The thyroid is an important gland in the body which is part of the endocrine system – a collection of glands that produce various hormones with a number of different functions. The functions vary, but include:
- Regulating metabolism
- Contributing to weight gain and loss
- Regulating blood sugar
- Controlling growth and development
- Maintaining tissue function
- Contributing to sexual function and reproduction
- Regulating sleep patterns
- Influencing mood
- …and many other essential ones.
With so many glands and functions, it is easy to understand why sometimes one of the endocrine glands can malfunction
Hypothyroidism is an underactive thyroid gland (often described as “slow”) that does not make enough thyroid hormone to keep the body functioning normally.
If you’ve been trying to diet but are still not having much success losing weight, and you’re experiencing other unusual symptoms, it could mean you have a slow thyroid. In this guide, we will cover the essentials about hypothyroidism, symptoms, causes and more, so you can take better care of your health. Let’s start first with the essential facts about hypothyroidism. 2551
The Facts About Hypothyroidism
What Is Hypothyroidism?
Hypothyroidism is a condition in which the body lacks sufficient thyroid hormone to perform its main function: to regulate the body’s metabolism. As mentioned above, it is commonly referred to as a slow thyroid, and hypothyroidism has appeared more and more frequently in the news as a potential hidden health problem that could be one reason why so many people in the US are struggling with their weight. 2553
How common Is It?
Approximately 10 million people in the US have hypothyroidism, but many more people might have it but not been diagnosed yet.
Who Gets It?
It is most common amongst women over the age of 60, who are ten times more likely to contract it than men. One type of hypothyroidism, Hashimoto’s thyroiditis, is an autoimmune disorder in which the body attacks the thyroid. It affects women over the age of 45 ( 2561 ).
Studies suggest that as many as 10% of all women in the US have or will develop hypothyroidism in their lifetime.
Where Is the Thyroid Gland and What Does It Look Like?
The thyroid glands are at the front of your neck, below your Adam’s apple (larynx). It resembles an upside-down butterfly, with the two lobes of the thyroid looking like the wings (2562 ).
Why Is the Thyroid Gland Important?
The thyroid gland absorbs iodine from the food we eat and converts it into different types of thyroid hormone, including T3 and T4, which regulate our metabolism (2566).
Two areas of the brain, the pituitary gland and the hypothalamus, control how much thyroid hormone is produced and then released. It is a delicate balancing act. If something alters that balance, a range of symptoms will soon manifest. Let’s look at the most common symptoms of a slow thyroid in the next section ( 2571 ).
The Symptoms of Hypothyroidism
In addition to weight gain and trouble losing weight, there are other common symptoms which might indicate you are suffering from hypothyroidism. These include:
- Tiredness all the time
- General weakness
- Dry, brittle hair
- Hair loss
- Dry skin
- Brittle fingernails
- Feeling cold all the time
- Muscle cramps and spasms, loss of control
- Aches and pains
- Depression, anxiety
- Foggy memory
- Abnormal menstrual cycles if you have periods
- Decreased sex drive
Some suffers will have several of these symptoms, while others might be unfortunate enough to experience them all. This will usually be determined by how great the deficiency is and how severe the thyroid is malfunctioning ( 2573 ).
Many people overlook these symptoms because they think they are a natural part of aging. However, if you are really struggling with your weight, or any of these symptoms have caused you to suffer from a greatly diminished quality of life, it might be time to dig a bit deeper into the causes of your symptoms to see if they could be related to hypothyroidism (2575) .
The Causes of Hypothyroidism
There are many potential causes of hypothyroidism. However, there are three main ones that doctors will look for first before diagnosing and treating ( 2577 ).
The first main reason is inflammation – that is, irritation of the thyroid gland, such as because of the body attacking it, or for some other unknown (idiopathic) reason. The autoimmune form of hypothyroidism is known as Hashimoto’s thyroiditis (2579).
