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Health Tip:
Hypothyroidism. Part 1: The Illness
The thyroid is butterfly-shaped gland located at the base of the front of the neck.
Hypothyroidism is an endocrine disease in which the thyroid gland does not produce
an adequate amount of thyroid hormone.
It is estimated that 3% to 5% of the population has some form of hypothyroidism.
This condition is particularly common in women over the age of 50. Since thyroid
hormone is involved in maintaining many important functions in the body, having
an inadequate amount can cause a variety of physical as well as mental disorders.
What are the symptoms of hypothyroidism?
Symptoms
can be divided into early and late manifestations. Early symptoms develop once the
amount of available thyroid hormone drops below a critical level. These symptoms
include:
- cold sensitivity
- constipation
- depression
- fatigue
- menstrual disorders
- unintentional weight gain
- thin, brittle hair or fingernails
- dry skin
- excessive sleepiness
- muscle aches, tenderness or stiffness
If the condition is not addressed
in its early stages, late manifestations can develop which include hoarseness, slow
speech, puffiness around the eyes, a slowing of the heart rate, a drop in body temperature,
and even heart failure.
In most cases, manifestations of hypothyroidism develop
slowly, usually over a number of years. Symptoms can be subtle, and often the disease
is not readily recognized. At other times the symptoms can mimic other conditions,
adding to the difficulty with making the diagnosis.
What causes hypothyroidism?
In this country, the most common cause of hypothyroidism is a condition known as
Hashimoto's thyroiditis. Hashimoto's is an autoimmune disease in which the body
produces antibodies that inappropriately attacks the thyroid gland. In Hashimoto's
the thyroid often becomes enlarged (goiter) along with the decreased ability to
produce thyroid hormone. Various causes for Hashimoto's have been proposed including
a viral or bacterial infection. There appears to be a genetic basis toward developing
Hashimoto's, since this type of hypothyroidism often runs in families. Other causes
of hypothyroidism include:
- Medications. A few medications can lead to the development
of hypothyroidism. These include the psychiatric medication, Lithium, a heart medication
called amiodarone, and a medication that is used to treat an overactive thyroid,
propylthioruacil (PTU).
- Radiation treatment to the neck to treat different cancers,
which, in the process, damages the thyroid gland.
- Radioactive iodine which may
be used to treat an overactive thyroid (hyperthyroidism). Patients who have been
treated for a hyperthyroid condition (such as Graves' disease) and received radioactive
iodine may be left with little or no functioning thyroid tissue after treatment.
- Viral thyroiditis which may cause temporary over-secretion of thyroid hormone
(hyperthyroidism), followed by hypothyroidism.
- Pregnancy. Some women develop hypothyroidism
during or after pregnancy, often because they produce antibodies to their own thyroid
gland.
- Congenital disease. Approximately one in 3,000 babies in the United States
is born with a defective thyroid gland or no thyroid gland at all.
- Iodine Deficiency.
The mineral iodine, which is found naturally in seafood and seaweed, is essential
for the production of thyroid hormones. The addition of iodine to table salt has
virtually eliminated this problem in the United States.
How is hypothyroidism treated?
The purpose of treatment is to replace the thyroid hormone that is lacking. Standard
treatment for hypothyroidism involves daily use of the synthetic thyroid hormone
levothyroxine (e.g.Levothroid, Levoxyl, Synthroid) that is taken by mouth. The correct
dosage is determined by periodically monitoring blood tests to assure that the thyroid
levels are in the proper range. Symptoms generally improve within one to two weeks
of starting treatment, however, in most cases, treatment of hypothyroidism is lifelong.
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