Download H Hypothy yroidism (undera active th hyroid)

Hypothy
H
yroidism (undera
active th
hyroid)
Definition
D
Hypothyroidis
H
sm (underacttive thyroid) is a condition
n in which yo
our thyroid gland doesn't produce eno
ough of certa
ain
im
mportant horrmones.
Women,
W
espe
ecially those older than age
a 60, are m
more likely to
o have hypoth
hyroidism. H ypothyroidism upsets the
e
normal
n
balance of chemiccal reactions in your bodyy. It seldom causes
c
symp
ptoms in the early stages
s, but, over time,
untreated
u
hyp
pothyroidism
m can cause a number of health proble
ems, such as
s obesity, joi nt pain, inferrtility and hea
art
disease.
d
The
T good new
ws is that acccurate thyroid function te
ests are availlable to diagn
nose hypothyyroidism, and treatment of
o
hypothyroidis
h
sm with synth
hetic thyroid hormone is u
usually simple, safe and effective oncce you and your
y
doctor find
th
he right dose
e for you.
Symptom
S
ms
The
T signs and
d symptoms of hypothyro
oidism vary, depending on
o the severitty of the horm
mone deficie
ency. But in
general,
g
any problems yo
ou have tend to develop sslowly, often over a numb
ber of years.
At
A first, you m
may barely no
otice the sym
mptoms of hyypothyroidism
m, such as fa
atigue and weeight gain, or you may simply
attribute
a
them
m to getting older.
o
But as your metabo
olism continu
ues to slow, you
y may devvelop more obvious
o
signss and
symptoms.
s
Hypothyroidism signs and symptom m
may include:

Fatigue

H
Hoarseness

Incre
eased sensitivvity to
cold

M
Muscle weak
kness

E
Elevated blood
ccholesterol le
evel

M
Muscle ache
es,
ttenderness and
a stiffness

Consstipation

Dry sskin

Unexxplained weig
ght gain

Puffyy face

P
Pain, stiffnes
ss or
sswelling in yo
our joints

Heavierr than normal or
irregular menstrual
periods

Thinning
g hair

Slowed heart rate

Depress
sion

Impaired memory
When
W
hypoth
hyroidism isn't treated, sig
gns and sym
mptoms can gradually
g
bec
come more ssevere. Cons
stant stimulattion
of
o your thyroid gland to re
elease more hormones m
may lead to an enlarged th
hyroid (goiteer). In addition, you may
become
b
more
e forgetful, yo
our thought processes
p
m
may slow, or you
y may feell depressed.
Advanced
A
hypothyroidism
m, known as myxedema, is rare, but when
w
it occurrs it can be liife-threatenin
ng. Signs and
d
symptoms
s
incclude low blo
ood pressure
e, decreased breathing, decreased
d
bo
ody temperatture, unrespo
onsiveness and
a
even
e
coma. In
n extreme ca
ases, myxedema can be fatal.
Hypothyroid
H
dism in infan
nts
Although
A
hyp
pothyroidism most often affects
a
middle
e-aged and older
o
women
n, anyone ca n develop the condition,
in
ncluding infa
ants. Initially, babies born without a th yroid gland or
o with a glan
nd that does n't work prop
perly may ha
ave
fe
ew signs and
d symptoms. When newb
borns do havve problems with
w hypothy
yroidism, theyy may includ
de:
The
T information contained in thiis clinical aware
eness communiccation is for edu
ucational purpos
ses only, and is not intended as
s medical advice
e,
diagnosis
d
or trea
atment. If you arre experiencing symptoms or n eed health adviice, please cons
sult a healthcaree professional.

st cases, thiss occurs whe
en a baby's liver
Yello
owing of the
e skin and whites
w
of the
e eyes (jaund
dice): In mos
can't metabolize a substance called bilirub
bin, which no
ormally forms
s when the bbody recycles
s old or damaged
blood cells.
red b

Frequ
uent choking
g.

A larg
ge, protrudin
ng tongue.