The second main reason is certain medications, such as beta blockers for heart disease, and antidepressants. Some stimulate thyroid hormone production, while others suppress it or change the way it is converted into the different forms of thyroid hormone, particularly T3 and T4. Too much hormone production is thought to cause “burnout” of the gland ( 2581).
The third main reason is that treatment has affected the thyroid in some way, such as removing part of it due to lumps on the gland (nodules), cancer or other issues, or removing it completely. In these cases, the body will not be able to produce the hormone that is needed ( 2583 ).
One of the most common treatments to beware of is due to hyperthyroidism – that is, a thyroid which is too fast. This can also lead to health issues, such as too much weight being lost without even trying, and heart health symptoms ( 2050 ).
In this case, the doctors might use radioactive iodine to kill off some of the thyroid cells in order to bring the T3 and T4 levels back to normal. However, it is not an exact science and too many thyroid cells might be killed off, resulting in hypothyroidism ( 2047) .
Some studies suggest there might also be a genetic component to hypothyroidism, and perhaps a link with overall hormonal activity due to the prevalence of hypothyroidism in women.
Apart from the dangers of being obese, what are the other health risks involved with untreated hypothyroidism? Let’s look at this topic in the next section. 2044
The Potential Dangers of Hypothyroidism
Thyroid hormone is needed in order to maintain metabolism and overall health. The pituitary gland will sense if there is not enough thyroid hormone circulating in the body, and continually send more and more thyroid stimulating hormone (TSH) to the thyroid to try to kick-start it into producing more T3 and T4 ( 2036 ).
However, the TSH constantly being sent can cause swelling, known as a goiter, and gradually, symptoms will become more and more severe ( 2052 ). If the hypothyroidism is not treated, any symptoms will worsen and more can develop. In extreme cases, complications can include:
- Severe depression
- Heart failure
- Adrenal insufficiency
- Coma, namely, myxedema coma, which can result in death
Severe depression can result in a lack of self-care, leaving a person even more ill, or prone to suicidal thoughts which might be acted upon ( 2053 ).
Heart failure will lead to more and more disability, and eventual death, unless a heart transplantation can be performed. 2915
Adrenal insufficiency is a potentially life-threatening condition which can be triggered by thyroid treatments. The adrenal glands, two small glands just above the kidneys, will stop producing their hormones, which can lead to death if not treated promptly. 2916
Changes in your health can contribute to imbalances in your thyroid hormones. The following can contribute to myxedema coma: 2918
- Infections, especially lung and urinary tract infections
- Heart failure
- Injury in an accident generally, or to the thyroid in particular
- Drugs, such as phenothiazines, amiodarone, lithium, and tranquilizers, and prolonged iodide drugs use
- Not taking prescribed thyroid medications, or not taking exactly as recommended
If you think you have hypothyroidism, go to your doctor. If you have severe, worsening symptoms, phone 911. It can be diagnosed with a simple blood test in most cases. Once you get the results, if you do have hypothyroidism, you will be referred to an endocrinologist so you can explore all of your treatment options. 2919
Your treatment choices will be based upon age, overall health, lifestyle choices, personal preferences, and how severe your symptoms and deficiency are. 2920
Let’s look in the next section at your treatment options for hypothyroidism.
