Some people are more likely to develop thyroid disorders than others, and while It’s impossible to prevent thyroid disease, knowing the signs and symptoms can help you get a prompt diagnosis and treatment. Early detection is key to preventing complications and needless suffering.
Internal medicine physician Dr. Samuel I. Fink is devoted to helping you and the entire family maintain wellness. With extensive experience in preventive medicine, Dr. Fink partners with patients to prevent and manage a range of a full range of health conditions, including hypothyroidism.
Your thyroid is a small, butterfly-shaped gland situated at the base of your neck. This mighty gland is part of the endocrine system and produces important hormones that your body needs to regulate various functions such as heart rate, body temperature, and energy production.
Hypothyroidism 101
The thyroid has a major job to do, and it usually does it without any input on your part. However, thyroid failure can and does occur, and when it does, the thyroid is unable to produce enough hormone to meet your body’s needs.
Autoimmune thyroiditis (Hashimoto’s disease) is the most common cause of hypothyroidism. In people with AT, the immune system produces antibodies against the thyroid. Over time, the ongoing attack on your thyroid prevents the gland from doing its job.
Symptoms of hypothyroidism
Hypothyroidism causes a wide range of symptoms and can vary from person to person. Think of your body as a car and thyroid hormone as the gas for your car. Many of the symptoms of hypothyroidism are associated with lack of energy production. Common symptoms include:
Fatigue
Weight gain
Problems concentrating
Menstrual irregularities
Hair loss
Cold hands and feet
Cold sensitivity
Decreased libido
Low mood
Daytime sleepiness
If you have symptoms of hypothyroidism, discuss them with Dr. Fink.
Hypothyroidism risk factors
Some factors increase your likelihood of developing hypothyroidism. However, you may develop hypothyroidism with or without these risk factors. The more risk factors you have, the higher your chance of developing hypothyroidism. The following are common risk factors for thyroid failure:
- Gender:
Women are more likely to develop hypothyroidism than men
- Age:
Your risk of hypothyroidism increases with age
- Existing autoimmune disease:
Having an autoimmune condition boosts your risk for hypothyroidism
- History of radiation:
Radiation exposure to the neck increases your chance for thyroid disease
- Previous thyroid surgery:
Any previous surgical procedure on the thyroid gland raises your risk of thyroid failure
- Family history of hypothyroidism:
Having a close relative with hypothyroidism increases the chances that you will develop it, too
Having any of these risk factors does not mean you will automatically develop thyroid disease, but it’s good to be aware of them.
Evaluating hypothyroidism
Diagnosing hypothyroidism is relatively straightforward. Dr. Fink orders a blood test that checks for key thyroid-related chemicals:
Thyroid stimulating hormone
(TSH): The pituitary gland secretes this hormone to stimulate the thyroid gland to release its hormones. People with hypothyroidism have a higher than normal TSH level.
Thyroxine
: This is the main hormone produced by the thyroid; a low thyroxine level suggests hypothyroidism.
Dr. Fink may also check your blood for antibodies against the thyroid.
Treatment for hypothyroidism
Treating hypothyroidism involves replacing the hormone that your body lacks. Levothyroxine is the most common medication prescribed to treat hypothyroidism. It comes as a tablet or capsule and is usually taken once daily.
Dr. Fink rechecks your thyroid levels after 6-12 weeks and adjusts the dose until your thyroid hormone levels normalize, as indicated by a TSH level within the normal range. He may also check your level of thyroxine and liothyronine to ensure optimal treatment. Liothyronine is the active form of levothyroxine.
Seeking professional help for hypothyroidism
Hypothyroidism can cause symptoms that are subtle and difficult for you to detect. If you suspect you’re having problems with your thyroid, it’s wise to undergo screening for thyroid disease.
For more information and for all of your primary care needs, call our Tarzana, California, office to schedule a visit, or request an appointment online.
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Hypothyroidism may develop for a number of different reasons, the most common being an autoimmune attack on the thyroid gland, called Hashimoto's thyroiditis. Hypothyroidism may also be the result of taking a medication like lithium, genetics, or an underlying pituitary gland problem.
Understanding the "why" behind a diagnosis of hypothyroidism is critical to moving forward with a proper treatment plan. While some people may require lifelong thyroid hormone replacement, others may have a short-lived case of hypothyroidism (for example, postpartum thyroiditis), need to stop taking a medication, or require further diagnostic tests like imaging of the pituitary gland.
© Verywell, 2018Hashimoto's thyroiditis is the leading cause of hypothyroidism in the United States.
In Hashimoto's, antibodies react against proteins in your thyroid gland, causing gradual destruction of the gland itself, rendering it unable to produce the thyroid hormones your body needs.
Hashimoto's thyroiditis is more common in women, and while it may occur at any age, it's more common as people get older. For women, Hashimoto's often develops during pregnancy, after delivery, or around the time of menopause.
Antibodies attack thyroid gland cells, affecting function and size.
Other causes of hypothyroidism include:
People with hyperthyroidism, thyroid nodules, or thyroid cancer may need to have surgery. If all of the thyroid gland is surgically removed, a person will be hypothyroid and require lifelong thyroid hormone replacement medications. If only part of the thyroid gland is removed, there is a good chance that it will still be able to make sufficient thyroid hormone.
