General Practice 2022

Hypothyroidism: what é, symptoms, causes and treatment

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Hypothyroidism: what é, symptoms, causes and treatment
Hypothyroidism: what é, symptoms, causes and treatment

Hypothyroidism is a thyroid disorder characterized by decreased production of the hormones T3 (triiodothyronine) and T4 (thyroxine), which are essential for the proper functioning of the body, leading to the appearance of some symptoms, such as excessive tiredness, decreased heart rate, weight gain, hair loss and dry skin.

Hypothyroidism is more common in women over 40 years of age, who have close family members with hypothyroidism, who have had part or all of their thyroid removed, 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, alleviate the symptoms, and the endocrinologist normally recommends the use of synthetic hormones, such as Levothyroxine, for example.

Symptoms of hypothyroidism

The main symptoms of hypothyroidism are:

  • Headache, muscles and joints;
  • Irregular menstruation;
  • Fragile, brittle nails;
  • Rough and dry skin;
  • Swollen eyelids;
  • Hair loss without apparent cause and thinner, dry and dull hair;
  • Heartbeat slower than normal;
  • Excessive fatigue;
  • Difficulty concentrating;
  • Low memory;
  • Decreased libido;
  • Unexplained weight gain.

In addition, in some cases the person may have 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 they can have delayed puberty and short stature, for example.

When hypothyroidism is severe and not treated properly, it can cause fluid retention and result in tissue inflammation. As a consequence of inflammation, there is an increase in pressure on the peripheral nerves and cause tingling and numbness in the wrist, mainly.

In addition, in the case of congenital hypothyroidism, if it is not detected in the first week after birth, the child may have neurological alterations, with a 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 were harmful to the body itself.In addition, hypothyroidism can occur 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 T3 and T4 due to a decrease in iodine concentration.

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 are identified so that discontinuation can be indicated. medication or replacement.

People who have taken thyroid medication to lose weight can 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 arise during pregnancy or in the postpartum period, which tends to return to normal soon afterwards.In addition, it is important to remember that this disease decreases a woman's fertility, causing problems in getting 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 recommends blood tests to check the amount of circulating thyroid hormones.

Thus, the dosage of T3 and T4, which are normally decreased in hypothyroidism, and the dosage of TSH, which is increased, is indicated. In the case of subclinical hypothyroidism, normal levels of T4 and increased TSH can be seen. See more about tests that evaluate the thyroid.

Furthermore, the physician may recommend performing antibody screening, thyroid mapping, and thyroid ultrasound when nodules are noted during thyroid palpation.It is also possible for the person to perform a thyroid self-exam to identify any changes, especially nodules. Learn how to perform a thyroid self-exam.

Who needs thyroid tests

In addition to people who have signs and symptoms that may indicate hypothyroidism, these tests should also be performed by:

Women over 50 Who has had radiation therapy to the head or neck People with Type 1 Diabetes
During pregnancy Who had thyroid surgery People with autoimmune disease
If you have a goiter If you have thyroid disease in your family In case of heart failure
Who has Down Syndrome Who has Turner Syndrome Production of milk outside of pregnancy or not breastfeeding

Hypothyroidism in pregnancy

Hypothyroidism, if not well controlled, can make it difficult to get pregnant and have repercussions for both mother and baby. It can also happen in the postpartum period, a few months after the baby's birth, in a transitory way and that also needs care with the treatment.

Thus, it is normal that, during prenatal care, the doctor asks for T3, T4 and TSH tests to assess thyroid functioning and continue to monitor postpartum how thyroid hormone values ​​are and if there are any need to use medication to get back to normal. Learn about the risks of hypothyroidism in pregnancy.

How to treat Hypothyroidism

Treatment for hypothyroidism is relatively simple and must be done through hormone replacement with synthetic hormones, Levothyroxine, which contains the T4 hormone, and which must be taken on an empty stomach, at least 30 minutes before breakfast, so that the digestion of food does not diminish its effectiveness.The dose of the drug must be prescribed by the endocrinologist and may vary throughout the treatment according to the levels of T3 and T4 circulating in the blood.

After 6 weeks of starting medication, the doctor may check the person's symptoms and order a TSH test to see if the medication dose needs to be adjusted until the amount of free T4 is normalized. After that, tests to evaluate the thyroid should be performed 1 or 2 times a year, to check if the drug dose needs to be adjusted.

In addition to the use of medication, it is important for the person to control blood cholesterol levels, avoiding the consumption of fats, following a diet that helps the liver function properly 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 an iodine supplement can help 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 these 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 food can improve thyroid function in the video below.

Signs of improvement and worsening

Signs of improvement in hypothyroidism appear approximately 2 weeks after the start of treatment, and a decrease in tiredness and an improvement in mood can be observed. In addition, long-term treatment of hypothyroidism also helps to control weight and reduce blood cholesterol levels.

Signs of worsening appear when treatment is not performed correctly or when the dose of Levothyroxine is not adequate, with insomnia, increased appetite, palpitations and tremors, for example.

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