Hypothyroidism, or underactive thyroid, is known to occur when too few hormones are produced in the thyroid gland. It is also known that all hormones are produced in the thyroid gland for metabolic processes and is therefore essential for life. If the production of hormones decreases, the performance of a person decreases rapidly.
What is hypothyroidism?
Infographic on the anatomy and location of the thyroid gland, and the symptoms of hyperthyroidism and hypothyroidism. Click image to enlarge. Hypothyroidism is a common disease worldwide. Despite this, many unaffected people are unaware of the importance of the thyroid gland. The thyroid gland is a vital organ that sits below the larynx and controls the entire metabolism of the human body. It does this by producing two thyroid hormones, thyroxine and triiodothyronine. The appearance of the thyroid gland resembles a butterfly, as it has a right and left lobe that are joined in the middle. Its weight ranges from 20 to 60 grams in adults. In hypothyroidism, the thyroid gland produces too few or even no hormones. The lack of thyroid hormones in the human body results in slowing down of all metabolic processes and decreasing efficiency. Hypothyroidism is particularly dangerous in children, as it can delay physical and mental development, because thyroid hormones are already responsible for the development and maturation of the body, especially the brain, in the embryo. To produce the hormones, the thyroid gland needs iodine (iodine), which is taken in through the diet. In adults, the thyroid gland controls metabolism as well as heart rate and body temperature, among other things.
Causes
There are different causes of hypothyroidism. For example, it may already be congenital, or more likely, triggered by a disorder of the thyroid tissue. Thus, hypothyroidism is first differentiated into congenital and acquired hypothyroidism. In the case of acquired, there are again two forms: hypothyroidism, which is caused by iodine misutilization or too little iodine, or hypothyroidism, which is a lack of thyroid tissue due to disease, radiation therapy or surgery. Despite the different forms and causes, the symptoms of hypothyroidism are the same: those affected are often tired, listless and depressed. Loss of appetite, lack of thirst and weight gain are also consequences of hypothyroidism. Dry and brittle skin and brittle hair can also be signs of this disease. Due to the slowed metabolism, the pulse also slows down and the body temperature drops, increasing sensitivity to cold.
Symptoms, complaints and signs
A deficiency of thyroid hormones affects various organs and can therefore lead to a wide variety of symptoms. These can be physical and psychological. The most common signs of hypothyroidism include fatigue with an increased desire to sleep, listlessness and listlessness. Impaired performance may also present as impaired concentration, poor memory, or slowing of reflexes. These signs are often only recognized very late in older people as indications of hypothyroidism. In addition, depressive moods and increased disinterest may occur. Similarly, freezing (sensitivity to cold) and pale skin may be indicative of hypothyroidism. Dysfunction can also lead to weight gain, elevated LDL levels in the blood, and pain and muscle weakness. Because the body is only “running on fumes” due to hypothyroidism, hair and fingernails become brittle. Skin problems may develop. There may be swelling of the subcutaneous connective tissue, especially on the eyelids. Voice and speech may also be affected. Hypothyroidism can lead to decreased sexual desire and male potency. Constipation and loss of appetite are also among the signs of slowed metabolism due to hypothyroidism. Symptoms may also include circulatory problems.Prolonged untreated hypothyroidism can cause a slowing of the heartbeat. Likewise, heart muscle weakness can occur.
Disease progression
If hypothyroidism is not treated or is diagnosed too late in young children, mental and physical disability may result from the lack of hormones. In adults, the organs in particular become impaired in their functionality. Noticeable symptoms include sensitivity to cold, dry skin, weight gain, slowed pulse and lack of drive.
Complications
Congenital hypothyroidism, which is not treated, progresses with significant complications and does so even in infancy. The diagnosis is considered within embryonic development as a special form of improperly formed thyroid gland. The reason for this could be attributed to insufficient iodine supply to the mother. If the expectant mother fails to follow the medical advice during pregnancy as well as the legally required newborn screening, she risks the life and healthy development of the child. Congenital hypothyroidism can affect one in 3,000 newborns. Early diagnosis avoids complications such as numerous developmental deficits that cause the child to become a foster child. A maldevelopment of the thyroid gland impairs mental maturity, overall body growth, psychomotor function and bone formation. Hearing and breathing are also massively impaired. If targeted medication is given within 14 days of birth, many of the physical and mental sequelae can be avoided. Irreversible deficits can be circumvented. If the mother refuses any medical help, the infant’s condition can deteriorate to such an extent that myxedema coma threatens as a result of hypothyroidism. In the latter, accumulations of water form under the infant’s skin and wash it up, especially around the limbs and face. If this life-threatening complication form is not treated immediately, the child may succumb to myxedema.