Instead of thyroid surgery or antithyroid medication, some people with hyperthyroidism are treated with radioactive iodine, which will destroy the thyroid gland, rendering a person hypothyroid. People who undergo radiation treatment for Hodgkin's lymphoma or head and neck cancer are also at risk of developing hypothyroidism.
Thyroiditis describes thyroid gland inflammation and is a general term for a variety of thyroid conditions.
Hashimoto's disease is the most common type of thyroiditis and is caused by an autoimmune attack.
Another example of thyroiditis is subacute thyroiditis (also called de Quervain's thyroiditis), which is believed to be caused by a virus. With this type of thyroiditis, a person experiences hyperthyroidism followed by hypothyroidism, in addition to a tender thyroid gland.
Certain medications may trigger hypothyroidism. These medications include:
- Lithium
- Amiodarone
- Thionamides (antithyroid drugs)
- Interferon-alpha
- Interleukin-2
- Certain cancer drugs (tyrosine kinase inhibitors and checkpoint inhibitor immunotherapies)
Too much iodine (for example, from dietary supplements that contain kelp) can cause or worsen hypothyroidism. In addition, a deficiency of iodine, which is seen in some people in underdeveloped countries, may cause hypothyroidism. Iodine is necessary for the production of thyroid hormone and is found in foods, like dairy products, chicken, beef, pork, fish, and iodized salt.
Some babies are born without a thyroid gland or with only a partial thyroid gland. Since there is no thyroid gland (or not enough) to produce thyroid hormone, hypothyroidism develops, which is serious and requires treatment with a thyroid hormone pill.
The pituitary gland is located in the brain and stimulates other glands within the body, like the thyroid gland, to release hormones. If the pituitary gland is damaged by a brain tumor, radiation, or brain surgery, it may not function well enough to signal the thyroid gland. This can then result in it becoming underactive. This type of hypothyroidism is called central or secondary hypothyroidism.
Rarely, certain diseases, like hemochromatosis, can deposit abnormal substances (iron, in the case of hemochromatosis) in your pituitary gland, causing central hypothyroidism, or less commonly, your thyroid gland, causing primary hypothyroidism.
Besides hemochromatosis, sarcoidosis can cause granuloma deposition in the thyroid gland. There is also a rare condition called fibrous thyroiditis (or Riedel's thyroiditis), in which fibrotic tissue replaces normal thyroid tissue.
Your DNA plays a role when it comes to developing autoimmune hypothyroidism, and this has been supported by a number of studies.
One German study found a 32-fold increased risk for developing Hashimoto's thyroiditis in children and a 21-fold increased risk in siblings of people with Hashimoto's thyroiditis.
When looking at the specific genes linked to Hashimoto's, scientists have found mutations in the genes for human leukocyte antigen (HLA), T-cell receptors, and other molecules involved in the immune system.
To further support the role of genes in developing Hashimoto's thyroiditis, people with Turner syndrome and Down syndrome (both of which are genetic in origin) have a higher than expected rate of autoimmune thyroid disease, especially Hashimoto's thyroiditis.
All said, though, it's important to remember that your genes are but one factor that help predict your risk of developing hypothyroidism. There are many other factors that come into play, like pregnancy or taking certain medications.
In the end, it's the combination of genes and an environmental trigger that predict a person's unique risk for developing hypothyroidism.
Factors that increase a person's risk of developing hypothyroidism include:
- Being female
- Being of an older age
- Being Caucasian or Asian
- Having a family history of Hashimoto's thyroiditis or another autoimmune disease
- Having a personal history of an autoimmune disease (for example, adrenal insufficiency, rheumatoid arthritis, or type 1 diabetes)
- Being pregnant or postpartum
- Too much or too little iodine consumption
- Treated with radioactive iodine
- Received radiation to the neck or upper chest
- Underwent thyroid surgery
- Treated with certain medications (for example, lithium for bipolar disorder)
Interestingly, research suggests that selenium deficiency may be linked to developing Hashimoto's thyroiditis and hypothyroidism. Moreover, having underlying headache disorders, like migraines, has been found to be associated with an increased risk of hypothyroidism, especially in obese women.
It's still unclear precisely how smoking affects the thyroid gland, although it's likely complex. While some studies suggest that cigarette smoking increases the risk of hypothyroidism in people with Hashimoto's thyroiditis, other research suggests that smoking is actually linked to a lower prevalence of hypothyroidism and a higher prevalence of hyperthyroidism.
Frequently Asked Questions
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Why is hypothyroidism more common in women?
The most common cause of hypothyroidism is an autoimmune condition called Hashimoto disease, and women are more likely to be affected by autoimmune conditions in general. One reason may be that hormones play a significant role in the functions affected by autoimmune conditions, and women experience more shifts in hormones during their lifetime.
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What increases your chances of getting Hashimoto disease?
Having another autoimmune condition such as rheumatoid arthritis is one factor that puts you at risk for Hashimoto thyroiditis. A family history of the disease also increases your risk. Women are seven times more likely than men to develop Hashimoto disease.