Her physician checked her thyroid hormone levels. Sure enough, her thyroid gland was underfunctioning in a condition called hypothyroidism.
Hypothyroidism is the underproduction of the thyroid hormones triiodothyronine (T3) and thyroxine (T4), says Deepika Reddy, MD, Endocrinologist. Thyroid hormones are the accelerators for every action in your body. A decrease in T3 and T4 results in a decrease in metabolism.
Hypothyroidism affects around five percent of the U.S. population, according to the National Institutes of Health. It’s most common in women in their 30s to 50s.
Symptoms of Hypothyroidism
Symptoms of hypothyroidism are elemental of your metabolism slowing down:
- Weight gain
- Inability to lose weight
- Cold intolerance — feeling cold all the time
- Menstrual irregularity
- Dry skin and hair
“You may also have a goiter, an enlarged thyroid gland, as it’s trying to entrap as much iodine as it can,” says Dr. Reddy. Iodine molecules are needed to make thyroid hormone.
Based on your symptoms, if your physician suspects you may have hypothyroidism, says Dr. Reddy, your physician will run a series of blood tests to confirm the diagnosis:
- Free T4
“The TSH is a pituitary hormone that stimulates the thyroid gland. So when the thyroid hormone levels are low, you will have an increase in TSH, because your body is trying to stimulate the thyroid to make more thyroid hormone,” Dr. Reddy explains.
Causes of Hypothyroidism
“There are multiple causes of hypothyroidism,” but most of the time it tends to be an autoimmune problem, the most common of which is Hashimoto’s disease. You develop antibodies that attack your thyroid cells and over time you lose functionality in your thyroid cells,” no longer producing enough thyroid hormone to meet the needs of your body.
Other causes of hypothyroidism, Dr. Reddy says, include:
- Irradiated thyroid or neck
- Thyroid removed for some reason
- Family history of thyroid disease
- Pregnancy within the last six months
Hypothyroidism generally requires lifelong treatment with medication.
“The medication — levothyroxin — is identical to the human T4. It’s important we give just the right amount, which is dependent on many factors that can mess up dosing, including weight changes and whether you take it with food, vitamins or estrogen,” Dr. Reddy says.
Dr. Reddy offers these tips for maintaining a steady level of thyroid hormone:
- Purchase the medication from the same pharmacy
- Avoid fluctuations in weight
- Take two to three hours before or after food
- Take the medication at the same time every day
Dangers of Untreated Hypothyroidism
The symptoms of hypothyroidism — fatigue, weight gain, depression — often mimic those of other syndromes and diseases. If your hypothyroidism progresses without being diagnosed and treated, Dr. Reddy says, over the years it may advance to:
- Significant mental status changes
- Bradycardia – severe reduction in heart rate
- Respiratory difficulty – unable to breathe deeply or maintain respiratory function
- Microglossia – significant thickening of the tongue
If these symptoms persist without treatment, hypothyroidism can progress to its most severe form called myxedema coma, Dr. Reddy says, where your body slows down almost to the point of death. It requires immediate intensive-care treatment.
Untreated, advanced hypothyroidism happens primarily to elderly patients who live alone, says Dr. Reddy.
“They’re not used to going out much, and people don’t say, ‘Where is Mrs. X?’ because she’s pretty much home all the time, and there’s a gradual worsening of symptoms. Those are the ones who end up coming in severely hypothyroid,” says Dr. Reddy.
“For patients with overt hypothyroidism,” says Dr. Reddy, “replacing thyroid hormone with levothyroxine makes a big difference in terms of mood and in terms of quality of life.”