Hypothyroidism

Hypothyroidism is an endocrine disorder condition identified by abnormally low thyroid production. It’s a condition wherein the thyroid gland is unable to make enough thyroid hormones to keep the body running normally. As the thyroid hormone play an important role in growth, development and many other cellular processes, inadequate thyroid hormone create across the board consequences on the body. People are called to be hypothyroid, when they have too little thyroid hormone in the blood.

To understand hypothyroidism, we first need to understand the thyroid gland. The thyroid gland is a butterfly shaped endocrine gland (system that secretes its hormones using ducts), which is normally located in the lower front of the neck just below the Adam’s apple. These glands produce the hormones, namely, tetraiodothyronine (T4) and triiodothyronine (T3), which are secreted into the blood and then carried to each and every tissue in the body.  Together these hormones regulate how the cells of our body use the energy to stay warm and keep the brain, heart, muscles and other organs working the way they should. This process is called metabolism. The hypothalamus and the pituitary in the brain control the normal secretion of thyroid hormones, which in turn control metabolism. In case the body does not have enough thyroid hormone, the system processes slows down, this means, the body makes less energy and the metabolism becomes sluggish.

The process is as follows:

• The T4 and T3 hormones regulate the body’s metabolic functions like heat generation and utilization of carbohydrates, fats and proteins. I n children, these hormones are responsible for growth and development.
• In the pituitary gland, thyrotropinstimulating hormone (TSH) is released when more thyroid hormone is needed and travels via the bloodstream to the thyroid gland. The TSH then stimulates the thyroid to produce T4 and T3.
• The pituitary gland acts like a thermostat i.e. when there is too much or less thyroid hormones in the bloodstream, it releases TSH accordingly to signal the thyroid hormone production.

About 20 million people suffer from thyroid disorder in the U.S. It’s more common in women than in men and increase with age.

Causes of Hypothyroidism

There may be numerous reasons why the cells in the thyroid gland can’t make enough thyroid hormone. Following are some of the major causes:

• Autoimmune Diseases – In some cases, the immune system that protects the body from invading infections can mistake thyroid glands and their enzymes for invaders and attack them, in turn there aren’t enough thyroid cells and enzymes left to produce enough thyroid hormones. This is more common in women than in men. Autoimmune thyroiditis can begin suddenly or may develop slowly over years. The most common forms are :
• Hashimoto’s thyroiditis – An autoimmune disease causing chronic inflammation and consequential failure of thyroid gland. It is also called as chronic lymphocytic thyroiditis. It often leads to hypothyroiditism.
• Grave’s Disease – It is an autoimmune disease in which the over activity of the thyroid gland causes over production of thyroid hormones. Grave’s disease is the most common cause of hypothyroidism. It has major negative impact on an individual’s mental and physical health.
• Atrophic Thyroiditis – This condition is considered to be the opposite of Grave’s disease. In atrophic thyroiditis, TSH is blocked from activating thyroid cells. Tissue changes in atrophic thyroiditis are characterized by fibrosis and stunted cell growth, and hypothyroidism generally progresses to complete thyroid failure.

• Radiation Treatment – Some patients with Grave’s disease, thyroid nodules or thyroid cancer, Hodgkin’s disease and lymphoma or cancer of neck or head are treated with radioactive iodine (I-131) in order to destroy or reduce the thyroid gland. All these patients can lose part or whole of their thyroid function.
• Damage to the pituitary gland. The pituitary tells the thyroid how much hormone to make. When the pituitary is damaged by a tumor, radiation, or surgery, it may no longer be able to give the thyroid instructions and the thyroid may stop making enough hormones. 

• Surgery – Some patients with thyroid nodules, thyroid cancer or Grave’s disease need to go under the thyroid removal surgery. If the whole thyroid is removed, there are 100 percent chances of hypothyroid, but if the part of gland is left, it may still produce enough thyroid hormone for the body. 

• Medications – Certain medicines such as amiadarone, lithium, interferone alpha and interleukin-2 can affect the production of thyroid hormone. These medicines are most likely to trigger hypothyroidism in patients who have genetic tendency to autoimmune thyroid diseases. 

• Congenital Hypothyroidism – A few babies are born without or with only a partly formed thyroid. In some cases babies have a part or their entire thyroid in wrong places. 

• Too much or too little iodine in the diet – The thyroid glands need iodine to produce thyroid hormones. To maintain the thyroid hormone production in the body, right amount of iodine is needed. Taking in too much of iodine can cause or worsen hypothyroidism. 

• Rare Disorders that infiltrate the thyroid – In some people, different diseases deposit abnormal substances in the thyroid and disturb its ability to function. For example, sarcoidosis can deposit granuloas, amydoilosis deposits amyloid protein etc. 

Symptoms

Hypothyroidism generally manifests as a slowing in the mental and physical activity of the affected person. As the symptoms are too variable and nonspecific, the only way to know for sure whether you have hypothyroidism is with a simple blood test for TSH.

The following are the symptoms for Hypothyroidism:

• Fatigue, loss of energy, lethargy
• Weakness
• Sensitivity to cold
• Dry skin
• Hair loss
• Sleepiness
• Muscle pain, joint pain
• Depression
• Menstrual Disturbances and impaired fertility
• Blurred vision
• Brittle hair and nails
• Constipation

If it is left untreated, the following symptoms can occur:

• Puffiness of the face, hands and feet
• Hoarseness
• Decreased taste and smell
• Thin eyebrows
• Thickened skin
• Slowed speech
• Myxedema Coma
• Altered Mental Status
• Hypercarbia – abnormally elevated carbon dioxide (CO2) levels in the blood
• Hypothermia – unusual and dangerous low body temperature
• Bradycardia – abnormally slow heart action
• Hyponatremia – low sodium concentration in the blood
• Cardiomegaly, pericardial effusion, cardiogenic shock, and ascites may be present. 

