thyroid?
An underactive thyroid, also known as hypothyroidism, is a condition where the thyroid gland does not produce enough thyroid hormones. The thyroid is a small, butterfly-shaped gland located at the base of the neck that helps regulate growth, metabolism, and other important bodily functions. When the thyroid is underactive, it does not make adequate amounts of thyroid hormones triiodothyronine (T3) and thyroxine (T4). This can cause a variety of symptoms including fatigue, weight gain, feeling cold, dry skin, hair loss, muscle aches, depression, and impaired memory. Hypothyroidism is more common in women, especially over the age of 60, but can affect anyone at any age.
What Causes Underactive Thyroid?
There are several potential causes of an underactive thyroid:
– Hashimoto’s thyroiditis – This is an autoimmune disorder and the most common cause of hypothyroidism in the United States. With Hashimoto’s, the immune system mistakenly attacks and damages the thyroid gland, leading to reduced hormone production over time. There is often a gradual onset of symptoms.
– Thyroiditis – Inflammation of the thyroid can temporarily or permanently impair thyroid function. Types include postpartum thyroiditis after pregnancy and subacute thyroiditis caused by a virus.
– Treatment of hyperthyroidism – Some treatments for an overactive thyroid like radioactive iodine therapy or surgery can lead to permanent hypothyroidism over time.
– Congenital hypothyroidism – Babies can be born with an underactive thyroid due to developmental problems with the gland. This is detected through newborn screening.
– Iodine deficiency – Consuming too little iodine can affect thyroid hormone production. This is rare in developed countries where iodized salt is used.
– Pituitary disorder – The pituitary gland controls the thyroid, so pituitary tumors or inflammation can disrupt signals to the thyroid.
– Medications – Drugs like lithium, interferon alpha, and IL-2 can trigger hypothyroidism.
– Radiation treatment – Radiation used to treat cancers of the head and neck can damage the thyroid gland.
Signs and Symptoms
The symptoms of hypothyroidism tend to develop gradually over months and years. They may be subtle at first before worsening. Common signs and symptoms include:
– Fatigue and weakness
– Increased sensitivity to cold
– Constipation
– Dry skin and hair
– Unexplained weight gain
– Muscle aches, stiffness and cramps
– Elevated blood cholesterol
– Muscle weakness, especially in the upper arms and thighs
– Fluid retention and swelling, especially around the eyes
– Slow heart rate
– Depression and anxiety
– Impaired memory and concentration
– Irregular or heavy menstrual periods
– Reduced libido
– Enlarged thyroid gland (goiter)
Infants with congenital hypothyroidism can have symptoms like persistent jaundice, feeding problems, constipation, enlarged tongue, and delayed development.
Is Underactive Thyroid Considered a Disability?
Whether or not hypothyroidism is considered a disability depends on the severity of someone’s symptoms and how much they impair normal day-to-day activities.
According to the Social Security Administration (SSA), hypothyroidism can be considered a disability if it meets the following criteria:
– There must be a diagnosis of hypothyroidism with signs and symptoms consistent with the condition. This includes things like fatigue, feeling cold, weight gain, dry skin, etc.
– Laboratory testing must show abnormal thyroid hormone levels. A TSH level above the normal range with low T4 confirms hypothyroidism.
– The condition results in significant impairment that disrupts a person’s ability to work and carry out daily activities for at least 12 months.
– The impairment and limitations must be verifiable through clinical exams, medical imaging, and/or laboratory findings. Self-reported symptoms alone are generally not sufficient.
– The individual requires ongoing medical treatment to manage hypothyroidism, such as thyroid hormone replacement medication.
Essentially, hypothyroidism itself does not automatically qualify as a disability. The thyroid condition must be severe enough to truly impair normal functioning to the extent that working or completing routine daily tasks is no longer reasonably possible.
The SSA has a detailed list of criteria under their “Blue Book” that outlines specific ways hypothyroidism can impact different body systems to meet the threshold for disability status. This includes things like:
– Heart and cardiovascular symptoms like enlarged heart, heart failure, irregular heart rhythms
– Musculoskeletal effects like muscle inflammation, joint pain, swelling
– Neurological effects like numbness, tingling, muscle weakness, seizures, mental impairment
– Gastrointestinal problems like recurrent nausea, vomiting, weight loss
– Genitourinary problems like menstrual disturbances and kidney disease
For someone with mild hypothyroidism whose symptoms are managed well with medication and lifestyle adjustments, it is less likely to be considered disabling by the SSA’s standards. On the other hand, someone with severe untreated hypothyroidism that has profoundly impacted many aspects of health may potentially qualify for disability benefits.
