An overview of hypothyroidism for the general public

Author: Dr. Nabin Bhattarai
(Written during the Endocrine rotation with Dr. Lubna Mirza)

What is thyroid gland?

Thyroid gland is an endocrine gland located in front of the neck covering thyroid cartilage. It produces thyroid hormones which are responsible for maintaining the basal metabolic activity the body. It means thyroid hormones regulate the energy expenditure at the resting phase of the body. It also helps in development of brain especially in fetus and child. It maintains body temperature, weight, nail and hair growth as well as menstruation. Thyroid hormones contain large amount of iodine.

What is hypothyroidism?

Hypothyroidism occurs when the thyroid gland does not produce enough thyroid hormones for the body’s requirements. It can be due to deficiency of iodine in food especially in the iodine deficient regions** or defect in thyroid gland.

What are the symptoms of hypothyroidism?

*   weight gain
*   increase sensitivity to cold
*   dry skin
*   constipation
*   tiredness or fatigue
*   difficulty concentrating and depression
*   menstrual irregularities
*   hair loss
*   proximal muscles (arm and thigh) weakness
*   slowed heart rate

Hypothyroidism in infants and women

Hypothyroidism is mostly seen in children and women. Infants and children with hypothyroidism have mental disabilities and short height and we call it cretinism. It is mostly due to lack of thyroid gland in the body or in iodine deficient regions, it is due to lack of iodine in food. In women, hypothyroidism is mostly due to destruction of thyroid gland by bodies’ protective mechanism.

Role of thyroid hormones in pregnancy

As mentioned above, thyroid hormones are important in development of brain in the fetus. So, it is very important to know the thyroid status in women of childbearing age. Moreover, it is very important to increase the dose of thyroid hormones in women who are taking it if they become pregnant.

Foods that may affect thyroid functions

Certain foods may be goitrogens (which may depress the thyroid function) if consumed in large amount. However, in regular amounts, they may be beneficial to overall health and do not interfere with thyroid functions. Examples includes collards, brussels sprouts, kale, broccoli, cauliflower, cabbage, soy.

Is it treatable condition?

Hypothyroidism is easily treated with thyroid hormones replacement available in market and dosing is usually once a day in the morning. Thyroid medicine should be taken on empty stomach at least 1 hour before breakfast. Levothyroxine tablets in multiples of 25 micrograms are usually available.

What should be done?

In newborn babies, thyroid screening should be done after 24 hours of age. Children from iodine deficient regions should be provided with fortified food by iodine. In adults who develops symptoms as mentioned above, should have thyroid hormones and TSH measured and treated. In pregnant women, thyroid hormones level should be measured early in the pregnancy and start the treatment or increase the dose if required.

*This information is for general awareness. This is not for self-diagnosis and any symptoms should be consulted to physician.
**Himalayan region of Asia, Africa and Andean region in South America

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