Hypothyroidism cannot be cured, but in almost all patients it can be completely controlled, as the Hospital’s endocrinology team explains to us here, although they first take a look at the disease and its possible causes.
What is the thyroid gland?
The thyroid is a butterfly-shaped endocrine gland that is located in the lower part of the neck, in front of the windpipe and below the “nut” or thyroid cartilage.
It is composed of 2 lobes (right and left) and a central portion that unites these lobes called the isthmus. This gland has a very important function in the body as it is responsible for producing two hormones, thyroxine (T4) and triiodothyronine (T3), which are secreted into the bloodstream and then distributed to all tissues of the body.
The hormones produced by the thyroid, help the body to use energy, intervene in the regulation of temperature and in the proper functioning of the brain, heart, muscles and many other organs.
TSH hormone or thyroid stimulate
Another hormone to consider when we talk about this gland is the so-called thyroid stimulating hormone or TSH. This hormone is produced in the pituitary gland (a gland located in the brain) and is responsible for regulating the production of T3 and T4 by the thyroid , depending on the levels of thyroid hormones in the individual’s blood.
What is hypothyroidism and hyperthyroidism?
The disorders of the thyroid gland are the result primarily of processes in the system immune of the body stimulates the overproduction of thyroid hormones or causes destruction glandular with subsequent hormone deficiency.
When the thyroid is not able to produce enough thyroid hormone to maintain the proper functioning of the body, the disease called hypothyroidism occurs. In affected individuals, low levels of thyroid hormones will be detected in the blood (T4 and / or T3).
The hyperthyroidism other hand, consists of an increase in the production of thyroid hormones, objectifying elevated blood levels thereof.
Symptoms of hypothyroidism
Here are the signs and symptoms you may notice if you have hypothyroidism in descending order of frequency.
It is reasonable to note that because symptoms are so varied, the only way to know for sure if you have hypothyroidism is to have blood tests.
|Dry and rough skin; cold limbsSwollen face, hand, and feetHair lossLow heart rateSlow tendon reflexesCarpal tunnel syndrome
|Tiredness, weaknessDry skinFeeling coldHair lossDifficulty concentrating and poor memoryConstipationWeight gain and poor appetiteHoarselyMenstrual disturbancesTingleHearing impairment
Causes of hypothyroidism
Hypothyroidism can have multiple causes, including:
- Autoimmune disease (Hashimoto’s thyroiditis)
In these cases, the immune system that protects the body against foreign infections, mistakes the thyroid cells for invading agents and destroys them. As a result, as less and less thyroid cells remain over time, the amount of thyroid hormones decreases and hypothyroidism occurs. It is usually more common in women than in men and can have an abrupt onset but usually develops slowly over several years.
- Surgery of part or all of the thyroid gland
Some people with thyroid nodules, thyroid cancer, or Graves’ disease (autoimmune hyperthyroidism) need surgery to remove part or all of the thyroid gland. If the entire gland is removed, the person will undoubtedly develop hypothyroidism, in those cases where only half of the gland is removed, usually the other half can produce enough thyroid hormone.
- Radioactive iodine treatment
Some people with severe disease, toxic nodular goiter, or thyroid cancer are treated with radioactive iodine (I-131) in order to destroy the thyroid gland, leading to hypothyroidism. Other types of radiation such as that used in patients with Hodgkin’s disease, lymphoma, or cancers of the head or neck can also affect thyroid function.
- Congenital hypothyroidism (hypothyroidism at birth )
Some babies are born without a thyroid gland or with a gland that is only partially formed or located outside of its usual location (ectopic thyroid).
Thyroiditis is an inflammation of the thyroid gland, usually caused by an autoimmune attack or by a viral infection. These patients may have permanent or transient hypothyroidism.
The amiodarone, lithium, interferon alpha and interleukin-2 , among others, can alter the production of thyroid hormones. They tend to cause hypothyroidism more frequently in patients with a genetic predisposition to develop autoimmune thyroid disease.
- Iodine deficiency
There are geographic areas where the intake of iodine from food may be insufficient to guarantee an adequate amount and thus be able to maintain a normal thyroid hormone production causing hypothyroidism.
- Damage to the pituitary gland
The pituitary gland, through its hormone TSH, regulates how much thyroid hormone the thyroid must produce.
When the pituitary gland has been damaged by a tumor, radiation, or surgery, it will no longer be able to give the thyroid instructions, and as a result, the gland will stop producing enough hormone.
Does it have an associated genetic component?
Several thyroid diseases have an associated genetic component, especially those in which the immune system intervenes, such as autoimmune hypothyroidism (Hashimoto’s thyroiditis).
Susceptibility to this type of hypothyroidism depends on a combination of genetic and environmental factors, and the risk of suffering it is increased, especially among siblings .
How is hypothyroidism diagnosed?
The correct diagnosis of hypothyroidism will be made through the signs and symptoms that the patient presents , the search for relevant data in the medical history (thyroid surgery, radiation, use of drugs that cause hypothyroidism, etc.), the physical examination performed by the doctor and a blood test.
Hypothyroidism does not have any characteristic symptoms, and there are no symptoms that are present in all people with hypothyroidism.
There are two blood tests that are used in the diagnosis of hypothyroidism.
- Determination of TSH (thyroid stimulating hormone). This is the most important and sensitive test for hypothyroidism. An abnormally high TSH is the first indication of the presence of hypothyroidism. TSH rises to try to stimulate the thyroid to produce its hormones because there is not enough T4 and T3 in the blood.
- Determination of free T4. It will be decreased in cases of hypothyroidism.
- Determination of antibodies against the thyroid. Measuring the blood for antibodies that attack the gland can help diagnose the cause of hypothyroidism.
Are there ways to prevent it or is there a cure?
There is no method to prevent hypothyroidism except:
- E vitar drugs that can provoke.
- Have an adequate intake of iodine through the consumption of foods that contain it and iodized salt .
There is also no cure , but in some patients it may be transitory (eg, inflammatory thyroiditis or postpartum thyroiditis) and normal thyroid function can regain in a few months.
What is your treatment for hypothyroidism?
- Replacement of thyroid hormones.
As we have mentioned before, hypothyroidism cannot be cured, but in almost all patients it can be completely controlled . This is accomplished by replacing the amount of thyroid hormone that your thyroid can no longer produce, to return your TSH and T4 to normal levels. For this, there is a medicine called levothyroxine, which is synthetic thyroxine (T4), the same as the hormone produced by the thyroid. Usually it is necessary to regulate the dose of levothyroxine by measuring TSH and T4 in blood tests. Treatment is for life and is usually very well tolerated.
- Side effects and complications .
The only danger from thyroxine occurs when you take a very high or very low dose. If you take too little, hypothyroidism will persist and you will continue to notice symptoms. If you take too much, you will develop symptoms of hyperthyroidism (difficulty sleeping, increased appetite, nervousness, trembling, feeling hot when other people are cold, heart palpitations, etc.). Patients with symptoms of hyperthyroidism should have their TSH checked. If it is low, the dose should be reduced.