Hypothyroidism (Underactive Thyroid)


Underactive Thyroid occurs when the thyroid gland doesn’t produce enough hormones to meet the needs of the body. The thyroid gland is a small butterfly-shaped gland located in the front of your neck, and it produces hormones that control how the body uses energy.

These hormones affect almost every organ in your body and control many of the most critical functions in your body, for example affecting your breathing, Heart rate, weight gain, digestion, and mood. And without enough thyroid hormones, many bodies’ functions slow, yet some treatments can help.

What is hypothyroidism?

Underactive Thyroid is a health problem that occurs when the thyroid gland can’t produce enough of its hormones for the body. Thyroid hormones regulate metabolism, or how the body uses energy.

If thyroid hormone levels decrease as a result of poor thyroid performance, most of the body's functions slow down. Thyroid deficiency is classified in three different ways: primary, secondary, and tertiary.

  • In primary hypothyroidism: the thyroid gland is correctly stimulated with TSH; however, it isn't possible to produce enough thyroid hormones to meet the needs of the body.
  • In the case of secondary hypothyroidism: the thyroid gland itself is normal. But its insufficient secretion doesn't sufficiently stimulate the thyroid-stimulating hormone (TSH) of the pituitary gland.
  • In triple hypothyroidism: insufficient secretion of thyrotropin (TRH) from the hypothalamus leads to insufficient secretion of TSH, which leads to insufficient stimulation of the thyroid gland.

Causes of Underactive Thyroid

Hypothyroidism can develop for many different reasons. The disease can have many causes, including autoimmune diseases, treatments for hyperthyroidism, radiotherapy, thyroid surgery, and some medications. The most common causes of Underactive Thyroid listed as the next one:

Autoimmune disease of the thyroid gland

  • the most common cause of hypothyroidism is an autoimmune disease known as thyroiditis, autoimmune disorders occur when the immune system produces antibodies that attack the body's tissues.
  • Sometimes these antibodies are produced against the thyroid gland; the cause of this disease hasn't yet been clarified. Still, it is estimated that it is caused by a combination of genetic and environmental factors.

Complications of treatment of hyperthyroidism

  • People who frequently produce thyroid hormone (hyperthyroidism) are usually treated with radioactive iodine or anti-thyroid medication, and the purpose of these treatments is to restore the thyroid function to normal.
  • However, these treatments can reduce the production of thyroid hormone a lot, which leads to permanent hypothyroidism.

Thyroid surgery

  • The surgical removal of all or most of the thyroid gland can reduce or stop hormone production, in which case a thyroid hormone supplement is required for life.

Radiation therapy

  • radiation therapy given to the patient to treat brain and neck cancer can damage the thyroid and lead to hypothyroidism.


  • Some medications can cause hypothyroidism. For example, the thyroid hormone may affect the treatment used for some mental disorders.

Congenital diseases

  • In some children, the thyroid gland is defective or absent at birth. Mostly, it doesn't usually grow for unknown reasons. In general, children with congenital hypothyroidism appear naturally at birth, but if it isn't diagnosed and treated early, it causes severe consequences such as mental retardation.

The pituitary disorder

  • It is a relatively rare cause of hypothyroidism, which is that the pituitary gland doesn’t produce enough thyroid hormones (TSH), which often occurs due to a benign tumor in the pituitary gland.


  • Some women develop hypothyroidism during or after pregnancy, and this condition is often the result of the body producing antibodies against thyroid cells during pregnancy.
  • If this condition isn't treated, it causes an increased risk of miscarriage, premature birth, and preeclampsia and causes an increase in significant blood pressure in a woman in the last three months of pregnancy can severely affect fetal development.

Iodine deficiency

  • Iodine is a rare mineral, which is found in seafood and plants grown in soil rich in iodine and iodized salt, and is necessary for the production of thyroid hormones. So inadequate iodine intake with the diet can lead to hypothyroidism, eating excess iodine worsens symptoms in people who already have hypothyroidism.
  • Iodine deficiency is common in some parts of the world, however, by adding iodine to table salt, this problem has been almost eliminated in many countries.

Diagnosis of Underactive Thyroid

In the past years, most thyroid diseases couldn’t diagnosed due to technological deficiency. Today thanks to advanced medicine, these diseases can often diagnosed through some blood tests, and successful treatments can make with early diagnosis.

With the development of diagnostic and treatment methods, thyroid cancers can diagnosed perfectly. They can successfully treat in the first period.

Hormone levels diagnosed with a blood test called a thyroid function test. In this test, the TSH and thyroid hormone T4 is examined and produce some hypothyroidism, including the following:

  • High TSH levels in the blood and low thyroid hormone T4 mean hypothyroidism.
  • If the TSH is high, but the T4 level is normal, there is a risk of future hypothyroidism.
  • T3 levels in the blood are variable and can sometimes be within the normal range during hypothyroidism.
  • Diagnosis made based on antibodies. The cause of hypothyroidism is immune thyroiditis or the so-called Hashimoto.
  • High levels of creatinine (CPK) and prolactin (PRL) can be found.

