What is hypothyroidism and how to treat it?

Introduction 

Hypothyroidism is a disease which occurs when the thyroid gland fails to produce certain essential hormones. Most people who get affected by this condition are women above the age of 60 years. Hypothyroidism leads to a situation in which there is no balance of chemical reactions in the body. In its early stages, this condition rarely causes symptoms. However, with time, if it remains untreated, it causes several health problems such as heart diseases, infertility, joint, and obesity (Jonklaas et al., 2014) . It is important to note that there are several tests which can help in diagnosing this condition and its treatment with synthetic thyroid hormone is a simple one, effective and safe for the patients. 

Symptoms 

Depending on the level of hormone deficiency, the signs and symptoms of this condition vary. It may not be easy for one to link the symptoms of the disease with it since most people who get affected often attribute these signs and symptoms to the normal aging process. Even so, as the metabolism processes continue to become slow, one may develop more obvious signs. Some of the signs and symptoms of hypothyroidism include the following; 

Constipation. 

Fatigue. 

Increased cold sensitivity. 

Dry Skin. 

Weight gain. 

A weakness of the muscles. 

Puffy face. 

Hoarseness. 

Slowed heart rate. 

Aches in the muscles. 

Joint pains. 

Causes of Hypothyroidism 

When thyroid glands fail to produce enough of the essential hormones, the balance of chemical reactions in the body gets upset. There are several factors which can cause this condition including radiation therapy, autoimmune disease, hyperthyroidism treatment, thyroid surgery, and certain medication (Ahmed& FleihHassen, 2015) . The hormones produced by thyroid glands can have a great effect on one's health, affecting metabolism. These hormones also ensure that the body uses carbohydrates and fats at a balanced rate. Also, they help the body to control the body temperature, regulates the rate at which the body produces protein and influences the heart rate. Hypothyroidism may occur because of the following factors: 

Autoimmune disease- Autoimmune disorders such as Hashimoto's thyroid are common cause of hypothyroidism. Such disorders occur when an individual's immune system produces antibodies which attack their own tissues (Ahmed & FleihHassen, 2015) . This process may sometimes involve thyroid glands. Researchers have not yet found the reason why sometimes the body produces antibodies attacking its own tissues. While some scientists believe that bacteria or virus may trigger the response, others believe that it may be as a result of genetic flaw. What is generally agreed is that the autoimmune disease may come about because of more than one factor. Whichever factor causes it, the antibodies affect the ability of the thyroid to produce hormones. 

Hyperthyroid treatment- people who produce a lot of thyroid hormones are mostly treated with anti-thyroid medicines or radioactive iodine which helps in normalizing the thyroid function. Even so, in some cases, treatment of hyperthyroidism can cause hypothyroidism. 

Thyroid surgery- If a larger part of thyroid glands are removed, the process of hormone production may either be halted or totally diminished. If this happens, one needs to take hormones for life. 

Radiation Therapy- Cancer patients who undergo radiation therapy may have the procedures affect their thyroid glands which may subsequently cause hypothyroidism. 

Medications- Several medications can lead to hypothyroidism. An example of such medication is lithium, used for treating psychiatric disorders. 

Other causes of hypothyroid include pregnancy, iodine deficiency, congenital disease, and pituitary disorder. 

Risk Factors 

While anyone can develop hypothyroidism, people who are at greater risk include: 

Woman aged 60 years and above 

Person with autoimmune disease. 

The family history of thyroid disease. 

A person who has been treated anti-thyroid medications or radioactive iodine. 

A person who has had thyroid surgery. 

One who has undergone radiation therapy to the upper chest, head or neck. 

Pregnant woman or one who has delivered a baby in the last six months. 

Complications 

Goiter- When there is constant stimulation of thyroid; more hormones are released making the thyroid gland to enlarge. This condition is known as goiter. 

Heart problems- Hypothyroidism is linked with increased risk of heart problems. It can also cause heart failure or an enlarged heart. 

Mental Health problems- A patient with hypothyroidism may have depression during the first stages and the condition may become severe with time. 

Diagnosis 

The doctor can diagnose the condition by checking the thyroid glands and looking for changes such as swelling, slower reflexes , slower heart rate, and dry skin (Jonklaas et al., 2014) . The doctor can also conduct blood tests to diagnose the condition. There are two types of blood test which can be done including a thyroid-stimulating hormone test and T4 test. Thyroid stimulating hormone test is the most sensitive and essential test for the condition. It measures the amount of thyroid hormone which is being made by thyroid glands. When there is abnormally high TSH, it means that there is hypothyroidism (Ahmed, 2017) . For the T4 test, if there are high T4 cells in the blood then it means that there is hypothyroidism. The doctor may also screen the patient to find out about the family and medical history of the patient. It is important for the patient to disclose if he has ever had thyroid surgery or radiation therapy around the head or neck. The patient can also reveal if their family has a history of an individual with thyroid disease. 

Treatment 

Replacement of Thyroxine 

While hypothyroidism cannot be cured, it can be controlled almost in every patient. This can be done by replacing the number of hormones which cannot be made by the patient's thyroid glands. This helps in bringing the TSH and T4 levels to the normal levels. Replacement of T4 restores the hormone levels and ensures that the body functions normally (Jonklaas et al., 2014) . Synthetic thyroxine pills have hormones similar to the T4 which is made by thyroid glands. All patients with this condition can be treated as outpatients except for those with life-threatening hypothyroidism otherwise known as severe myxedema. 

References 

Ahmed, R. G. (2017). Hypothyroidism and brain development. J.  Anim Res Nutr ,  2 (2), 13. 

Ahmed, S. A., & FleihHassen, A. (2015). Assessment Contributing Factors related to hypothyroidism/hyperthyroidism for adult patient at Bagdad Teaching Hospitals.  kufa Journal for Nursing sciences ,  5 (3), 1-10. 

Jonklaas, J., Bianco, A. C., Bauer, A. J., Burman, K. D., Cappola, A. R., Celi, F. S., ... & Sawka, A. M. (2014). Guidelines for the treatment of hypothyroidism: prepared by the american thyroid association task force on thyroid hormone replacement.  Thyroid ,  24 (12), 1670-1751.