Hypothyroidism: Symptoms, Diagnosis, Treatment and Causes

Hypothyroidism means that the thyroid gland does not work properly. The condition can be divided into three types. Primary hypothyroidism is caused by the thyroid gland. In secondary hypothyroidism there is a disorder in the pituitary gland and in tertiary hypothyroidism the cause must be sought in the brain that controls the pituitary gland. Primary hypothyroidism is the most common. Sporadic are secondary hypothyroidism and tertiary hypothyroidism.

Symptoms

The difficult thing about hypothyroidism is that symptoms are very diverse in each patient. This makes the diagnosis difficult. A patient may have been suffering from hypothyroidism for years without knowing it. The most common complaints are fatigue, feeling cold quickly, memory loss and muscle weakness. Below is a list of symptoms that can occur with a poorly functioning thyroid gland. There are patients with many complaints, but there are also people who barely notice that they have hypothyroidism.

  • Fatigue
  • Getting cold quickly
  • Fluid accumulation in the face, legs and eyelids
  • Cold and dry skin
  • To gain weight
  • Hair loss
  • Voice becomes low and hoarse
  • Amnesia
  • Muscle weakness
  • Thick tongue
  • Tingling
  • Constipation
  • Nails become crumbly
  • Appetite decreases
  • Excessive monthly bleeding
  • Deafness
  • Muscle weakness
  • Slower heart rate
  • Higher blood pressure
  • Swollen thyroid gland

 

Diagnosis

There are several studies that can demonstrate hypothyroidism. The TSH concentration, the low FT4 and the T3 level are examined in the blood. When a patient suffers from hypothyroidism, the TSH concentration is elevated, the FT4 level is low and the T3 level is low. When a patient has TPO antibodies in his blood, this may indicate Hashimoto’s disease.

Therapy

Patients with hypothyroidism are treated with thyroid hormones. The shortage of T4 is compensated by taking pills containing synthetic T4. This usually concerns Euthyrox, Eltroxin or Thyrax tablets. The pills contain different strengths. In the elderly, patients with the heart disease angina pectoris and people with a very severe form of hypothyroidism, the amount of synthetic T4 prescribed gradually increases. Patients usually use a serving of 0.1 to 0.150 milligrams per day.

Myxedema coma

Patients with a very severe form of hypothyroidism can end up in the hospital. This condition is serious, because the sick can fall into a coma. This is called myxedema coma. If not treated in time, the patient can die.

Newborn babies with hypothyroidism

Babies and children can also get hypothyroidism. This may be due to, among other things, poor development of the thyroid gland, Hashimoto’s disease or an abnormality in the production of T4 and T3. In newborn infants, hypothyroidism not detected in time can have major consequences. Babies can then suffer from a brain defect. A heel prick is performed on every newborn baby. This allows the TSH concentration to be measured. Blood tests do not always reveal hypothyroidism. The condition can then be recognized as a swollen belly with a bulged navel. Symptoms that occur in adults can also occur in babies and children. See the previous list of symptoms for this.

Causes

Hypothyroidism can have several causes. The best known cause is a lack of iodine. When there is no iodine, the thyroid cannot produce thyroxine (T4) and triiodothyronine (T3). Iodine deficiency is rare in the Western world. In the Netherlands, Hashimoto’s disease is the biggest culprit for hypothyroidism. This is an autoimmune disease that produces antibodies against the thyroid cells. As a result, not enough thyroid hormone can be produced. When the thyroid cells are unfilled, hypothyroidism strikes. The thyroid gland can also function poorly after treatment with radioactive iodine, surgery or due to the use of certain medications. Other causes are thyroid inflammation, a congenital defect, a defect in the pituitary gland or the use of X-ray contrast agents, lithium, Tasmanian cabbage or Japanese seaweed.

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