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LOUISIANA HEART CENTER Slidell - Covington - Hammond - Laplace (985) 649-2700 Hypothyroidism The thyroid gland is located in the lower part of the neck, just above the sternum. As part of the endocrine system, the thyroid gland secretes hormones that regulate growth and the metabolism. There are two principal thyroid hormones. T4 (thyroxine) and T3 (triiodothyronine). The thyroid hormones are released in the bloodstream and carried to the organs and tissues of the body. These hormones are chemical messengers that affect many things, among them the metabolic rhythm of the body, which in turn influences the way in which the body uses fats and carbohydrates. It affects temperature regulation, muscular strength, heart rate and cholesterol levels. A hypoactive thyroid gland can reduce the heart rate of the body and cause symptoms. Hypothyroidism is the term used to indicate that there is not a sufficient amount of thyroid hormone in the body. Women are more likely than men to suffer from hypoactive thyroids. It is more common after the age of 50. It is more likely that people who have parents with hypothyroidism will also develop this problem. Hypothyroidism can be caused by many things. Among the most common are: Hashimoto’s thyroiditis. o This occurs when your body produces antibodies that attack the thyroid gland. The reasons for which this occurs are still not completely clear. When this happens, the thyroid gland cells that produce the thyroid hormone are destroyed and can no longer produce thyroid hormone. Radiation therapy. o The radiation therapy used to treat certain forms of cancer can also destroy the thyroid cells that produce the thyroid hormone. Thyroid surgery o Some patients need to have surgery to remove the thyroid gland, either partially or completely. Surgery can be performed to remove tumors of the thyroid or an enlarged thyroid gland, called a goiter. If too much thyroid gland is removed, there will no longer remain sufficient cells to make adequate amounts of thyroid hormone and this will result in hypothyroidism. Treatment of hypothyroidism. o On occasions, the body produces too much thyroid hormone, which causes symptoms. This is treated with medications or radiation which makes the thyroid gland produce less hormone. The result of some treatments is that the thyroid gland produces an insufficient amount of hormone and hypothyroidism occurs. Medication o Some medications affect the ability of the thyroid gland to produce hormone. If this happens, it is possible that you will need a thyroid hormone replacement therapy. The symptoms of hypothyroidism include: reduction in the frequency of bowel movement, constipation, weight gain, hoarse or deeper voice, increase in sensitivity to low temperatures (feeling cold all the time), depression, increase in sleepiness and fatigue, muscular weakness, pain and stiffness, joint pain and stiffness, dry skin, increase in menstrual flow and more frequent menstrual periods in women, fine, brittle hair, hand tremors, Accelerated heart rate or rapid heartbeats (tachycardia). Diagnosis There are a set of examinations that are generally used to measure the amount of thyroid hormone in the blood. T3 (triiodothyronine) and T4 (thyroxine) can be measured in the blood. TSH (thyroid stimulating hormone) is produced in a part of the brain called the hypothalamus. When the levels of thyroid hormone decline too much, the hypothalamus produces more thyroid hormone. The TSH increases when the levels of T3 and T4 decline too much. Your doctor can also perform a test to measure the TSH in the blood. If these examinations turn out to be positive, it is possible that the doctor will request additional examinations to evaluate the functioning of the gland and tests to determine the size and structure of the gland. A thyroid scan evaluates the size and shape of the gland. A test known as the thyroid uptake test measures the activity in the gland. Together, these examinations can determine if the entire gland is inflamed (thyroiditis) or if only some parts of the gland (thyroid nodules) are functioning abnormally. A thyroid ultrasound evaluates the size and shape of the gland. It can also determine the presence of nodules or cysts in the thyroid gland. Treatment When hypothyroidism is diagnosed for the first time, medications are usually used to treat the symptoms of the disease. Levothyroxine is a synthetic thyroid hormone that is used to replace the thyroid hormone in patients who display low levels of the natural hormone. Your doctor will perform periodic blood tests to make sure that you are taking the correct dose. Some foods and other medications can affect the capacity of the body to absorb levothyroxine. Consult your doctor or pharmacist about the best time of day to take your thyroid medication.