Hypothyroidism

Hypothyroidism is a common endocrine disorder in which the thyroid gland (located in the front of the neck) does not produce enough thyroid hormones (T3 and T4).

These hormones are essential for regulating metabolism, energy levels, and body temperature, essentially controlling the rate at which the body uses energy. When their levels are low, bodily functions slow down. The most common cause of hypothyroidism is the autoimmune disease Hashimoto’s thyroiditis, in which the immune system attacks and gradually destroys the tissue of the thyroid gland. Other causes may include treatment for hyperthyroidism (with radioactive iodine or surgery), certain medications, iodine deficiency, or congenital defects.

Symptoms

Since the condition leads to a slowing of metabolic processes, symptoms usually develop slowly and gradually, often being mistaken for normal signs of aging or other conditions:

• Chronic fatigue and exhaustion: A persistent feeling of tiredness that does not improve with rest.
• Weight gain: Despite normal or reduced food intake, as metabolism is slowed.
• Cold intolerance: Feeling cold even at normal temperatures.
• Skin and hair: Dry, rough skin, brittle nails, and hair loss.
• Neurological and mental symptoms: Slowing of thought processes, memory and concentration issues, depression.
• Cardiovascular system: Slow heart rate (bradycardia).
• Other: Constipation, muscle pain and stiffness, facial swelling and puffiness, especially around the eyes.

Diagnosis

The diagnosis is made through blood tests. The main indicator is measuring Thyroid-Stimulating Hormone (TSH). In hypothyroidism, TSH is elevated because the pituitary gland attempts to ‘stimulate’ the non-functioning thyroid gland to produce more hormones. Levels of free Thyroxine (fT4) are also measured, which are usually low. If Hashimoto’s thyroiditis is suspected, antibodies (Anti-TPO and Anti-Tg) are also tested. In some cases, an ultrasound of the thyroid gland is performed to assess its structure.

Treatment

Treatment for hypothyroidism is highly effective and consists of replacement hormone therapy.

• Levothyroxine (synthetic T4): This is the standard treatment. Patients take a daily synthetic form of the hormone Thyroxine (L-Thyroxine).
• Dosage: It begins with a low dose, which is gradually increased to reach optimal TSH levels, indicating that metabolism is restored. The dosage is highly individual and requires periodic monitoring of TSH and fT4 (usually every 6 to 12 months) by an endocrinologist.
• Administration: Levothyroxine is taken on an empty stomach, 30 to 60 minutes before the first meal or intake of other medications, as its absorption can be affected by food and supplements (especially calcium and iron).
• Prognosis: Hypothyroidism is a lifelong condition, but with strict adherence to therapy, patients can lead a completely normal and healthy life.

Synonyms: Hashimoto’s, Lazy thyroid, High TSH, Myxedema