A pufffy appearance to the fac
ce.
As
A the diseasse progresse
es, infants are
e likely to ha
ave trouble fe
eeding and may
m fail to groow and deve
elop normallyy.
They
T
may alsso have:

Consstipation

Poor muscle tone
e

Excessive sleepin
ness
When
W
hypoth
hyroidism in infants isn't treated, even
n mild cases can lead to severe
s
physiical and men
ntal retardatio
on.
Hypothyroid
H
dism in child
dren and tee
ens
In
n general, ch
hildren and te
eens that dev
velop hypoth
hyroidism have the same
e signs and ssymptoms as
s adults do, but
b
th
hey may also
o experience
e:

Poor growth, resu
ulting in shorrt stature

Dela
ayed pubertyy

Delayyed developm
ment of perm
manent teeth

Poor mental devvelopment
When
W
to see
e a doctor
See
S your docctor if you're feeling
f
tired for no reaso n or have an
ny of the othe
er signs or syymptoms of hypothyroidis
h
sm,
such
s
as dry sskin, a pale, puffy
p
face, co
onstipation o
or a hoarse voice.
v
You'll
Y
also ne
eed to see yo
our doctor forr periodic tessting of your thyroid functtion if you'vee had previou
us thyroid
surgery;
s
treattment with ra
adioactive iod
dine or anti-tthyroid medic
cations; or ra
adiation theraapy to your head,
h
neck or
upper
u
chest. However, it may
m take yea
ars or even d
decades befo
ore any of these therapiees or procedu
ures result in
n
hypothyroidis
h
sm.
Iff you have hiigh blood cho
olesterol, talk to your docctor about wh
hether hypotthyroidism m
may be a caus
se. And if you're
re
eceiving horm
mone therap
py for hypothyroidism, sch
hedule follow
w-up visits as
s often as yoour doctor rec
commends.
In
nitially, it's im
mportant to make
m
sure yo
ou're receivin
ng the correct dose of me
edicine. And oover time, th
he dose you need
n
may
m change.
Causes
C
When
W
your th
hyroid doesn't produce en
nough hormo
ones, the ballance of chem
mical reactioons in your bo
ody can be
upset.
u
There can be a number of caus
ses, includin g autoimmun
ne disease, treatment
t
forr hyperthyroidism, radiation
th
herapy, thyro
oid surgery and
a certain medications.
m
The
T information contained in thiis clinical aware
eness communiccation is for edu
ucational purpos
ses only, and is not intended as
s medical advice
e,
diagnosis
d
or trea
atment. If you arre experiencing symptoms or n eed health adviice, please cons
sult a healthcaree professional.
Your
Y
thyroid iis a small, bu
utterfly-shape
ed gland situ
uated at the base
b
of the front of your nneck, just be
elow your Adam's
apple.
a
Hormones
H
prroduced by th
he thyroid gla
and — triiodo
othyronine (T
T3) and thyro
oxine (T4) — have an enormous impa
act
on
o your health, affecting all
a aspects off your metab
bolism. They
y maintain the rate at whi ch your body
y uses fats and
a
carbohydrate
c
es, help contrrol your body
y temperature
e, influence your
y
heart ra
ate, and helpp regulate the
e production of
proteins.
p
Hypothyroidis
H
sm results when the thyro
oid gland faills to produce
e enough horrmones. Hyppothyroidism may be due to a
number
n
of facctors, including:

atory disorderr known as Hashimoto's
H
oimmune dis
sease: People who deve lop a particular inflamma
Auto
thyro
oiditis suffer from
f
the mos
st common ca
othyroidism. Autoimmunee disorders occur
o
when your
y
ause of hypo
une system produces
p
anttibodies that attack your own
o
tissues. Sometimes this process
s involves yo
our
immu
thyro
oid gland. Sciientists aren''t sure why th
he body prod
duces antibodies againstt itself. Some
e think a viruss or
erium might trigger
t
the re
esponse, whi le others bellieve a genettic flaw may be involved. Most likely,
bacte
autoimmune dise
eases result from
f
more th
han one facto
or. But howev
ver it happenns, these anttibodies affecct
hyroid's abilitty to produce
e hormones.
the th

ce too much thyroid
t
horm
mone (hyperth
hyroidism) arre
yperthyroidiism: People who produc
Treattment for hy
often treated with
h radioactive iodine or antti-thyroid me
edications to reduce and normalize their thyroid
er, in some ca
ases, treatm ent of hypertthyroidism ca
an result in ppermanent hy
ypothyroidism
m.
function. Howeve

e portion of your
y
thyroid gland
g
can dim
minish or halt hormone
y: Removing all or a large
Thyroid surgery
uction. In tha
at case, you'll need to takke thyroid hormone for life
e.
produ