Symptoms (side effects) of Underactive Thyroid

symptoms of hypothyroidism and complaints seen in hypothyroidism differ depending on the severity of hormones; the symptoms are vague at first and gradually become apparent within a few years.

In the beginning, non-specific symptoms of the thyroid gland such as weight loss are encountered.

People with an underactive thyroid suffer from the following symptoms and signs :

  • Weakness
  • Constipation
  • Dry skin
  • Cold allergy
  • Overweight
  • Swelling of the face, hands, and feet
  • Hoarseness
  • Muscle weakness
  • Increased level of cholesterol in the blood
  • Pain and stiffness in the muscles
  • Pain, stiffness, or swelling in the joints
  • Irregular menstrual periods
  • Painful menstruation
  • Hair loss
  • The fragility of hair and nails
  • Fast heart rate
  • Mood swings and life-threatening depression
  • Poor memory
  • Goiter
  • Balance and coordination problems
  • Loss of sexual desire
  • Anemia
  • Reduced sweating
  • Eyebrows didn't present due to hair loss
  • Hearing problems

In the presence of hypothyroidism, the signs and symptoms that appear in children or adolescents are similar to adults, but the following symptoms may also be associated:

  • Slowing growth
  • Dental growth delay
  • Weak mental development
  • Delayed puberty
  • Fetal anomalies, especially if mothers have hypothyroidism.

How long is a treatment for Underactive Thyroid?

Hypothyroidism is a disease that needs lifelong treatment. It isn't a temporary disease, and it isn't a disease in which treatment is stopped. If you stop taking medicine, your complaints will start again, so you don't stop taking medication. The protocol for treating hypothyroidism is as follows:

  • In the case of hypothyroidism, the thyroid hormone is low in our bodies. The treatment will be an attempt to use synthetic T4 drugs that are given outside the body and contain levothyroxine, the same T4 hormone made in your body.
  • In women who are considering having children, it is essential to treat hypothyroidism before pregnancy for themselves and their children appropriately. Hence, if women are pregnant, and those who have a pregnancy plan suffer from hypothyroidism, they must inform the doctor.
  • Diet alone doesn't treat hypothyroidism. However, a combination of appropriate foods and medications can help restore thyroid function and reduce symptoms.
  • Hypothyroidism often suffers from a slower metabolism, and research shows that water aerobic exercise helps raise thyroid hormone levels; additionally, consuming more protein increases metabolism.
  • Selenium helps the body to stimulate thyroid hormones so that the body can use hormones. This essential mineral, with its anti-oxidant property, prevents molecules called free radicals from damaging the thyroid gland, and eating foods such as tuna, sardines, eggs, and selenium-rich legumes supports the treatment of hypothyroidism. In addition to zinc, it is an essential ingredient to stimulate the production of thyroid hormones, and foods like chickpeas, cashews, spinach, beef, and chicken are rich in zinc.

Iodine consumptioon

  • If there is a shortage of iodine, it is useful to use iodized table salt in meals or eat foods rich in iodine, such as seaweed, fish, milk, and eggs, and iodine supplements aren’t necessary. Some studies have shown that overeating iodine can also damage the thyroid gland because it can receive enough iodine in the diet.
  • In cases of hypothyroidism caused by iodine deficiency, foods rich in iodine are added to the diet to ensure adequate iodine intake.

Is Underactive Thyroid a chronic disease?

  • Does the patient often question about the thyroid gland, is it a chronic disease, and continues for the rest of life? Or can it cured and return to a healthy life? It is worth mentioning here that we stress that hypothyroidism depends on the individual's awareness because hypothyroidism is a chronic disease, its medications are taken throughout life, and from here it is possible to protect the person himself. Especially the individual, who has a family history with this disease, so that he has a high rate of insufficiency Hypothyroidism, through continuous examination and balanced eating, has a lower risk of hypothyroidism.
  • But it isn't annoying, or painful as some belief; hypothyroidism remains under control doesn’t represent any exaggerated damage to the body, and is similar to other chronic diseases such as diabetes and high blood pressure.

Complications of hypothyroidism

Although an enlarged thyroid gland, in general, isn’t a very uncomfortable condition, still it can be dangerous if left untreated, and hypothyroidism can cause life-threatening complications. Hence, a frequent question can answered. Is hypothyroidism dangerous?

