You probably don’t think about it very often, but your thyroid is a very powerful part of your body. It’s a small gland at the base of your neck that produces hormones to regulate your metabolism and other necessary bodily functions.
When your thyroid isn’t producing enough of these crucial hormones, you may have a condition called hypothyroidism, or underactive thyroid. Dr. Aruna Venkatesh, an endocrinologist at University Health, breaks down what hypothyroidism is, the symptoms you should be on aware of and how it can be treated.
What Is Hypothyroidism?
Hypothyroidism is the most common thyroid condition, and affects about 12% of the U.S. population, according to the American Thyroid Association.
“Hypothyroidism occurs when you do not produce enough of the thyroid hormones needed to regulate your metabolism, heart rate, body temperature and cholesterol levels,” said Dr. Venkatesh.
It’s the flip side of hyperthyroidism, in which you produce too much of the thyroid hormones, often creating a rapid heartbeat, excessive weight loss and anxiety.
Symptoms of Hypothyroidism
Symptoms may vary, but common ones include:
- Fatigue and tiredness
- Sensitivity to cold
- Constipation
- Dry skin
- Voice changes
- Unexplained weight gain
- Brain fog or confusion
Hypothyroidism Often Goes Undetected
Hypothyroidism is more common in women over 60. “Because some symptoms could be attributed to other conditions or just ‘getting older,’ hypothyroidism may go undetected and untreated,” Dr. Venkatesh notes.
If left untreated, hypothyroidism may result in complications like:
- Enlarged thyroid (goiter)
- Heart disease
- Nerve damage
- Infertility
Pregnancy and Hypothyroidism
Additionally, pregnant women with hypothyroidism are at higher risk for miscarriage and birth complications. Pregnant women who are at higher risk for thyroid disease should have their thyroid-stimulating hormone (TSH) levels checked once they know they’re pregnant. An increased dosage of levothyroxine hormone replacement can treat hypothyroidism during pregnancy.
Dr. Venkatesh notes that if you already have hypothyroidism and become pregnant, you will likely need a dosage adjustment and be closely monitored by a thyroid specialist.
Diagnosing Hypothyroidism
Diagnosing hypothyroidism starts with your primary care provider (PCP). Usually, your PCP will conduct a physical exam, discuss your symptoms and health history, followed by a simple blood test. The blood sample will be tested for thyroid-stimulating hormone, or TSH. Higher TSH levels indicate hypothyroidism.
Causes of Hypothyroidism
The most common cause of hypothyroidism is an autoimmune disorder called Hashimoto's thyroiditis, in which the immune system attacks itself.
Radioactive Iodine Therapy
Other causes include radioactive iodine therapy, which occurs when the thyroid is destroyed by radiation from Graves’ disease (an overactive thyroid condition), thyroid cancer or thyroiditis (a condition sometimes triggered by pregnancy).
Congenital Hypothyroidism
Congenital hypothyroidism is rare in newborns but can damage a baby’s brain and nervous system. Most states (including Texas) require a blood test shortly after birth to identify and treat it if necessary.
Diabetes
Hypothyroidism and diabetes are both conditions of the endocrine system. According to one study, “Type 2 diabetes can be exacerbated by thyroid disorders, and diabetes can worsen thyroid dysfunction.” Additionally, the study suggests that “Thyroid disorders are also significantly more prevalent in type 2 diabetes mellitus (T2DM) patients.”
Treating Hypothyroidism
The good news is that hypothyroidism is highly treatable with a synthetic hormone replacement called levothyroxine. Your age and other health factors will determine your dosage and how long you take it.
Most people will need to take levothyroxine for life to manage their symptoms, while others will only need to take it for a few months. Your doctor will help you understand what treatment option is best for you. Hormone replacement should resolve your symptoms and help you feel more energized. You should start to feel better in a couple of months.
Endocrinology Care at University Health
Managing your endocrinological conditions goes beyond treatment. It’s about supporting your overall health. Learn more about the expert endocrinological care at the University Health Texas Diabetes Institute and ask your PCP for a referral.
Our endocrinologists are experts in treating all thyroid disorders, including hypothyroidism. They will provide you with comprehensive lifestyle planning, ongoing monitoring and support you through your health journey.