at cancers of
n used to trea
o the head and neck can affect your thyroid
t
gland
d and
py: Radiation
Radiation therap
othyroidism.
may lead to hypo

n
of medications ca
an contribute
e to hypothyrroidism. Onee such medic
cation is lithiu
um,
Mediications: A number
which
h is used to treat
t
certain psychiatric d
disorders. If you're
y
taking medication, ask your do
octor about its
effectt on your thyyroid gland.
Less
L
often, hyypothyroidism
m may resultt from one off the followin
ng:

b
are bo
orn with a de
efective thyro
oid gland or nno thyroid gla
and. In most
genital disea
ase: Some babies
Cong
casess, the thyroid
d gland didn't develop no
ormally for un
nknown reaso
ons, but som
me children have
h
an inherrited
form of the disord
der. Often, infants with co
ongenital hyp
pothyroidism appear norm
mal at birth. That's
T
one
on why mostt states now require newb
born thyroid screening.
reaso

ely rare cause
e of hypothyroidism is the
e failure of thhe pituitary gland
g
to produce
er: A relative
Pituittary disorde
enough thyroid-sttimulating ho
ormone (TSH
H) — usually because of a benign tum
mor of the pituitary gland.

me women de
evelop hypotthyroidism du
uring or afterr pregnancy ((postpartum hypothyroidism),
Pregnancy: Som
often because the
ey produce antibodies
a
to their own thyroid gland. Left untreateed, hypothyro
oidism increa
ases
ature deliveryy and preecla
ampsia — a condition thaat causes a significant
s
risse in
the risk of miscarrriage, prema
man's blood pressure during the last three month
hs of pregnan
ncy. It can alsso seriously affect the
a wom
developing fetus.

s
seaaweed, plants
s grown in
Iodin
ne deficiency: The trace mineral iodi ne — found primarily in seafood,
iodine
e-rich soil an
nd iodized sa
alt — is esse ntial for the production
p
off thyroid horm
mones. In so
ome parts of the
world
d, iodine deficciency is com
mmon, but th
he addition of iodine to table salt has virtually elim
minated this
problem. Converssely, taking in too much i odine can ca
ause hypothy
yroidism.
The
T information contained in thiis clinical aware
eness communiccation is for edu
ucational purpos
ses only, and is not intended as
s medical advice
e,
diagnosis
d
or trea
atment. If you arre experiencing symptoms or n eed health adviice, please cons
sult a healthcaree professional.
Risk
R facto
ors
Although
A
anyyone can devvelop hypothy
yroidism, you
u're at an inc
creased risk if you:

Are a woman olde
er than age 60
6

Have
e an autoimm
mune disease
e

Have
e a close rela
ative, such as
s a parent orr
grand
dparent, with
h an autoimm
mune disease
e

Have
e been treate
ed with radioa
active iodine
e or
anti-tthyroid mediccations

Received radiatiion to your neck or upperr
ches
st

Have had thyroidd surgery (pa
artial
thyro
oidectomy)

Have been preg nant or deliv
vered a baby
within the past ssix months
Complica
C
tions
Untreated
U
hyp
pothyroidism
m can lead to a number off health prob
blems:

o your thyro
oid to release
e more hormo
ones may caause the glan
nd to become
e
er: Constant stimulation of
Goite
large
er — a condittion known as a goiter. H ashimoto thy
yroiditis is on
ne of the mosst common causes
c
of a
g
nott uncomforta ble, a large goiter
g
can afffect your apppearance and may interfe
ere
goiter. Although generally
o breathing.
with sswallowing or

dism may alsso be associa
ated with an increased ri sk of heart disease,
d
prim
marily
Hearrt problems:: Hypothyroid
because high leve
els of low-de
ensity lipopro
otein (LDL) cholesterol — the "bad" chholesterol — can occur in
n
ple with an un
nderactive thyroid. Even ssubclinical hypothyroidism, a more beenign condition than true
e
peop
c cause an
n increase in total cholesterol levels and
a impair thhe pumping ability
a
of yourr
hypotthyroidism, can
heartt. Hypothyroidism can als
so lead to an
n enlarged he
eart and heart failure.

ession may o
occur early in
n hypothyroid
dism and may
ay become more
m
severe over
o
sues: Depre
Menttal health iss
time. Hypothyroid
dism can also
o cause slow
wed mental fu
unctioning.