Severe complications of hypothyroidism include

Heart problems
  • The thyroid gland can increase the risk of heart disease, mainly because it causes an increase in LDL levels called bad cholesterol.
Psychological problems
  • Depression can occur early in hypothyroidism, may worsen over time, and can also cause a slowdown in mental function.
Peripheral nerve damage
  • If hypothyroidism not controlled for a long time, this may damage peripheral nerves; peripheral nerves are nerves that carry impulses from the brain and spinal cord to the rest of the body. Include signs and symptoms of pain and tingling in the affected nerve area; over time, it can develop into muscle weakness and loss of control.
Mucosal edema
  • This rare and life-threatening condition can occur as a result of prolonged untreated hypothyroidism, including signs and symptoms of excessive intolerance, dizziness, loss of consciousness, and drowsiness that may even lead to the coma of edema.
Congenital diseases
  • The risk of congenital malformations is much higher in children born to mothers with hypothyroidism. Besides, these children are also more vulnerable to the underdevelopment of physical and mental development. After birth, children who suffer from hypothyroidism will face severe physical and mental retardation if they haven’t treated. If hypothyroidism can diagnosed in the first months of life, normal development can achieve.
Other complication
  • Low levels of thyroid hormones can disrupt ovulation, and some autoimmune diseases, which are the causes of hypothyroidism, may also affect fertility. Treating hypothyroidism with hormones may not completely increase fertility, and sometimes other initiatives may require.

Pregnancy and Underactive Thyroid

In pregnant women, structural and functional changes in the organs from conception to birth, early diagnosis, and treatment of hypothyroidism before pregnancy are significant. Since many hormonal disorders in women of childbearing age prevent childbearing, it may cause undesirable consequences for the mother and child during pregnancy.

It can differentiate between thyroid disorders and pregnancy, in that symptoms of similar thyroid diseases may lead to symptoms observed during pregnancy (palpitations, weakness, loss of appetite, nausea, vomiting, etc.). So TSH, T3, and T4 analysis should request to assess thyroid function in pregnant women during pregnancy, whether or not hypothyroidism exists. The TSH level of a pregnant woman under 2.5 IU / L must maintain in the first trimester of pregnancy, and less than 3.0 IU / L from the fourth month.

The risks involved in not treatment of hypothyroidism in a pregnant woman include

  • The risk of miscarriage.
  • Eclampsia.
  • Placenta separation and premature delivery.
  • Acute respiratory syndrome in a newborn also occurs more frequently in pregnant women with untreated hypothyroidism.
  • Congenital anomalies can occur in a newborn.
  • The child suffers from physical or mental retardation.
  • Tips for hypothyroidism patients
  • People with hypothyroidism should discuss significant dietary changes with doctors.
  • Eating a diet rich in fiber, eating lots of soybeans, or vegetables and paying attention to a proper diet; because diet can affect the way the body absorbs thyroid medications.
  • During pregnancy, iodine requirements increase, so you should consult your doctor in regulating iodine levels in pregnant food. Iodized salt can used in the diet, and prenatal vitamins taken to maintain the necessary iodine levels.
  • Hypothyroidism can managed appropriately according to the advice of a healthcare professional with appropriate treatment, and thyroid hormone levels should return to normal. In most cases, medications used for hypothyroidism must taken and adhered to. As the doctor recommends.

Prevention of hypothyroidism

There is no way to prevent hypothyroidism, but people who are more at risk of developing thyroid problems should consult their doctor about the need for additional iodine.

Screening not recommended for those without symptoms unless the following risk factors are present:

  • History of autoimmune diseases.
  • Receive radiation therapy to the head or neck.
  • A family history of thyroid problems.
  • The use of medications known to affect thyroid function.
  • These people can tested for early symptoms of the condition. And if the tests positive, they can take measures to prevent the development of the disease.
  • Thyroid gland testing should done for all pregnant women during pregnancy. Or if the woman is planning to become pregnant.
  • The neck should protected when exposed to any of the x-rays.
  • There is no evidence that a specific diet will prevent hypothyroidism. There is no way to prevent hypothyroidism unless you use a diet with a low level of iodine, such as individuals who live in some parts of Southeast Asia and Africa.

More health care advice to prevent hypothyroidism

  • A specific diet not recommended for hypothyroidism. But individuals should follow a varied and balanced diet that doesn’t contain a high percentage of fat, or sodium.
  • Also, people with autoimmune diseases may benefit from a gluten-free diet because gluten affects the thyroid gland and causes its disorder.
  • Additional iodine consumption can disrupt the balance involved in the body. May cause hyperthyroidism and iodine can be dangerous. Any dietary changes or supplements should discussed with your doctor.
  • Vegetables such as broccoli and cabbage can contribute to an enlarged thyroid gland. But only if many of them consumed. So eat them in moderation.
  • The need to avoid smoking because of its direct impact on the thyroid gland. As it causes the secretion of thiocyanate. Which reduces the absorption of iodine in the body, causing hypothyroidism.

Congenital diseases

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