Hypothyroidism
"Hypothyroidism is more common in women and affects 2% of adult women".
DR. JUAN CARLOS GALOFRÉ FERRATER
SPECIALIST. THYROID DISEASE AREA
What is hypothyroidism?
Hypothyroidism is a condition that occurs when the thyroid gland (located at the base of the throat near the windpipe) produces less thyroid hormones than necessary. These hormones, called T4 and T3, are essential because they regulate metabolism and many body functions.
The pituitary gland, a gland in the brain, controls the thyroid by releasing TSH (thyroid stimulating hormone). If T4 and T3 levels fall, the pituitary produces more TSH to stimulate the thyroid. However, in hypothyroidism, the thyroid does not respond as it should and does not produce enough hormones.
When thyroid hormones are missing, the body functions more slowly. This affects the metabolism, brain, heart, digestion and other systems, causing a general decrease in the body's activity.
At the Clínica Universidad de Navarra we have a Thyroid Pathology Department, made up of doctors specialising in Endocrinology and Nutrition, Otorhinolaryngology, General Surgery and Nuclear Medicine.
Symptoms of hypothyroidism
The onset is usually slow and progressive and symptoms are related to a decrease in the functional activity of all body systems.
In extreme situations it may progress to heart failure, generalised swelling (myxedema) and/or respiratory failure.
Occasionally, it can even lead to myxedema coma with loss of consciousness leading to a high degree of mortality.
The most common symptoms are
- Tiredness
- Intolerance to cold
- Decreased memory
- Apathy, indifference, depression
- Dry, brittle skin and/or hair
- Fragile nails
- Paleness of the skin
- Weight gain and/or constipation
- Excessive sleepiness
Do you have any of these symptoms?
If you suspect that you have any of the above symptoms,
you should consult a medical specialist for a diagnosis.
What are the causes of hypothyroidism?
- Hashimoto's thyroiditis: The most common cause of hypothyroidism is Hashimoto's thyroiditis, which results in progressive destruction of the thyroid as a consequence of autoimmune phenomena. It is as if the body does not recognise the thyroid as its own. It is more common in women over the age of 40, although it can also occur in men.
- Thyroid surgery for nodules, hyperthyroidism or thyroid carcinoma can also cause hypothyroidism. In these cases there is no autoimmune mechanism, but the removal of the glandular tissue leads to insufficient secretion of thyroid hormones into the blood.
- Radioactive iodine as a treatment for hyperthyroidism or thyroid cancer also causes hypothyroidism.
- Lithium treatment, used in manic-depressive psychosis, blocks the release of thyroid hormones and is also a cause of hypothyroidism.
- Less common is hypothyroidism caused by enzyme defects, often inherited, that compromise thyroid hormone synthesis. Enzyme defects may result in enlargement of the gland (goitre). Developmental defects of the gland can lead to hypothyroidism.
- Taking antithyroid drugs such as carbimazole, methimazole or propylthiouracil, iodine-rich drugs (such as the antiarrhythmic amiodarone, antitussive syrups and expectorants) can paralyse thyroid hormone synthesis and/or generate antithyroid antibodies causing hypothyroidism.
- Secondary hypothyroidism, caused by lack of TSH secretion by the pituitary gland, is more rare. In these cases the thyroid gland is intact, but its stimulating hormone is missing, which causes it not to function, lowering thyroid hormones in the blood.
Who is affected
Hypothyroidism is more common in women, affecting 2% of adult women compared to 0.1%-0.2% of men. Its incidence increases from the age of 40-50, especially due to autoimmune causes such as Hashimoto's thyroiditis.
The postpartum period is another critical period for its appearance due to hormonal changes.
In addition, newborns of hyperthyroid mothers should be screened for thyroid problems, whether they have been treated during pregnancy or not.
Those with anti-thyroid antibodies are at increased risk of developing thyroid disorders, underlining the importance of medical follow-up in these cases.
Diagnosis of hypothyroidism
TSH (thyroid stimulating hormone) testing is the most sensitive method of diagnosing hypothyroidism. Its increase indicates insufficient thyroid function, even before thyroid hormone levels in the blood drop.
In established cases, it is common to observe elevated TSH, decreased T4 and T3 in normal ranges. If developmental abnormalities of the gland or enzyme deficiencies are suspected, a thyroid scan may provide additional information.
When the origin is autoimmune, other glands such as the adrenal or parathyroid glands are also evaluated for possible involvement. With appropriate treatment, patients can lead an unrestricted life.
Treatment of hypothyroidism
The treatment of hypothyroidism consists of replacing the production of the thyroid gland. The most stable and effective way to achieve this is to administer thyroxine (T4), as it has a long life and in the body it is partly transformed into T3, so it is not necessary to replace this last hormone.
Once the adequate dose is established by the doctor, the controls that allow the adjustment are based on the clinical evaluation and the determination of T4 and TSH.
With few exceptions, established primary hypothyroidism is a chronic condition, which requires lifelong treatment. However, with the right dose, hypothyroid patients have no limitation in their activities.
The deficit of thyroid hormones is especially important in children, since these are essential for normal mental development and growth. Therefore, in all newborn children, an analysis is made to confirm the correct functioning of the thyroid and, if necessary, to begin treatment immediately.
Where do we treat it?
IN NAVARRA AND MADRID
The Thyroid Pathology Area
of the Clínica Universidad de Navarra
The Thyroid Pathology Area is made up of a multidisciplinary team of specialists who work together to offer patients with thyroid problems an accurate diagnosis.
After the diagnosis, the patient is indicated the most appropriate treatment for his or her case and a continuous follow-up is carried out to achieve the desired objectives.
The Clinic is a pioneer in the implementation of medical techniques in Spain and worldwide, and is an international reference in highly specialized procedures.
What diseases do we treat?
Why at the Clinica?
- Prestigious professionals who are a national reference.
- In 24-48 hours we make the diagnosis and we can start the most appropriate treatment for each patient.
Our team of hypothyroidism experts