When should you see a doctor?
If certain symptoms are prolonged, a doctor should be consulted in any case. It is important that the family doctor rule out other diagnoses in order to treat the condition professionally. If feelings of weakness or large weight gains are noted more often for no reason, hypothyroidism is suspected. The specialist for this hormonal disorder is the endocrinologist. The endocrinologist should be seen only if the primary care physician believes that the thyroid gland should be thoroughly examined. If on a normal blood check the thyroid level is only moderately low, it is not necessary to see a specialist. However, if values are in a very critically low range, an examination by an endocrinologist becomes inevitable. In the case of other critical values, the specialist should also be consulted. However, this only applies to the values that are far below the norm.
Treatment and therapy
Hypothyroidism should be treated as early as possible. Treatment is usually by medication with the administration of artificial thyroxine. This is best suited to help the thyroid gland do its job, as it is not broken down as quickly by the body. A cure for the actual causes of hypothyroidism has not been possible so far; medication can only effectively reduce the effects. In therapy, therefore, it is first essential to determine the disease by taking a blood sample. After that, the therapy is usually influenced by drugs that act as hormone substitutes. If the dosage is adjusted correctly and the patient adheres to the intake, the performance can return to a normal state. Thus, there is no danger to the patient’s life. The therapy starts with a low hormone dosage, which is gradually increased until the desired effect is achieved. The medication must be taken in the morning on an empty stomach. The metabolism should be checked annually on the basis of a blood sample. With the right treatment, those affected can usually lead a completely normal life; performance and life expectancy are then not restricted by the hypothyroidism. The most common side effect of this hormone therapy is weight gain.
Prevention
Hypothyroidism cannot be prevented directly.If hypothyroidism has already occurred, lifelong hormone treatment is necessary. Thus, hypothyroidism cannot be properly prevented as a rule, since the causes can be quite different and are usually not influenced by external factors. Lifelong hormone treatment helps to combat the symptoms of this disease. If the hypothyroidism is only caused by an iodine deficiency, the consistent use of iodized table salts can improve the iodine supply. Since sea fish in particular contains a lot of iodine, it should be on the menu twice a week. The additional intake of iodine supplements can also help to cover the daily iodine requirement.
Follow-up
The disease of hypothyroidism requires a lot of patience and lifelong treatment from those affected. The severity of the disease – and any surgery – determines the frequency of checkups. The long-term goal is to stabilize the body’s metabolic and hormonal balance within the normal range and to prevent (repeated) growth of the thyroid gland. In most cases, an annual blood test and regular ultrasound examination of the neck region are sufficient. Immediately following thyroid surgery, it is recommended that more frequent check-ups be performed until normalization of hormone levels is evident. Long-term use of the thyroid hormone thyroxine T4, which is no longer produced by the thyroid gland or is only produced in small amounts, is usually prescribed. The more thyroid tissue removed during surgery, the higher the prescribed dosage will be. In some cases, an additional intake of iodine tablets is useful. Any fluctuations in hormone levels in the body are detected in time by regular blood tests. An appropriate individual dosage of thyroxine counteracts these fluctuations and enables a largely normal life for those affected. If the values are within the ideal range after an operation, it is not necessary to take thyroxine. Nevertheless, this does not replace regular check-ups with the doctor.
What you can do yourself
In the case of hypothyroidism, medical treatment is necessary. Accompanying this, the diet must be changed. Patients should eat a healthy, balanced diet. Instead of processed foods, home-cooked meals made from fresh ingredients are best. The meals should contain zinc and selenium in particular. Both substances can be supplied via dietary supplements if the diet does not cover the daily requirement. In addition, legumes, dairy products, meat and fish are suitable. In addition, vitamins B12, A, E and D should be consumed in sufficient quantities. Patients should maintain a regular sleep schedule. A good sleep rhythm contributes to a balanced immune system and thus to a stable thyroid gland. The rule of thumb is eight hours of sleep, which should be combined with a consistent routine. Regular exercise is also important. Sports and an active lifestyle alleviate the physical and mental discomfort associated with hypothyroidism. Regular downtime is just as important, so that the body has sufficient time to recover. Rest periods are essential, especially after stressful periods. Medical check-up visits should continue to be maintained. In addition, the medical professional must be informed about any complaints and symptoms.
