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Taking a Look at Hypothyroidism

A look at what causes it and how it affects people.

One of the most important regulators of metabolic and bodily functions is the thyroid gland, a butterfly-shaped gland in the front of our neck between the Adam’s apple and collarbone.

Under the influence of yet another gland (the pituitary) located in the brain, the thyroid gland sets the tone for almost every other organ in the body. This is accomplished through the production and release of thyroid hormones into the bloodstream--hormones known as triiodothyronine (T3) and thyroxine (T4).

Millions of people have disorders of the thyroid gland, leading to overproduction (hyperthyroidism) or underproduction (hypothyroidism) of T3 and T4. If the symptoms are recognized, these conditions are readily diagnosed and treated. This week we will discuss hypothyroidism and next week we will focus on hyperthyroidism.

Since the general role of thyroid hormones is to regulate metabolism, it is no surprise that hypothyroidism, although frequently asymptomatic in its early stages, will lead to an overall sluggishness of the body and its functions.

Non-specific symptoms such as fatigue, weight gain and intolerance of cold temperatures are often seen.  Different organ systems, either in isolation or in various combinations, may be affected. The skin can become dry and thick; the hair coarse and thin; the nails brittle. The heart may slow down and have a weaker pumping function. The muscles controlling respiration can weaken, leading to shortness of breath. Sleep apnea may be seen.  A sluggish colon may lead to constipation.

There are several causes of hypothyroidism. In the United States, an autoimmune condition called Hashimoto’s thyroiditis, in which the body produces antibodies which attack normal thyroid gland cells, is the most common cause. It is more frequently seen in women. Certain medications, such as the cardiac therapy amiodarone, can injure the thyroid gland. 

Paradoxically, treatment for hyperthyroidism with surgery or radioactive iodine may render a patient hypothyroid. Finally, disorders of the thyroid gland’s regulator, the pituitary, may lead to less T3 or T4 production.

The diagnosis of hypothyroidism is straightforward and done through blood tests. Although all newborn babies in the United States are screened for thyroid disorders, adult testing is based upon signs and symptoms of thyroid dysfunction.

The treatment for hypothyroidism is a daily pill which supplies thyroxine. Usually a starting dose is chosen, and 6 weeks later a follow-up blood test is performed to see if dosage adjustment is necessary. Once a stable dose is established, an annual blood test will suffice unless symptoms emerge.

If you have concerns about your thyroid gland, please speak to your primary care physician. If you would like to consult an expert in thyroid gland disorders, make an appointment with the endocrinologists at NuHealth by calling 516-572-4848. The Endocrine Society web page at www.hormone.org/Thyroid/hypothyroidism.cfm is very informative.

pwoolever September 13, 2011 at 11:51 PM
This is a very biased article and does not address the MILLIONS of hypothyroid patients that are highly symptomatic, yet their blood tests are in the "normal" range. I am one of those people and my non-diagnosis changed my life in ways I never could have predicted. Beginning in the mid-point of the last century the protocol for treating thyroid disorders was changed to focus on the "straightforward and done through blood tests" method of diagnosis, totally disregarding the symptoms. A sufferer's blood work can fall within the "normal" range and they can still be incredibly symptomatic.I could write a five page essay on what I endured physically, mentally, financially, and career-wise due to the poor training and inferior protocols used in the U.S. medical system regarding hypothyroidism. I believe you will hear more and more noise about this because patients are exasperated with the misinformation and biased information that this article exemplifies and which future doctors are taught in medical school. This is not a simple disease and there is no simple diagnosis or treatment that works for everyone. Just Google "hypothyroidism" and you will find the generic WebMD, or endocrinweb descriptions but then you will also find numerous activist sites that are trying desperately to raise awareness in the patient and health care provider communities so that this travesty of incompetent and ignorant treatment can be abolished.

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