Treatments for Hypothyroidism
In most cases, your doctor will recommend taking some form of thyroid hormone replacement. It might be synthetic or natural, in pill or liquid form, and so on. It should make your thyroid function tests return to the normal range. Your doctor will continue to test you in order to make sure you are not taking too much or too little of the supplement that they have prescribed. 2921
Levothyroxine is the most common supplement, taken once a day (preferably in the morning). It is a pure synthetic form of T4 which is made in a laboratory to be an exact replacement for the T4 that a healthy thyroid gland normally secretes. It comes in multiple strengths, which means that an appropriate dosage can almost always be found for each patient. 2922
The dosage should be re-evaluated and possibly adjusted monthly until the proper level is established. Regular blood tests will help fine-tune your treatment regimen. Once your thyroid is back in balance, you should be able to manage with just an annual visit to the endocrinologist unless severe symptoms return. 2923
The goals of treatment are to help you feel as normal as possible and maintain a good quality of life, no matter what your age. Taking this medication will help lower the risk of heart disease and osteoporosis and should help you manage your weight better when used in conjunction with diet and exercise. 3220
It may take time for the medicine to work, but you should usually note relief of your symptoms within two weeks of starting to take it, and feel more like your old self within a couple of months. However, if you are still feeling tired and pestered by the same symptoms that have been troubling you, check with your doctor. 2214
If you encounter new symptoms, it’s possible that you are getting too much thyroid hormone, in which case, you might experience:
Some people experience loss of calcium, leading to lower bone density, which can lead to osteopenia (“poverty of bone”) or osteoporosis (bone that is porous or full of holes like a sponge).
If you already have heart issues, they should be well managed, since even a slightly high dose of thyroid hormone could lead to angina (chest pain) and possibly even a heart attack. If you are a heart patient, more frequent blood testing is recommended.
Testing over time should also give a hint as to the cause of the hypothyroidism. Over time, antibodies against the thyroid might appear – a sign of autoimmune thyroiditis, which is the most common cause of hypothyroidism.
Once treatment for hypothyroidism has started, it will usually continue for the rest of your life. Therefore, it is essential to get diagnosed accurately and to follow up with tests and all doctor’s appointments.
Certain medications can affect the function of the thyroid, in which case the medicine may have to be adjusted. In most cases, synthetic thyroid hormone can be safely taken with most other medications.
If you are likely to become pregnant or are pregnant, there are no restrictions because the medication is used in the body as if it were your own natural T3 and T4. However, the dose may have to be adjusted upwards in order to meet mother and baby’s needs, since your metabolism will speed up.
Those taking vitamins and supplements have to be careful of any which contain iron. It might also interact with blood thinners such as warfarin, digoxin for the heart, and theophylline for respiratory issues.
It is essential to take your medicine according to the stated schedule, and according to the instructions. Failure to control your hypothyroidism could result in myxedema coma, as mentioned above.
If you have trouble breathing, have swelling in the hands or feet, and/or are unable to function in the usual way, treat this as a medical emergency and call 911. If you have missed a dose of your medicine, do NOT take any before going to the ER.
Once you get to the ER, they will perform tests, and might administer fluids, give you a warming blanket, and try to alleviate the symptoms you report. Making sure you and your family members know what the signs and symptoms of myxedema coma are can help you get the care you need quickly in the event of a crisis.
In addition to medications, there are some natural treatments that have been reported as being helpful for hypothyroidism. Let’s look at these in the next section.
Natural Treatments for Hypothyroidism
In addition to synthetic thyroid hormone, there are a number of ways to lessen the impact of hypothyroidism on your life. The National Institutes of Health keeps track of Complementary and Alternative Medicine (CAM) practices that have been clinically researched that have been found to support thyroid function and/or relieve common symptoms of hypothyroidism.
This has been used in traditional Chinese medicine for centuries to move energy in the body to promote health and healing. Small thin needles are inserted into the skin to connect with the energy channels and centers, the meridians, in the body.
Acupressure works under the same principles as acupuncture, but no needles are involved. Rather, strong massage is applied.
Traditional Indian medicine tries to balance the body using herbs, supplements and natural remedies. You should look for a qualified practitioner and investigate the potential side effects of any herb they suggest.
Exercise is good for everyone, and can help those struggling with their weight to burn calories and keep a strong body. It is important to be cautious, however, and not overdo things. Hypothyroidism affects the muscles and ligaments, and control over one’s movements can be compromised (a condition called ataxia).
Avoid high-tech exercise equipment or anything that puts a lot of strain on the joints. Swimming is a great workout for people any age, plus tai chi and yoga (more about these below).
A qualified herbalist can offer a number of suggestions to support the function of the thyroid and accompanying symptoms. Traditional Chinese herbalism will offer an even wider range of choices. Be sure to investigate the potential side effects and interactions of any of the herbs suggested.