Applying for Disability with Underactive Thyroid
To apply for Social Security Disability Insurance (SSDI) or Supplemental Security Income (SSI) benefits based on hypothyroidism, you must provide extensive medical documentation. This includes records like:
– A clear diagnosis from an endocrinologist or other specialist
– Abnormal thyroid lab results
– Clinical exam notes documenting related symptoms
– Details on all treatments and medications tried
– Imaging results or other test findings
– Information on emergency room visits or hospitalizations
– Descriptions of how hypothyroidism specifically limits basic work activities
– Explanations of how daily routine is impacted by symptoms
In the application, it is important to thoroughly describe how hypothyroidism impacts your capacity to work and complete normal daily activities. This may include effects like:
– Severe constant fatigue making it impossible to regularly attend and perform job duties
– Impaired memory and concentration that prevent learning new tasks or operating equipment/machinery safely
– Muscle and joint pain and weakness that restrict mobility
– Depression or anxiety that interfere with appropriate social interaction
– The need for many unscheduled breaks to rest and manage symptoms
– Multiple weekly medical appointments to monitor health
– Side effects of medications that impair functioning
The SSA will evaluate all the evidence in your case to determine if hypothyroidism prevents you from working and warrants approval of disability benefits. Having an experienced disability lawyer assist with your application can significantly improve your chances of approval.
Treating Underactive Thyroid
While hypothyroidism usually cannot be cured, it can be effectively managed with appropriate treatment and monitoring. This may help reduce the impact of symptoms and potentially prevent severe disability:
– **Thyroid hormone replacement** – Synthetic T4 medication is the standard treatment for hypothyroidism. The dose is adjusted based on regular lab testing to keep thyroid hormone levels optimized. Common brands are Synthroid, Levoxyl, and Levothroid.
– **Thyroid hormone and T3 combination** – Some people do better adding a synthetic T3 medication like liothyronine (Cytomel) to their thyroid hormone regimen.
– **Regular monitoring** – Thyroid blood work needs to be checked every few weeks when first starting treatment and then every 6-12 months to ensure adequate hormone levels are maintained.
– ** Dietary modifications** – Eating foods rich in iodine, selenium, zinc and vitamin D can help support thyroid function. People with hypothyroidism should minimize intake of soy and supplements like iron that can disrupt thyroid absorption.
– **Treatment of underlying autoimmune disease** – If Hashimoto’s is the cause, medications may help calm the overactive immune system and slow further thyroid damage.
– **Lifestyle measures** – Getting adequate rest, managing stress, exercising regularly, and avoiding trigger foods can help manage hypothyroid symptoms.
While most people with hypothyroidism rely on lifelong thyroid hormone replacement pills, surgery or radioactive iodine treatment can sometimes be options if medications are not effective. Work closely with your endocrinologist to find the optimal treatment plan for your individual case.
Outlook for Underactive Thyroid
When hypothyroidism is caught early and treated appropriately, most people are able to effectively manage their symptoms and prevent severe disability. With the right thyroid hormone therapy, regular monitoring, and healthy lifestyle habits, it is possible to feel well and maintain an active daily routine.
However, hypothyroidism requires diligent lifelong thyroid care and monitoring. Failing to take thyroid medication consistently, missing blood work for dose adjustments, and neglecting follow-up care can allow symptoms to spiral out of control and result in disability.
A small number of people have severe refractory hypothyroidism that remains uncontrolled despite aggressive treatment. This may be more likely with certain conditions like thyroid cancer or Hashimoto’s thyroiditis. In these cases, the debilitating symptoms could potentially meet the SSA criteria for disability.
It is important to have realistic expectations when living with hypothyroidism. Working closely with your healthcare providers and being proactive about your treatment plan offers the best chance of keeping symptoms in check and preventing disability. But even with optimal care, thyroid levels can fluctuate and some bad days are inevitable. Patience and being attuned to your body’s needs helps foster long-term thyroid health.
Key Takeaways
– Underactive thyroid (hypothyroidism) can potentially qualify as a disability if it is severe enough to significantly disrupt normal functioning.
– To meet Social Security’s disability criteria, hypothyroidism must cause substantial work limitations that prevent self-support for at least 12 months.
– In addition to abnormal thyroid levels, detailed medical records must verify how hypothyroidism specifically impairs someone’s daily routine and abilities.
– With proper treatment and monitoring, many people are able to manage hypothyroidism symptoms and avoid disability. But lifelong diligent thyroid care is crucial.
– For those unable to work due to uncontrolled hypothyroidism despite aggressive treatment, Social Security disability benefits may provide much-needed financial and healthcare support.