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January Is Hypothyroidism Month

Where is your thyroid gland and what does it do?

photo-blog-hyperthyroidismThe thyroid is a butterfly shaped gland and is located in front of your neck.  When it does not produce enough thyroid hormone the condition is called hypothyroidism. Generally the condition develops slowly over a number of years.  Older women are more at risk than men.  Untreated hypothyroidism can make a person at increased risk of infection, heart disease because of higher levels of LDL (bad) cholesterol, and heart failure.  If you are younger and leave your condition untreated it can lead to infertility, miscarriage, or giving birth to a baby with birth defects.

What causes hypothyroidism?

The thyroid gland needs iodine to produce thyroid hormone, but a lack of iodine in the US is rare.  Most salt contains iodine, and other foods high in iodine are fish, eggs, and dairy products.
The thyroid gland is an important organ that produces hormones that control the way every cell in the body uses energy.  The process of body cells using energy is called metabolism.

Hormones released by the thyroid gland travel throughout the bloodstream and affect every organ from your brain, heart, muscles and skin. The most common cause of hypothyroidism is thyroiditis or swelling and inflammation that damage the thyroid gland’s cells.  The causes of thyroiditis include:

  • The body’s immune system attacking the thyroid gland
  • Viral infections such as a cold or other respiratory infection
  • Certain medicines such as lithium, and amiodarone
  • Radiation treatments to the neck or brain to treat cancers
  • Radioactive iodine used to treat an overactive thyroid gland
  • Surgical removal of part or all of the thyroid gland
  • Pituitary tumor or pituitary surgery
  • Pregnancy, often called postpartum thyroiditis
  • Congenital birth defects.

What are the symptoms of hypothyroidism?

There are early symptoms and late symptoms if the hypothyroidism is left untreated.  Some of the early symptoms are:

  • Fatigue or feeling slowed down
  • Joint or muscle pain
  • Constipation or hard stool
  • Increased sensitivity to cold temperatures
  • Weakness and weight gain
  • Pale or dry skin, and thin brittle hair or fingernails.

Some of the late symptoms are:

  • Puffy face, hands, and feet with thickening of the skin, and thinning of eyebrows.
  • Decreased taste and smell, hoarseness, and slow speech.

What exams and tests will diagnose hypothyroidism?

Upon physical exam of the thyroid gland the physician will find it to be enlarged.  The physician will also observe the face, skin, and hair changes and reflexes that are abnormal.

The physician will order a blood test called a TSH and T4 which will measure your thyroid hormones. Other blood tests ordered may include a CBC, cholesterol levels, and liver enzymes.

How is hypothyroidism treated?

Since the thyroid gland is not producing thyroid hormones the treatment is to take a medication called levothyroxine.  The physician will probably prescribe the lowest dose possible to relieve your symptoms and bring your thyroid blood level back to normal.  If you have an underactive thyroid gland you will need to take this medicine for life.  Your blood levels will be checked every 2 to 3 months until they are normal, then at least once every year.

Tips when taking Levothyroxine:

Absorption of this medication works best if taken on an empty stomach in the early morning.  Take this medicine about one hour before taking any other medicine.    Sometimes the medicine will be prescribed at bedtime, but always follow your physician’s instructions.  This medicine should never be discontinued even if you are feeling better.  If the brand of the medicine is changed by your pharmacist notify your doctor as the blood level may need to be checked.

If you take certain medicines, it is recommended that you wait four hours before taking them.  These include fiber supplements, calcium, iron, multivitamins, and aluminum and hydroxide antacids.  If thyroid replacement medicine is too high the person may experience palpitations, restlessness or shakiness, sweating or rapid weight loss.  Please notify your physician immediately.

Want to find out more?

Mayoclinic.org
Hypothyroidism (underactive thyroid)

Nlm.nih.gov
Hypothroidism

WebMD.com
Hypothyroidism (Underactive Thyroid)

Helen Trowsdale, President of AA Care Services, is a nurse administrator with over 30 years of experience as a BSN, psychiatric nurse, and geriatric care manager with adults as well as pediatrics in hospitals, private duty home health care agencies, and residential home health care. Her team of caregivers are dedicated to serving their clients with home care in San Antonio, New Braunfels, and Austin; providing clients with consistent, quality care while minimizing the number of caregivers in the home. Learn more about AA Care Services.

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