Hypothyroidism: what are the signs and consequences?

Hypothyroidism is characterized by a deficiency in thyroid hormones. It is estimated that around 5% of women have it. What are the signs that characterize it? What are the treatments and consequences?

During hypothyroidism, the functioning of the thyroid gland is slowed down. The production of thyroid hormones, T3 or T4, is reduced or absent and insufficient to ensure the proper functioning of the body. This slows down many functions. An enlargement of the thyroid accompanied by goiter may occur. The diagnosis is confirmed by blood tests for thyroid hormones, T3 and T4, as well as TSH. Hypothyroidism affects women over 50 more often. It is estimated that around 5% of the female population in France is affected by hypothyroidism.

Definition

Hypothyroidism is a dysfunction of the thyroid gland, which secretes thyroid hormones. The thyroid is located in the neck in front of the initial part of the trachea. Hypothyroidism, unlike hyperthyroidism, is the result of the low production of hormones by the thyroid gland. This pathology mainly concerns women from the age of 50.

Frank or frustrated hypothyroidism?

While “frank” hypothyroidism is defined by symptoms of hypothyroidism, a drop in T4 hormone, and an increase in TSH, the more common “frustrating” hypothyroidism is defined as increased HRT, but an increase in TSH. Normal T4. Frustrating hypothyroidism, or “subclinical” because it does not always cause symptoms, does not require systematic treatment, and can progress in a third of cases to frank hypothyroidism.

Congenital hypothyroidism

Congenital hypothyroidism is a rare genetic disease that affects 1 in 3,500 newborns in France. Present from birth, congenital hypothyroidism is characterized by low thyroid activity. This hormonal imbalance can lead to serious complications, including mental retardation and growth retardation. Screening is carried out systematically a few days after the birth of a baby (measurement of the TSH level). In the case of hypothyroidism, treatment with levothyroxine should be started quickly to replace the failing thyroxine and allow the child to develop his full intellectual potential.

Symptoms: fatigue, weight gain, dizziness …

The manifestations of hypothyroidism are the consequence of a slowing down of many body functions. Typical symptoms of hypothyroidism include:

  • severe fatigue, a desire to sleep, a lack of tone,
  • memory loss, difficulty concentrating,
  • depression,
  • slow heart rate
  • constipation, bloating,
  • dry, cold, and thick skin,
  • hair loss, brittle nails,
  • weight gain is possible despite a normal diet,
  • excessive chilliness and cramps,
  • Most of the time, women notice that their period has stopped.
  • Finally, a decrease in libido (decreased desire) can be observed.
Causes

Hypothyroidism is due either to a failure of the thyroid itself, we speak of primary hypothyroidism, or to a failure of the pituitary or hypothalamus, we then speak of secondary and tertiary hypothyroidism. The thyroid can malfunction due to iodine deficiency (very rare), an autoimmune disease called Hashimoto’s thyroiditis which causes the progressive destruction of the gland, following treatment with radioactive iodine, or taking certain medicines such as amiodarone. Thyroid removal or excessive consumption of so-called “goitrogenic” foods (crucifers, sweet potatoes, peanuts, millets …

Diagnosis: TSH assay

In order to detect hypothyroidism, the doctor will do tests that will assess how well the thyroid gland is functioning. The first test to be performed in case of suspicion is a determination of TSH, a thyrotropic hormone which is the hormone that stimulates the secretion of thyroid hormones. However, it is not recommended to perform a TSH test if there are no clinical signs suggestive of thyroid dysfunction. Namely, that one does not directly dose the thyroid hormones because the variation of TSH is faster and more revealing of the thyroid state. In case of doubt, the thyroid hormones will then be checked and measured: triiodothyronine (called T3) and thyroxine (T4) before the start of treatment.

Once the diagnosis is made, a workup is necessary to look for complications, especially cardiac complications, but also the cause of the hormonal problem. Note that the anti-TPO antibody assay is not indicated for diagnosing hypothyroidism. On the other hand, it is necessary to detect an autoimmune origin of the disease.

When to consult?

” Even if the causes of hypothyroidism are numerous, in most cases hypothyroidism is only treated in the event of bothersome symptoms on a daily basis. Abnormal and prolonged fatigue, chilliness, weight gain, or shortness of breath should be observed. consult without delay to measure TSH“, insists Dr. Claire Lewandowski, a doctor specializing in general medicine, addictology, and psychiatry. Fatigue, weight gain, constipation … Many seemingly banal ailments can be signs of thyroid dysfunction. A consultation with her general practitioner and a blood test is sufficient to guide the diagnosis in case of symptom. A consultation with an endocrinologist may be necessary in some cases to find the cause and consider treatment. a blood test, but in the absence of symptoms, simple monitoring is sufficient in most cases.

Treatment
Medical treatment

Hypothyroidism is a disease that cannot be cured but can be controlled by taking replacement hormones in order to restore normal metabolism. The most widely prescribed synthetic hormone is thyroxine (T4) in the form of levothyroxine sodium in tablet form. Treatment for hypothyroidism is individualized. The choice of the starting dose depends on the characteristics of the patient, namely their age, weight, cardiac condition, and the severity and duration of the hypothyroidism. Regular medical monitoring is necessary to detect overdose or underdose of thyroid hormone therapy which may cause symptoms of hyperthyroidism. Usually, a TSH test is prescribed 6 to 8 weeks after starting treatment, or after any change in dose or specialty. Then, monitoring is done once a year, by questioning, clinical examination, and TSH assay

Natural treatment

Even if the daily intake of thyroid hormones throughout his life remains the only cure for hypothyroidism, in some cases, always after the advice of his endocrinologist, it is possible to treat himself with natural remedies. A dietary intake of iodine can be supplemented with L-tyrosine and zinc, for example, which are involved in the synthesis of thyroid hormones. A balanced diet also helps to limit iron deficiencies for example, sometimes responsible for a slowing down of the thyroid. On the plant side, ashwagandha and guggul are known for their stimulating effect on the thyroid.

Weightloss

The weight gain caused by hypothyroidism is partly linked to the occurrence of edema. Thanks to a balanced treatment with hormonal values returned to the norms (in particular a TSH less than 2.5 min.

 

 

 

 

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