Learn About Hypothyroidism

16 December 2021

Hypothyroidism is a common disorder in endocrinology which can be caused by a number of different factors. It is most commonly caused by a direct attack on the thyroid gland by cells or autoantibodies in an immune process, leading to thyroid failure. This autoimmune disease is also known as Hashimoto's disease.

When a doctor determines that a patient has hypothyroidism due to autoimmunity, this means an autoimmune attack on the thyroid gland is causing it to fail to function properly.

Other causes of thyroid failure include:

1. Patients who have had their thyroid gland removed
2. Taking medication containing lithium, which can cause thyroid failure
3. Over-treatment of hyperthyroidism

The disease is hereditary and is more common in women than men.

For patients who have had their thyroid removed, they will have to take thyroxine (a thyroid hormone) and undergo radiation therapy for the rest of their lives. A patient with head and neck cancer who has had radiation therapy is also likely to develop hypothyroidism in the next few years.

In terms of medication, lithium can be used to treat certain mental illnesses, but it can cause hypothyroidism. If a person is taking this medication long term, it is recommended that their thyroxine levels are checked regularly. Over-treatment of hyperthyroidism can also cause hypothyroidism, but it is usually short-term and only requires a doctor to adjust the medication.

If a person has a problem with the pituitary gland, this can cause disruptions to other hormones in the body and increases the possibility of hypothyroidism. The fact that some babies are born with an underactive thyroid gland or even no thyroid gland increases the likelihood of hypothyroidism and therefore the need for thyroid supplements throughout life.

Pregnant women or women who have given birth can also experience hypothyroidism or hyperthyroidism, which may be permanent or temporary.

Can hypothyroidism be inherited? The answer is yes. If a parent has a thyroid problem, he or she is more likely to develop thyroid disease than a normal person, and women are slightly more likely to develop it than men, but this should not be ignored.

Sleepiness, constipation, brain fog

When a person has hypothyroidism, they may experience drowsiness, constipation, weight gain, chills and brain fog, which is a foggy feeling in the brain that prevents them from thinking properly or concentrating on their work.

Who is at high risk of hypothyroidism? The first is women, the second is people over 60 years of age, the third is people with a family history of the disease, and the fourth is people who already have autoimmune diseases such as type 1 diabetes and celiac disease, who are at an increased risk of developing hypothyroidism.

Patients who have received radioactive iodine or are on thyroid medication, those who have had radiation therapy to the neck or upper chest, those who have had thyroid surgery and those who have been pregnant and given birth in the last 6 months are all at high risk.

It is important to note that hypothyroidism can cause harm not only to the patient but also to the next generation. In other words, these children are likely to have mental or developmental problems later in life.

Severe hypothyroidism can be fatal

The swollen thyroid gland can affect breathing and if treatment is delayed, can slow the heart rhythm or cause heart failure.

Hypothyroidism can also lead to hyperlipidaemia, which increases the risk of cardiovascular disease. In addition to its physical effects, hypothyroidism can also have a psychological impact on the patient in the early stages, leading to depressio. As the condition continues to deteriorate, the chances of severe depression increases.

However, one of the most dangerous acute symptoms of hypothyroidism is myxedema coma, where the patient may become severely drowsy, cold intolerant and comatose, which can be life-threatening in severe cases.

Patients with thyroid disease always mention they have been told not to eat broccoli, cabbage or seafood. But studies have shown that food does not cause thyroid problems. In other words, the patient's diet has nothing to do with the thyroid gland. The normal functioning of the body's organs are essential for the growth and development of the body, especially the brain.

Iodine Deficiency Disorders (IDD) are very rare in Malaysia, so food do not normally cause thyroid disorders including hypothyroidism or hyperthyroidism.

Thyroxine non-drug

How should hypothyroidism be treated? Usually, doctors will give replacement thyroxine, which is a tablet that works to replenish the hormone that the patient is lacking.

Although it must be taken once a day, it is not a drug and it is compatible with most medications. However, if the patient is taking calcium or iron supplements or antacids, it is best to take them 1 to 2 hours apart to avoid interfering with the absorption of thyroid hormones.

How can I get the best out of my hormones? Calcium, iron supplements and antacids should be taken at a time separate from hormone medication. It  is best to take them in the morning on an empty stomach, or if you forget to take them in the morning, you must take them within the day.

It is important to note that if you miss a dose on the same day, you do not need to increase it the next day. Just take the normal dose unless you have missed it for a long time, then it is best to consult your doctor and have your body's thyroid hormones checked before adjusting to the appropriate dose.

Q1: How long do hypothyroid patients need to take thyroid hormones?
A: If a patient has autoimmune thyroid disease, prior thyroid surgery or radiation therapy, congenital thyroid disease or pituitary disorders, they may need to remain on thyroxine for the rest of their lives. For other causes of hypothyroidism, they need to be re-evaluated by a doctor after medication adjustment.

Q2: What should I do if I want to get pregnant with hypothyroidism?
A: Doctors usually recommend checking thyroid hormone levels in the early stages of pregnancy as it is sometimes necessary to increase the dose of thyroxine during pregnancy, especially in the early stages of pregnancy when the neurological development of the fetus is critical. If a pregnant woman becomes hypothyroid, taking thyroxine will ensure the health of the fetus.

Source: Sin Chew