Understanding Hypothyroidism: Thyroid Function, Causes And Management

The thyroid gland is a highly vascularised bilateral endocrine organ, producing hormones that regulate metabolism. Hypothyroidism is a condition in which the gland produces inadequate amounts of these hormones, which are pivotal in sustaining the body's diverse functions.

Learn in detail about hypothyroidism, its causes, treatment plans, and lifestyle changes to cope with this complicated condition.

Causes of Hypothyroidism

Hypothyroidism occurs due to many factors, from autoimmune disorders to genetic as well as acquired disorders.

Common Causes of Hypothyroidism

 Here are the most common reasons behind this condition:

• Hashimoto's Thyroiditis: It is a condition in which the immune system attacks the thyroid gland, causing inflammation and decreased hormone production.
• Thyroid Surgery: Hypothyroidism is expected after a thyroid surgery that involves a partial or complete absence of the thyroid gland in the body.
• Radiation Therapy: Radiation to the neck area negatively impacts the thyroid gland and hampers hormone secretion.
• Iodine Deficiency: Any iodine deficiency in the diet affects the synthesis of thyroid hormones.
• Certain Medications: Some medications, such as lithium, have some side effects on thyroid hormone synthesis.

Rare and Autoimmune Causes of Hypothyroidism

Some of the more complex causes of hypothyroidism are discussed below:

• Postpartum Thyroiditis: This autoimmune disorder may occur postpartum, causing damage to the thyroid gland by the immune system.
• Subacute Thyroiditis: It is an inflammation of the thyroid gland caused by a viral infection, which leads to temporary thyroid dysfunction.
• Pituitary Gland Disorders: One of the rare causes of hypothyroidism is a malfunction in the production of TSH.
• Congenital Hypothyroidism: It is a condition where the thyroid gland has been nonfunctional since birth.
• Grave's Disease Treatment Complications: Hypothyroidism can occur as a complication of treatments such as radioactive iodine or surgeries.

Risk Factors for Hypothyroidism

Hypothyroidism is characterised by various parameters that increase the risk of illness due to the interactions between genetic predisposition and environmental conditions. Knowledge of all these aspects can assist people in evaluating the possible risks of developing the condition.

Genetic Factors

These include: 

• Family History: Family members, especially first-degree relatives with hypothyroidism, raise personal risk.
• Gene Mutations: Separate gene polymorphisms can lead to the development of autoimmune thyroid diseases.

Lifestyle and Environmental Factors

These include:

• Iodine deficiency and radiation exposure negatively impact thyroid function.
• Autoimmune diseases, hormonal fluctuations during pregnancy, smoking, extended stress, and inadequate selenium and zinc nutrition may further increase vulnerability.

Symptoms of Hypothyroidism

Hypothyroidism manifests itself through a range of symptoms that impact various aspects of bodily functioning and may take years to become fully apparent.

• The first symptoms of hypothyroidism are lethargy, weight gain, cold intolerance, constipation, dry skin, hair loss, easy breakage of nails, depression, heavy or irregular periods, joint or muscle aches, and itching.
• In later stages, symptoms worsen and involve bradycardia, impaired memory and concentration, hoarseness, swelling of the face, muscle slowness, impotence or decreased sexual desire, symptoms of carpal tunnel syndrome, and thick and coarse hair and skin.

Diagnosis of Hypothyroidism

To diagnose hypothyroidism, healthcare providers conduct physical examinations, palpating the thyroid gland for swelling, enlargement, or nodules. They also look for signs such as dry skin, low pulse rate, periorbital oedema, and changes in physical appearance. Additional assessments may include testing muscle strength, tendon reflexes, and signs of swelling.

Blood Tests

Blood tests are crucial for diagnosing hypothyroidism. Physicians measure three key hormone levels:

• Thyroid Stimulating Hormone (TSH), with normal levels ranging from 0.4 to 4.5 milli-international units per litre (mIU/L).
• Thyroid hormone T3 (Triiodothyronine), which helps regulate metabolism and energy production.
• Thyroid hormone T4 (Thyroxine), which is converted into T3 in the body and plays a key role in metabolism regulation.

Imaging Studies

Imaging studies may be recommended by doctors depending on the specific structural and functional abnormality of the thyroid gland. These may include:

• Ultrasound: Assesses gland dimensions and identifies possible nodules
• CT Scan: Provides detailed images of the thyroid gland to assess its size, shape, and any abnormalities
• Thyroid Uptake Scan: Determines how well a gland can take up iodine and synthesise hormones

Complications of Untreated Hypothyroidism

If left undiagnosed and untreated, hypothyroidism can result in several severe disorders that deeply affect cardiovascular and mental health. Cardiovascular risks are high levels of cholesterol, arrhythmia, and chances of heart failure. Mental health conditions such as depression, anxiety, and cognitive disorders can further affect the quality of life.

Treatment Options for Hypothyroidism

Levothyroxine is the most common treatment for hypothyroidism, serving as a synthetic replacement for the hormone the thyroid no longer produces. Taken once daily, it helps normalise hormone levels, relieve symptoms, and reduce complications. The dosage varies based on factors such as the patient’s age, weight, and other health conditions.

In addition to medication, iodine-rich foods, such as selenium and zinc, can support thyroid function. Some patients also use natural treatments like selenium and vitamin D to maintain their thyroid health. Moreover, clinical trials have shown that yoga can reduce hypothyroidism health risks by supporting cardiovascular health, lung functions, and BMI (Body Mass Index).

Diet and Lifestyle Modifications for Hypothyroidism

To support thyroid function and boost hormone production, it is important to focus on foods rich in iodine, such as fish, dairy, and iodised salt. Selenium can be supplemented by incorporating foods like Brazil nuts, sunflower seeds, and lean meats into the diet. Additionally, consuming foods high in zinc, vitamin D, and omega-3 fatty acids can further support thyroid health.

Physical activity is especially vital in hypothyroidism, as it has other benefits, such as a better mood, more energy, and decreased stress. Low-impact exercises include water aerobics, yoga, Tai Chi, and gentle strength training. They assist in retaining muscle mass power, joint flexibility, and metabolism.

Living with Hypothyroidism: Strategies for Wellness

Specific lifestyle changes, such as regularly taking prescribed medications and monitoring your diet, can effectively manage hypothyroidism. A well-balanced diet, regular physical activity, and stress management are key components in controlling the condition.

Also, it is essential to track symptoms and fluctuations in energy levels, ensuring these are communicated to a healthcare practitioner for ongoing evaluation and adjustment of treatment.

Informal support for people with hypothyroidism is available through the Indian Thyroid Association, specific endocrinology departments of key hospitals in India, such as Apollo Hospitals, and online communities. Regional healthcare networks, telemedicine services, and regional language support provide holistic information.

Conclusion

Hypothyroidism is a lifelong condition that requires proper management to ensure a healthy and fulfilling life. With timely diagnosis, prescribed medications, and regular checkups, hormone levels can be effectively regulated, alleviating symptoms and preventing complications. Incorporating a thyroid-friendly diet, physical activity, and stress management into daily routines further supports overall well-being. Staying informed, connected with healthcare providers, and seeking community support can empower individuals to navigate this condition confidently and maintain a good quality of life.