WHAT IS HYPOTHYROIDISM?

Hypothyroidism means underactive thyroid. It can also be called as thyroid laziness. With these terms, it is meant that thyroid hormones are insufficient in the blood.

In our body, hormones called T4 and T3 and containing high levels of iodine are released from the thyroid gland. These hormones are released from the thyroid gland to the blood, from our hair to skin cells; They affect all cells in the body, from the heart cell to the digestive system. When thyroid hormones are insufficient in our body, the metabolism of these cells slows down. As a result, dysfunction develops in many different systems. The decrease in thyroid hormones in the blood, for example, causes a slow beat in the heart, while it causes constipation in the intestines, slowing down in thinking in the brain, and hair loss and dryness in the skin.

Causes of Hypothyroidism

Hypothyroidism mainly develops due to thyroid gland insufficiency. Rarely, it can be seen due to TSH deficiency from the pituitary gland.

The most common cause of hypothyroidism is Hashimoto's disease (See Hashimoto's disease for additional information). Other causes of hypothyroidism are removal of the gland with thyroid surgery, atomic therapy, insufficient or excessive iodine intake, use of various drugs, breastfeeding period and some thyroid inflammations.

Hypothyroidism Symptoms

Since thyroid hormones have effects on the whole body, thyroid insufficiency can also cause many complaints. These symptoms can differ markedly from person to person. Someone with severe thyroid deficiency may have mild symptoms, or mild thyroid hormone deficiency may cause severe symptoms.

The most common complaints caused by hypothyroidism are weakness, fatigue, constipation, difficulty concentrating, forgetfulness, getting cold easily, weight gain and inability to lose weight. In addition, dry skin, swelling around the eyes, high cholesterol, hoarseness, sexual reluctance, menstrual irregularity and infertility in women are common complaints. In the case of thyroid failure, one or more of these complaints may be present, not all of them. On the other hand, the presence of these complaints does not necessarily indicate thyroid disease, but may be due to other systemic diseases.

The first symptom of thyroid insufficiency in the body is the increase in TSH hormone released from the pituitary. The hypothalamus and pituitary regions in our brain always check whether the thyroid hormone levels are sufficient. If our brain perceives that the thyroid hormone level is insufficient, it responds by raising the TSH hormone from our pituitary gland. The TSH hormone released from the pituitary gland goes to the thyroid gland, increasing the production of thyroid hormone and enlarging the gland. However, if the gland does not produce enough, TSH cannot be successful in this task. As a result, thyroid insufficiency (Hypothyroidism) and thyroid gland enlargement (Goiter) develop.

Diagnosis of Hypothyroidism

It is important for people with the above symptoms to consult an endocrinologist for the control of thyroid hormones. TSH and thyroid hormone levels are checked for the diagnosis of hypothyroidism. If the diagnosis is made for the first time, measurement of TSH by a reliable laboratory is essential to avoid errors. If the cause of hypothyroidism is not clear, your doctor may additionally order thyroid antibody levels and thyroid ultrasonography.

Hypothyroidism Treatment

The treatment of hypothyroidism is to replace the thyroid hormone that the thyroid gland cannot produce. However, the drug may not be started in every patient with elevated TSH. Before starting the drug, attention should be paid to common laboratory errors in TSH measurement, other drugs used by the patient, and comorbidities of the patient. However, TSH reference intervals in pregnant and elderly are different when evaluating TSH. Therefore, treatment should be individualized for each patient.

When starting thyroid hormone therapy, a TSH range is targeted before treatment. This determined target is tried to be achieved by increasing or decreasing the dose of the drug. At this point, drug dose adjustment is important. Because the low dose of the drug causes the symptoms of hypothyroidism to continue, while the excess of the drug causes palpitations, tremors in the hands, excessive sweating, weight loss, osteoporosis, etc. It causes a kind of poisonous goiter symptoms with the characteristics of .

The dose of thyroid medications may vary during follow-up. For example, the dose requirement may increase as the patient gains weight, or if the thyroid gland insufficiency progresses, the drug dose may be insufficient. On the other hand, thyroid medications that are started in some temporary inflammations of the thyroid may start to become too much when the thyroid gland heals. For these reasons, patients using thyroid medication should be monitored at regular intervals to measure the dose of thyroid medication.