Complications

Hypothyroidism can lead to following complications it left untreated:

• Birth Defects – If the patient is pregnant and has an untreated thyroid disorder, the child may be at a higher risk of having birth defects than the ones born to healthy mothers. They may also have a significant mental  or physical development issues
• Goiter – In situations when the thyroid in the body exerts itself in an effort to produce an adequate amount of hormones, the excessive stimulation results in an enlarged thyroid gland i.e. a bulge in the neck.
• Heart Problems – Hypothyroidism even in its mildest form, can affect the heart conditions as it increases the levels of the bad cholesterol which leads to atherosclerosis, hardening of the arteries, therefore increasing the chances of heart attacks and strokes.
• Infertility – If the thyroid hormone levels are too low, it affects ovulation and decreases women’s chances of conceiving.
• Mental Health Issues

Treatment

• Thyroid Hormone Replacement Therapy – The goal of this replacement therapy is to compensate for the lack of hormones secreted by the thyroid gland. It is a very individualized treatment process. Its aim is to normalize the thyroid stimulating hormone (TSH) levels. In most cases, a daily dose of T4 pill is prescribed. The therapy is of variety of forms, including animal thyroid supplements.
• Synthetic T4 Supplements – The standard form of treatment of hypothyroidism is synthetic forms of thyroid hormone T4 supplement, generally called as levothyroxine. There are 6 types of supplements available – Levo-T, Levothyroxine Sodium, Levoxyl,Novothyrox, Synthroid, UNITHROID.
• Animal Thyroid Supplement – This type of treatment was once considered to be the standard treatment for hypothyroidism where in pig thyroid extract is used to make the supplement.

Side Effects of Drugs

The only dangers of thyroxin and other such drugs are caused by taking too little or too much. If it is taken too little, hypothyroidism will continue. If it is taken too much, development symptoms of hyperthyroidism—an overactive thyroid gland, is possible . The most common symptoms of too much thyroid hormone are fatigue but inability to sleep, greater appetite, nervousness, shakiness, feeling hot when other people are cold, and trouble exercising because of weak muscles, shortness of breath , and a racing, skipping heart. Patients who have hyperthyroid symptoms at any time during thyroxin replacement therapy should have their TSH tested. If it is low, indicating too much thyroid hormone, their dose needs to be lowered. 

Alternative Treatment

At our center we believe in treating the patients in every natural way possible. Our Comprehensive Treatment Approach helps us to study the patient’s health history and treat him accordingly.

• Eating foods with high levels of B-vitamins and iron, such as whole grains, fresh vegetables and sea vegetables
• Avoiding foods that interfere thyroid functions, such as, broccoli, cabbage, Brussels, sprouts, cauliflower, kale, spinach turnips, soybeans, peanuts, linseeds, pine nuts, cassava, millet and mustard greens.
• Eating food that is rich in antioxidants, including fruits like blueberries, cherries and tomatoes and vegetables like squash and bell pepper.
• Avoiding alcohol and tobacco.
• Omega3 fatty acids such as fish oil to help reduce inflammation and enhance immunity.
• Herbs like –
  • Coleus – for low thyroid function
  • Guggul – for low thyroid support

• 100% Gluten free – The molecular composition of thyroid tissue is almost similar to that gluten. Hence, eating gluten can increase the autoimmune attack on the thyroid.
• Acupuncture – It may be helpful in correcting hormonal imbalances including thyroid disorders.

• Natural Desiccated Thyroid (NDT)

A natural alternative to Synthroid and all other synthetic thyroid medication is natural desiccated thyroid. It is made from pork thyroid glands. This natural source of thyroid has been used to treat hypothyroidism since a long time. It is natural, safe and well tolerated. NDT is commonly standardized by iodine content and not thyroid hormone content. As this contains other sources of iodine besides T4 and T3, it helps the patient, stimulate the thyroid hormone production. Therefore, desiccated thyroid can immediately relieve the symptoms of hypothyroidism by replenishing T3 and T4. It can as well as supply the active ingredient (iodine) required by the thyroid to natively produce its own thyroid hormones. In addition, iodine is another natural alternative to Synthroid. Some cases of hypothyroidism can be treated with natural sources of iodine such as iodized salt and sea vegetables such as kelp (as mentioned earlier). 

Follow-up

The patients need TSH to be checked about every 6 to 10 weeks after a thyroxine dose change.  The patients may need tests more often if they are pregnant or in case they are taking a medicine that interferes with your body’s ability to use thyroxine. The goal of treatment is to get and keep the TSH in the normal range. Babies with hypothyroidism must get all their daily treatments and have their TSH levels checked as they grow, to prevent mental retardation and stunted growth. Once gained a settled thyroxine dose, the patient can return for TSH tests about once a year.

Keeping other people informed

The patients are advised to inform their family members. Because thyroid disease runs in families, people should explain their hypothyroidism to their relatives and encourage them to get regular TSH tests. Informing  other doctors and  pharmacist about their hypothyroidism and the drug and dose with which it is being treated. If at all the patient starts seeing a new doctor, the doctor should be informed about hypothyroidism condition and the need of TSH test every year.

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