g-term uncon
ntrolled hypo
othyroidism can
c cause daamage to you
ur peripherall
Perip
pheral neuro
opathy: Long
nerve
es — the nerrves that carrry informatio
on from your brain and sp
pinal cord to tthe rest of yo
our body, forr
exam
mple your arm
ms and legs. Signs and ssymptoms of peripheral neuropathy m
may include pain,
p
numbne
ess
and ttingling in the
e area affecte
ed by the ne
erve damage. It may also cause musccle weakness
s or loss of
musccle control.

ndition is the
e result of lon
ng-term, undiiagnosed hypothyroidism
m. Its
edema: Thiss rare, life-thrreatening con
Myxe
signss and sympto
oms include intense
i
cold intolerance and
a drowsine
ess followedd by profound
d lethargy an
nd
unconsciousnesss. A myxedem
ma coma ma
ay be triggere
ed by sedativ
ves, infectionn or other stress on your
e signs or sym
mptoms of m
myxedema, yo
ou need imm
mediate emerrgency medic
cal treatment.
body. If you have

evels of thyro
oid hormone can interfere
e with ovulatiion, which im
mpairs fertility
y. In addition,
rtility: Low le
Infert
some
e of the causses of hypoth
hyroidism — such as auto
oimmune disorder — alsoo impair fertility. Treating
hypotthyroidism with
w thyroid ho
ormone repla
acement the
erapy may no
ot fully restore
re fertility. Other interventtions
may be needed, as
a well.

abies born to
o women with
h untreated thyroid
t
disea
ase may havee a higher ris
sk of birth de
efects
Birth
h defects: Ba
than babies born to healthy mothers.
m
Thesse children are
a also more
e prone to seerious intellectual and
developmental prroblems.
The
T information contained in thiis clinical aware
eness communiccation is for edu
ucational purpos
ses only, and is not intended as
s medical advice
e,
diagnosis
d
or trea
atment. If you arre experiencing symptoms or n eed health adviice, please cons
sult a healthcaree professional.
Infantts with untreated hypothy
yroidism pressent at birth are at risk off serious prooblems with both
b
physicall and
mental development. But if this condition iis diagnosed
d within the first few montths of life, the
e chances off
ellent.
normal development are exce
Tests
T
and
d diagnossis
Because
B
hypothyroidism is more prev
valent in olde
er women, so
ome doctors recommend that older women
w
be
screened
s
for the disorder during routin
ne annual ph
hysical exam
minations. Some doctors aalso recomm
mend that
pregnant
p
wom
men or wome
en thinking about
a
becom ing pregnantt be tested fo
or hypothyroiidism.
In
n general, yo
our doctor may test for an
n underactive
e thyroid if yo
ou're feeling increasinglyy tired, have dry skin,
constipation
c
a
and weight gain,
g
or have had previou
us thyroid pro
oblems or go
oiter.
Blood
B
tests
Diagnosis
D
of hypothyroidism is based on your sym
mptoms and the
t results off blood tests that measurre the level of
o
TSH
T
and som
metimes the level
l
of the th
hyroid hormo
one thyroxine
e. A low leve
el of thyroxinee and high le
evel of TSH
in
ndicate an un
nderactive th
hyroid. That's
s because yo
our pituitary produces
p
mo
ore TSH in ann effort to stiimulate your
th
hyroid gland into producing more thyrroid hormone
e.
In
n the past, doctors weren
n't able to de
etect hypothyyroidism untill symptoms were
w
fairly addvanced. But by using the
sensitive
s
TSH
H test, doctorrs are able to
o diagnose th
hyroid disord
ders much ea
arlier — oftenn before you experience
symptoms.
s
Because the TSH
T
test is th
he best scree
ening test, yo
our doctor will
w likely checck TSH first and
a follow with a
th
hyroid hormo
one test if ne
eeded. TSH tests
t
also pla
ay an importa
ant role in managing hyppothyroidism. They help your
y
doctor
d
determ
mine the rightt dosage of medication,
m
b
both initially and over time.
In
n addition, TSH tests are
e used to help
p diagnose a condition called subclinical hypothyyroidism, whic
ch usually
causes
c
no ou
utward signs or symptoms. In this con
ndition, you have
h
normal blood levels of triiodothy
yronine and
th
hyroxine, butt higher than
n normal leve
els of TSH.
Treatmen
T
nts and drrugs
Standard
S
trea
atment for hyypothyroidism
m involves da
aily use of the synthetic thyroid hormoone levothyrroxine
(Levothroid, S
Synthroid, otthers). This oral
o medicatio
on restores adequate
a
hormone levelss, reversing the
t signs and
d
symptoms
s
of hypothyroidism.
One
O to two w
weeks after sttarting treatm
ment, you'll n otice that you're feeling less fatigued . The medica
ation also
gradually
g
low
wers choleste
erol levels ele
evated by the
e disease an
nd may reverse any weighht gain. Trea
atment with
le
evothyroxine
e is usually liffe long, but because
b
the dosage you need may ch
hange, your doctor is like
ely to check your
y
TSH
T
level eve
ery year.
Determining
D
sage may take time
proper dos
To
T determine
e the right dosage of levothyroxine inittially, your do
octor genera
ally checks yoour level of TSH
T
after two
o to
th
hree monthss. Excessive amounts of the
t hormone
e can cause side
s
effects, such as:

