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Hypothyroidism is one of the most common endocrine diseases and is characterized by low thyroid activity, which causes it to produce less hormones than is necessary for the optimal functioning of all body functions, leading to the appearance of some symptoms with excessive tiredness, decreased heart rate, weight gain, hair loss and dry skin.
This change is more common in women over 40 years of age, who have close family members with hypothyroidism, who have already removed part or all of the thyroid or who have received some type of radiation to the head or neck. The treatment of hypothyroidism aims to regulate the levels of thyroid hormones and thus relieve symptoms, and the use of synthetic hormones, such as Levothyroxine, for example, is usually indicated by the endocrinologist.
Signs and symptoms
The signs and symptoms that may indicate low thyroid function may appear slowly over the years according to the decrease in the levels of thyroid hormones, T3 and T4. The main signs and symptoms of hypothyroidism are:
- Headache, in muscles and joints;
- Irregular menstruation, which can make it difficult to get pregnant;
- Fragile, brittle nails and rough, dry skin;
- Eyes, in the region of the eyelids, swollen;
- Hair loss without apparent cause and thinner, dry and dull hair;
- Heartbeat slower than normal;
- Excessive tiredness;
- Difficulty concentrating, poor memory;
- Decreased libido;
- Weight gain for no apparent reason.
In addition, in some cases the person may experience personality changes, depression and dementia, however these symptoms occur in people who have very low levels of T3 and T4.
In the case of children, hypothyroidism can also interfere with development, so that in adolescence, puberty may be delayed and short stature, for example. In addition, in the case of congenital hypothyroidism, if it is not detected as early as the first week after birth, the child may have neurological changes, with the risk of developing mental retardation. See more about congenital hypothyroidism.
Main causes
The most common cause of hypothyroidism is Hashimoto's thyroiditis, which is an autoimmune disease, in which antibodies begin to attack the thyroid gland, as if it is harmful to the body itself. In addition, hypothyroidism can happen due to iodine deficiency, which is a condition known as goiter, in which there is an increase in the size of the thyroid, but less amount of T3 and T4 due to a decrease in the concentration of iodine.
Treatment against hyperthyroidism or the use of medications such as lithium carbonate, amiodarone, propylthiouracil and methimazole can also lead to hypothyroidism, and it is important to consult the endocrinologist if any of the symptoms is identified so that the suspension of the medication or replacement can be indicated. .
People who have taken thyroid medications in order to lose weight may also develop hypothyroidism because once these hormones are already present in the bloodstream, the thyroid can stop or decrease its natural production.
In addition to these causes, hypothyroidism can also appear during pregnancy or in the postpartum period that tends to return to normal soon after. In addition, it is important to remember that this disease decreases the woman's fertility, causing problems to get pregnant. See more about hypothyroidism and pregnancy.
How to know if it is hypothyroidism
To find out if it is hypothyroidism, the endocrinologist evaluates the signs and symptoms presented by the person and indicates the performance of blood tests to check the amount of circulating thyroid-related hormones.
Thus, the dosage of T3 and T4 is indicated, which are normally decreased in hypothyroidism, and the dosage of TSH, which is increased.In the case of subclinical hypothyroidism, normal levels of T4 and increased TSH can be observed. See more about the tests that evaluate the thyroid.
In addition, the doctor may recommend carrying out antibody research, thyroid mapping and thyroid ultrasound when nodules are noticed during palpation of the thyroid. It is also possible for the person to perform a self-examination of the thyroid to identify any changes, especially nodules. Learn how to do thyroid self-examination.
Who needs to have thyroid exams
In addition to people with signs and symptoms that may indicate hypothyroidism, these tests should also be performed by:
Women over 50 | Who had radiation therapy to the head or neck | People with type 1 diabetes |
During the pregnancy | Who had thyroid surgery | People with autoimmune disease |
If you have a goiter | If you have cases of thyroid disease in the family | In case of heart failure |
Who has Down syndrome | Who has Turner Syndrome | Milk production outside of pregnancy or without breastfeeding |
Hypothyroidism in pregnancy
Hypothyroidism, if not well controlled, can hinder the possibility of becoming pregnant and have repercussions for both mother and baby. It can also happen in the postpartum period, a few months after the baby is born, in a transient way and that also needs treatment care.
Thus, it is normal that during prenatal care, the doctor orders T3, T4 and TSH tests to assess thyroid function and continue to monitor in the postpartum how the thyroid hormone values are and whether there is a need to use medications. to get back to normal. Know the risks of hypothyroidism in pregnancy.
How to Treat Hypothyroidism
The treatment for hypothyroidism is relatively simple and must be done through hormone replacement with the taking of synthetic hormones, Levothyroxine, which contains the hormone T4, and which must be taken on an empty stomach, at least 30 minutes before having breakfast. morning, so that the digestion of food does not decrease its effectiveness. The dose of the medication should be prescribed by the endocrinologist and may vary throughout the treatment according to the levels of T3 and T4 circulating in the blood.
6 weeks after the medication is started, the doctor can check the person's symptoms and order a TSH test to see if it is necessary to adjust the dose of the medication until the free T4 is normalized. Thereafter, tests to evaluate the thyroid should be performed once or twice a year, to see if it is necessary to adjust the dose of the medication.
In addition to the use of medications, it is important that the person controls the blood cholesterol levels, avoiding the consumption of fats, eating a diet that helps in the proper functioning of the liver and avoiding excess stress, as it impairs the secretion of hormones by the thyroid . In some cases, consultation with a nutritionist may also be recommended so that nutritional treatment with iodine supplementation can help to reduce the symptoms of hypothyroidism.
In the case of subclinical hypothyroidism, when there are no symptoms involved, the doctor may recommend the use of medications because they can help to reduce the risk of cardiovascular problems, which can be important for people who are overweight or who have high cholesterol or diabetes.
See how eating can improve thyroid function in the following video.
Signs of improvement and worsening
The signs of improvement in hypothyroidism appear more or less 2 weeks after the start of treatment, with a reduction in tiredness and an improvement in mood. In addition, long-term treatment of hypothyroidism also helps to control weight and reduce blood cholesterol levels.
The signs of worsening appear when the treatment is not performed correctly or when the dose of Levothyroxine is not adequate, with insomnia, increased appetite, palpitations and tremors, for example.