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Hypothyroidism Table of Contents > Conditions > Hypothyroidism Also listed as: Thyroid - underactive Signs and Symptoms What Causes It? What to Expect at Your Provider's Office Treatment Options Following Up Supporting Research Hypothyroidism happens when your thyroid gland, at the front of your neck, doesn't produce enough thyroid hormone (underactive thyroid). There are several types of hypothyroidism. The most common is Hashimoto's thyroiditis, an autoimmune disease where the immune system mistakenly attacks the thyroid gland. The disease affects both sexes and all ages, but is most common in women over age 50. Because the thyroid gland helps regulate your metabolism, low thyroid levels cause your body to slow down and can affect everything from appetite to body temperature. Symptoms can appear over time and can be hard to diagnose. Left untreated, hypothyroidism can cause serious health complications. Signs and Symptoms Slow pulse Fatigue Hoarse voice, slowed speech Goiter (caused by swollen thyroid gland) Sensitivity to cold Weight gain Constipation Dry, scaly, thick, coarse hair Numbness in fingers or hands Confusion, depression, dementia Headaches Menstrual problems In children, slowed growth, delayed teething, and slow mental development What Causes It? There are different kinds of hypothyroidism with different causes. In Hashimoto's thyroiditis, antibodies in the blood mistakenly attack the thyroid gland and start to destroy it. Posttherapeutic hypothyroidism occurs when treatment for hyperthyroidism leaves the thyroid unable to produce enough thyroid hormone. And hypothyroidism with goiter happens when you don’t get enough iodine in your diet. In the developed world iodine is added to salt so goiter is rare, although it still happens in undeveloped countries. What to Expect at Your Provider's Office Your thyroid gland produces two main thyroid hormones, T3 and T4. In addition, the pituitary gland produces thyroid-stimulating hormone (TSH), which helps control how much T3 and T4 the thyroid makes. Your health care provider will draw blood to measure levels TSH. When levels of thyroid hormones are low, your body produces more TSH to increase production of thyroid hormones. Your doctor may also test for levels of T3 or T4. Natural medicine practitioners may pay particular attention to levels of T3 hormone. T3 is the active form of thyroid hormone. Your thyroid gland makes some T3, but the body also converts T4 into T3. If you are unable to convert T4 to T3, your laboratory tests for T4 may be normal, but you still may have all the symptoms of hypothyroidism. Talk to your doctor about including T3 laboratory tests in the treatment of your hypothyroidism. Treatment Options Drug Therapies A natural dessicated thyroid hormone drug, made from the thyroid glands of pigs, is available by prescription. Your health care provider may prescribe a synthetic thyroid hormone called levothyroxine (Levothroid, Synthroid, Unithroid) that you will take daily. Your doctor will want to adjust your dose over a period of several weeks, after regular blood tests to check the amount of thyroid hormone in your blood. Complementary and Alternative Therapies If you have hypothyroidism, you need conventional medical treatment. Nutrition and herbs can help support conventional treatment, but should not be used by themselves to treat hypothyroidism. Nutrition and Supplements Following these nutritional tips may help reduce symptoms: Eat foods high in B-vitamins and iron, such as whole grains (if no allergy), fresh vegetables, and sea vegetables. Avoid foods that interfere with thyroid function, including broccoli, cabbage, brussels sprouts, cauliflower, kale, spinach, turnips, soybeans, peanuts, linseed, pine nuts, millet, cassava, and mustard greens. If you take thyroid hormone medication, talk to your doctor before eating soy products. There is some evidence soy may interfere with absorption of thyroid hormone. Taking iron supplements may interfere with the absorption of thyroid hormone medication, so ask your doctor before taking iron. Eat foods high in antioxidants, including fruits (such as blueberries, cherries, and tomatoes) and vegetables (such as squash and bell pepper). Avoid alcohol and tobacco. Talk to your doctor before increasing your caffeine intake, as caffeine impacts several conditions and medications. These supplements may also help: Omega-3 fatty acids, such as fish oil, 1 - 2 capsules or 1 - 2 tbs. of oil daily, to help decrease inflammation and help with immunity. Omega-3 fatty acids may increase the risk of bleeding, especially if you already take blood-thinning medication. Ask your doctor before taking omega-3 fatty acids if you take blood thinners such as warfarin (Coumadin) or if you have a bleeding disorder. L-tyrosine, 500 mg two to three times daily. The thyroid gland combines tyrosine and to make thyroid hormone. If you are taking prescription thyroid hormone medication, you should never take L-tyrosine without direction from your doctor. Do not take L-tyrosine if you have high blood pressure or have symptoms of mania. Do not take an iodine supplement unless your doctor tells you to. Iodine is only effective when hypothyroidism is caused by iodine deficiency, which is rare in the developed world. And too much iodine can actually cause hypothyroidism. Herbs Herbs are generally a safe way to strengthen and tone the body's systems. As with any therapy, you should work with your health care provider to get your problem diagnosed before starting any treatment. You may use herbs may as dried extracts (capsules, powders, teas), glycerites (glycerine extracts), or tinctures (alcohol extracts). People with a history of alcoholism should not take tinctures. Unless otherwise indicated, make teas with 1 tsp. herb per cup of hot water. Steep covered 5 - 10 minutes for leaf or flowers, and 10 - 20 minutes for roots. Drink 2 - 4 cups per day. You may use tinctures singly or in combination as noted. Few herbs have been studied for treating hypothyroidism. More research is needed. Coleus (Coleus forskohlii), standardized extract, 50 - 100 mg two to three times a day, for low thyroid function. Guggul (Commiphora mukul), standardized extract, 250 - 500 mg three times a day, for low thyroid support. Bladderwrack (Fucus vesiculosus), 600 mg one to three times daily, for low thyroid support. Do not take bladderwrack unless directed by your doctor. Bladderwrack contains iodine. Although lack of iodine can cause hypothyroidism, most cases of hypothyroidism in the developed world are not caused by iodine deficiency. In fact, too much iodine can actually cause hypothyroidism. Bladderwrack may also contain toxic heavy metals. Homeopathy Homeopathy may be useful as a supportive therapy. Physical Medicine Contrast hydrotherapy (hot and cold applications) to the neck and throat may stimulate thyroid function. Alternate 3 minutes hot with 1 minute cold. Repeat three times for one set. Do two to three sets per day. Acupuncture Acupuncture may be helpful in correcting hormonal imbalances, including thyroid disorders. Following Up After you start on thyroid hormone replacement therapy, your provider will want you to have frequent checkups to monitor its effectiveness. Supporting Research Carayanniotis G. Recognition of thyroglobulin by T cells: the role of iodine. Thyroid. 2007;17(10):963-73. Conrad SC , Chiu H, Silverman BL. Soy formula complicates management of congenital hypothyroidism. Arch Dis Child. 2004 Nov;89(11):1077. Klein I, Danzi S. Thyroid disease and the heart. Circulation. 2007;116(15):1725-35. Lomenick JP, El-Sayyid M, Smith WJ. Effect of levo-thyroxine treatment on weight and body mass index in children with acquired hypothyroidism. J Pediatr. 2008;152(1):96-100. Lynn WR, Lynn JA. Hypothyroidism is easily overlooked. Practitioner. 2007;251(1699):61-2, 645, 67. Messina M, Redmond G. Effects of soy protein and soybean isoflavones on thyroid function in healthy adults and hypothyroid patients: a review of the relevant literature. Thyroid. 2006 Mar;16(3):249-58. Triggiani V, Tafaro E, Giagulli VA, Sabbà C, Resta F, Licchelli B, Guastamacchia E. Role of iodine, selenium and other micronutrients in thyroid function and disorders. Endocr Metab Immune Disord Drug Targets. 2009 Sep;9(3):277-94. Review. Vanderpas J. Nutritional epidemiology and thyroid hormone metabolism. Annu Rev Nutr. 2006;26:293-322. Velija-Asimi Z, Karamehic J. The effects of treatment of subclinical hypothyroidism on metabolic control and hyperinsulinemia. Med Arh. 2007;61(1):20-1. Visser TJ. The elemental importance of sufficient iodine intake: a trace is not enough. Endocrinology. 2006;147(5):2095-7. Wu P. Thyroid disorders and diabetes. It is common for a person to be affected by both thyroid disease and diabetes. Diabetes Self Manag. 2007;24(5):80-2, 85-7.