eased appetitte
Incre

Insom
mnia

Heartt palpitationss

Shakkiness
The
T information contained in thiis clinical aware
eness communiccation is for edu
ucational purpos
ses only, and is not intended as
s medical advice
e,
diagnosis
d
or trea
atment. If you arre experiencing symptoms or n eed health adviice, please cons
sult a healthcaree professional.
Iff you have co
oronary arterry disease orr severe hyp
pothyroidism, your doctor may start treeatment with
h a smaller
amount
a
of me
edication and
d gradually in
ncrease the d
dosage. Progressive hormone replaccement allow
ws your heartt to
adjust
a
to the iincrease in metabolism.
m
Levothyroxine
L
e causes virttually no side
e effects whe
en used in th
he appropriate dose and iis relatively inexpensive. If
you
y change b
brands, let yo
our doctor kn
now to ensurre you're still receiving the
e right dosagge. Also, don
n't skip dosess or
stop
s
taking th
he drug beca
ause you're fe
eeling better . If you do, th
he symptoms
s of hypothyrroidism will gradually
g
retu
urn.
Proper
P
abso
orption of lev
vothyroxine
e
Certain
C
mediccations, supp
plements and
d even some
e foods may affect your ability
a
to absoorb levothyro
oxine. Talk to
o
your
y
doctor iff you eat larg
ge amounts of
o soy produccts or a high--fiber diet or you take othher medicatio
ons, such as:

Iron ssupplementss

Chole
estyramine

Alum
minum hydroxxide, which is
s found in so
ome antacids
s

Calcium supplem
ments
Iff you have su
ubclinical hypothyroidism
m, discuss tre
eatment with your doctor.. For a relativvely mild incrrease in TSH
H,
you
y probably won't benefit from thyroid hormone ttherapy, and treatment co
ould even bee harmful. On
n the other hand,
fo
or a higher T
TSH level, thyyroid hormon
nes may imp
prove your ch
holesterol lev
vel, the pumpping ability off your heart and
a
your
y
energy level.
Alternativ
A
ve medicin
ne
Although
A
mosst doctors reccommend sy
ynthetic thyro
oxine, natura
al extracts co
ontaining thyrroid hormone
e derived from
th
he thyroid gla
ands of pigs are available. These pro
oducts contain both thyroxine and triioodothyronine
e. Synthetic
th
hyroid mediccations conta
ain thyroxine only, and th e triiodothyro
onine your body needs iss derived from
m the thyroxine.
Extracts
E
are a
available by prescription only and sho
ouldn't be co
onfused with the glandulaar concentrattes sold in na
atural
fo
oods stores. These produ
ucts aren't re
egulated by tthe Food and
d Drug Administration, annd their potency and purity
is
sn't guarante
eed.
Source:
S
The Mayo Clinic
Contact
C
us
Please
P
feel frree to contacct your Aon Hewitt
H
Health
hcare Consulltant if you ha
ave any conccerns. You may
m also con
ntact
th
he Aon Reso
olution Centrre on 0860 83
35 272 or e-m
mail: arc@ao
on.co.za for further inform
mation.
For
F more info
ormation from
m Aon Hewittt Healthcare on this topic
c and other healthcare inddustry news go to
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w
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ou.co.za. You
u can also fo
ollow us on:
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The
T information contained in thiis clinical aware
eness communiccation is for edu
ucational purpos
ses only, and is not intended as
s medical advice
e,
diagnosis
d
or trea
atment. If you arre experiencing symptoms or n eed health adviice, please cons
sult a healthcaree professional.