12120 Hypothyroidism

Overview

Hypothyroidism (say: hy-poh-THY-roy-dih-zum) is a condition where your thyroid gland does not make enough thyroid hormone. The thyroid is a small butterfly-shaped gland in the front of your neck. Thyroid hormone helps control your body's energy. When levels are too low, your body's processes slow down.

Yes. Hypothyroidism is one of the most common thyroid problems. It affects around 2% of the UK population, and up to 5% of women over 60.

Hypothyroidism can affect people of any age, but it is most common in women, especially those over the age of 60. It can also be present from birth occasionally.

Symptoms

Common symptoms

• Feeling very tired or having low energy
• Weight gain that is hard to explain
• Feeling cold all the time, especially in your hands and feet
• Dry skin and brittle hair
• Constipation
• Muscle aches and joint pain
• Feeling depressed or low
• Slow heart rate
• Heavy or irregular periods

Symptoms in children

• Slower growth than expected for their age
• Delayed puberty
• Tiredness and low energy
• Difficulty concentrating at school

Symptoms in older adults

• Memory problems or feeling confused
• Slow movements and speech
• Hearing loss
• Feeling unusually cold

Causes

Main causes

• An autoimmune condition called Hashimoto's disease, where the immune system attacks the thyroid gland
• Treatment for thyroid conditions, such as surgery to remove part or all of the thyroid
• Radiotherapy to the neck area
• Certain medicines that affect thyroid function
• Severe lack of iodine (more common in some other countries)
• A thyroid gland that did not develop normally before birth (congenital hypothyroidism)
• Problems with the pituitary gland, which controls the thyroid

Risk factors

• Being female
• Being over 60 years old
• Having a family history of thyroid disease
• Having another autoimmune condition, such as type 1 diabetes
• Having had thyroid surgery or radiotherapy

When to see a doctor

See a doctor urgently if:

• If you feel severely unwell with extreme fatigue, confusion, chest pain, or shortness of breath, seek urgent care right away.

Book a routine appointment if:

• If you have ongoing symptoms like tiredness, weight gain, or feeling cold for more than a few weeks, make an appointment with your doctor.

Diagnosis

A doctor can usually diagnose hypothyroidism based on your symptoms and a simple blood test. The blood test checks the level of thyroid-stimulating hormone (TSH) and thyroid hormone in your blood.

Tests that may be done

• Thyroid function blood test (TSH and free T4)
• Thyroid antibody blood test (to check for autoimmune thyroiditis)

What to expect at your appointment

Your doctor may also examine your neck, discuss your medical history, and ask about your symptoms. The blood test is quick and results are usually ready within a few days.

Treatment

Hypothyroidism is usually treated successfully with daily hormone replacement tablets. You take one tablet a day, usually in the morning, to replace the thyroid hormone your body is missing. Your doctor will check your blood levels regularly and adjust the dose as needed.

Self-care at home

• Take your medication at the same time every day, as prescribed
• Keep all your follow-up appointments and blood tests
• Tell your doctor if you start any new medicines or supplements
• Eat a balanced diet and ask your doctor about foods that can affect the medication

Medical treatments

Treatment is usually with a daily thyroid hormone replacement. The dose is individual and may be adjusted over time. You will need regular blood tests to check your levels and to keep the dose safe. Never stop or change your medication without talking to your doctor.

When is surgery considered?

Surgery is not used to treat hypothyroidism itself. However, if part of the thyroid was removed for other reasons, it may cause hypothyroidism and replacement hormone is then needed.

Living with this condition

Once your medication is adjusted, you can expect to feel much better, usually within a few weeks. It is important to take your medicine as prescribed and to have regular check-ups. Many people live full, active lives without major limits.

Lifestyle tips

• Get enough rest and manage stress
• Stay active with gentle exercise
• Avoid smoking and limit alcohol
• Keep a record of your symptoms to share with your doctor

Diet and exercise

There is no special diet that cures hypothyroidism, but eating a balanced diet and staying physically active can help you maintain a healthy weight and feel well. Some foods and supplements can affect your medicine, so talk to your doctor or pharmacist.

Mental health and emotional wellbeing

Hypothyroidism can cause low mood, anxiety, or depression. These symptoms can improve with treatment. If you are feeling overwhelmed, talk to your doctor or a trusted mental health professional. You are not alone.

Prevention

In most cases, hypothyroidism cannot be prevented. It usually happens because the immune system attacks the thyroid gland. If you live in an area with iodine deficiency, using iodised salt can help, but this is not advised in the UK because iodine levels are usually adequate.

Screening programmes

Routine screening for hypothyroidism is not recommended for everyone. However, if you have a family history or another autoimmune condition, your doctor may recommend regular blood tests.

Complications

If left untreated

• High cholesterol
• Heart problems, including an enlarged heart
• Infertility
• Birth defects if untreated during pregnancy
• A rare, life-threatening condition called myxedema coma

Long-term outlook

With proper treatment, hypothyroidism is generally well controlled. Most people live normal, long, and healthy lives. It may take a little time to adjust medication, but many people feel much better once treatment begins. Talk to your doctor about any concerns you have.

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