Homeopathy was invented in Germany at the end of the 18th century and uses elements from nature to stimulate certain effects in the body. A qualified homeopath can recommend a number of herbs, creams and tinctures that can help support healthy thyroid function.
There’s something soothing about water. Hydrotherapy in your home can include using a hot tub, bath tub or warm shower to relax and lower stress and inflammation. You should not use a hot tub, however, if you have any underlying heart issues. Swimming in a pool that’s not too cold is ideal for exercise and stress relief.
Massage can stimulate the circulation and lymph system, and enhance wellbeing. It can reduce stress and the inflammation that accompanies it, so it can be helpful for anyone who has autoimmune thyroid disorder.
The goal of meditation is to create a calm, peaceful mind that can be used for self-improvement. It lowers stress and inflammation and takes only a few minutes a day.
This modality moves energy in the body in a similar way to acupressure, in order to use that energy for health and healing. You should be able to find a practitioner near you who can help your body get back into balance.
Tai chi is an ancient martial art that means “supreme ultimate fist.” It moves energy in the body, giving you strength and power, even though the movements are very low impact and you don’t actually hit anything. It is gentle enough for even seniors to do, and has the added benefit of lowering stress and reducing inflammation. 3195
Yoga offers all the same benefits as tai chi and is even more common, with studios everywhere and many free resources online that can help you start a daily yoga practice. A yoga teacher can give you specific poses that stimulate the thyroid naturally. Just be sure to take note of the point made in the exercise section, and don’t do any poses that could be dangerous if your muscles started to go weak or spasm. 3196
One other medical practitioner you would benefit from seeing in relation to your hypothyroidism would be a nutritionist/dietitian to find out the best things to eat for your hypothyroidism. Let’s look at suggested dietary guidelines for hypothyroidism in the next section. 3197
Suggested Dietary Guidelines if You have Hypothyroidism
Due the increased attention hypothyroidism has been getting as a possible reason why so many people, especially women, might not be able to lose weight, a range of dietary guidelines have been proposed. 3198
The cornerstone of a healthy diet is one rich in fruits and vegetables, low in fat, and low in refined foods such as cakes, cookies and white pasta. Any carbohydrates consumed should be “slow carbs” such as whole grains, whole wheat pasta and so on. 2999
A good diet can help no matter what the reasons are for your hypothyroidism. However, it is important to note that the main dietary recommendation, to consume more iodine, will not work for people with autoimmune hypothyroidism. 2998
If your doctor does recommend iodine, you can get it naturally from sea vegetables such as seaweed, nori and dulse. If you like Japanese food such as sushi or seaweed salad, just a tiny amount of seaweed can give you your full daily allowance of iodine. Other foods rich in iodine include iodized table salt, cod fish, cow’s milk and potatoes. 2996
As with many things in life, however, too much of a good thing can be bad for you. So it is important not to overdo it, as some studies suggest too much iodine can contribute to hypothyroidism. 2997
Vitamins and Minerals
A number of vitamins and minerals have been suggested as being of potential benefit to those with hypothyroidism in order to treat symptoms and support thyroid function.
- Vitamin A
- Possibly iron, depending on the cause of your thyroid issues
It is possible to overdose on A, selenium, and iron, however, so you should avoid extremes. Whenever possible, try to get your nutrition from natural sources, not tablets. Aim for organic if you can afford it. 2995
If you do take any herbs or supplements, be sure to tell your doctor to avoid any unsafe interactions, for effective treatment of your condition.
Hypothyroidism can cause a troublesome range of symptoms, and the longer it goes untreated, the more damage it can cause to your health. If you’ve been feeling drained of energy and struggling with your weight, it might be time to see your doctor for a check-up and a blood test to measure your thyroid hormone levels. 2994
If you do have hypothyroidism, there are simple, effective treatments that should have you looking and feeling better quickly, for a much better quality of life.