Thyroid disorders, which results in the overactivity or the under activity of the thyroid gland are a common health condition in India. Thyroid disorders are found to affect around 42 million people in India. Out of which the cases of hypothyroidism are greater than hyperthyroidism. Hypothyroidism affects approximately 11% of the population of India. With such a large percentage of people affected by hypothyroidism in India, it is important to be aware of this health condition. Therefore, in this article let us discuss hypothyroidism in detail including its symptoms in infants, children, and adults, causes, and treatment.

What is Hypothyroidism?

Hypothyroidism is a common disorder characterised by the under activity of the thyroid gland, that is, the thyroid gland does not produce enough thyroid hormone in your body. Thyroid hormone circulates in all parts of the body through blood, therefore, the overexpression or underexpression of these hormones causes a variety of symptoms in your body and affects all the major organs including the brain, heart, skin, and muscles. Metabolism is one of the major pathways regulated by the thyroid. Thus, it affects the utilisation of energy from food, the temperature of the body, the burning of calories, and your heartbeat. Therefore, reduced levels of thyroid hormone lead to less energy utilisation by the body, making your body feel sluggish.

What are the Symptoms of Hypothyroidism?

The symptoms of hypothyroidism generally remain the same, however, they may vary in younger people, that is, infants and children less than 19 years of age.

Common Symptoms of Hypothyroidism

Based on how severely a person is affected by hypothyroidism, the signs and symptoms may vary from person to person. These symptoms do not develop instantly but progress gradually over the years. The most common and observable symptoms of hypothyroidism include:

• Increased sensitivity to cold
• Fatigue
• Constipation
• Unexplained weight gain
• Dry skin
• Hoarseness
• Puffy face
• Muscle weakness, muscle ache, stiffness, and tenderness
• Increased levels of cholesterol in the blood
• Swelling, stiffness, or pain in your joints
• Thinning of hair
• Irregular menstrual cycle
• Heavy bleeding during the menstrual cycle
• Heart rate slower than normal
• Impaired memory
• Depression
• Enlargement of the thyroid gland, known as goitre

Symptoms of Hypothyroidism in Infants

Hypothyroidism is most commonly observed in middle-aged individuals, however, it may occur in infants as well. Babies generally suffer from hypothyroidism, if they are devoid of the thyroid gland or if they have a thyroid gland that does not work properly. The signs and symptoms of hypothyroidism in babies include:

• Jaundice, that is, the whites of the eye and the skin turns yellow.
• A large tongue that is protruding
• Difficulty in breathing
• An umbilical hernia
• Hoarse crying
• Trouble in feeding
• Interrupted growth and development
• Constipation
• Feeling sleepy all-day
• Poor muscle tone

Symptoms of Hypothyroidism in adolescents and Teenagers

If children and teenagers are affected by hypothyroidism, their symptoms remain almost the same as adults. However, you may observe some additional symptoms in teenagers as well. These symptoms include:

• Short stature due to poor growth
• Delayed puberty
• Delay in the development of permanent teeth
• Poor mental development

What are the Causes of Hypothyroidism?

Hypothyroidism or the under activity of the thyroid gland can be caused due to various reasons. The different reasons for hypothyroidism include:

Thyroid Surgery

If in case you have had any thyroid disorder in the past due to which your thyroid hormone has been removed partially or completely, then the levels of thyroid hormone may decrease in your body resulting in hypothyroidism. In case of complete removal of the thyroid gland, the levels of thyroid hormone in the body are replenished by using long-term medicines.

Deficiency of Iodine

The iodine deficiency in your body is one of the main causes of hypothyroidism. Iodine is an essential mineral that is required by the body for the production of the thyroid hormone. Therefore, it is advised to have a diet that consists of iodine-rich food like seafood, dairy products, eggs, and iodized salt. Iodine deficiency also leads to goitre, a thyroid disorder that is characterised by the development of swelling at the base of your neck.

Medicines

There are certain medicines that are used for the treatment of heart issues, mental health, and cancer, which can also reduce the activity of the thyroid gland and ultimately the production of thyroid hormone. These medicines include:

• Immunotherapy drug IL-2 (interleukin-2)
• Antiarrhythmic drug amiodarone or pacerone
• Lithium is used for the treatment of mania in bipolar disorders
• Anti-CTLA-4 used for the treatment of melanoma
• Stavudine is used for the treatment of HIV

Radioactive Iodine Treatment for Hyperthyroidism

In case of the overactivity of the thyroid hormone, that is, hyperthyroidism, the levels of thyroid hormone production are reduced using the radioactive iodine treatment. In this treatment, radioactive iodine is used to destroy the thyroid-producing cells. This may lead to a permanent decrease in the thyroid hormone levels leading to hypothyroidism.

Radiation Therapy

Radiation therapy is often used for the treatment of cancer. These radiations can attack the thyroid gland cells of your body causing a decrease or complete blockage of the thyroid hormone levels in your body.

Hashimoto’s Thyroiditis

Hashimoto’s thyroiditis is a common autoimmune disease, wherein the immune system of your body attacks the body’s own cells causing damage to the thyroid gland. This reduces the activity of the gland leading to hypothyroidism. Hashimoto’s thyroiditis can be genetic as well, therefore, people with a family history of the disease are at a higher risk.

Pituitary Disorder

The pituitary gland controls the functioning of various endocrine glands, therefore, any disorder in the pituitary gland affects the functioning of other glands as well, including the thyroid gland. The pituitary disorders that can affect the functioning of the thyroid gland include the use of medicines like dopamine and opioids, damage to the pituitary gland (Sheehan syndrome), radiation therapy used in areas around the brain, and pituitary tumours. Hypothyroidism caused the pituitary gland disorders are known as secondary hypothyroidism because the defect is not in the thyroid gland but in an associated gland that is causing the disorder.

Pregnancy

Postpartum thyroiditis, that is, the development of pregnancy a few months after pregnancy has also been observed. Pregnancy is seen to be the cause of hypothyroidism in around 5-10% of pregnant women. Postpartum thyroiditis often leads to permanent hypothyroidism. Women with a history of postpartum thyroiditis, type I diabetes, and those who have antibodies against thyroid peroxidase present in the blood are more prone to the development of postpartum thyroiditis.

Congenital Disease

Hypothyroidism may also be present in an individual from birth itself. This condition is known as congenital hypothyroidism. This may happen because of the underdeveloped thyroid gland or the complete absence of the gland regulated by genetic factors or the deficiency of iodine. Congenital hypothyroidism is more common in females and affects approximately 1 in every 2000-4000 newborn babies.

De Quervain Thyroiditis

De Quervain thyroiditis is a condition that is caused by an upper respiratory infection that damages the cells of the thyroid gland. This condition is also known as subacute granulomatous thyroiditis and is found to be more common in females. It is generally a temporary condition but may progress into permanent hypothyroidism as well. The most common symptoms of this condition include tender and enlarged thyroid gland, fatigue, fever, and pain in the jaw, neck, throat, or complete body.

How is Hypothyroidism Treated?

Currently, there is no complete cure available for hypothyroidism, however, the levels of thyroid hormone can be controlled to maintain the optimum levels in your body. The current treatment protocol involves replenishing the reduced levels of thyroid hormone in your body by the use of medicines. 

Synthetic thyroxine

Synthetic thyroxine is an alternative to the T4 hormone as it is identical to the hormone and can replenish the reduced levels of the hormone in your body. The medicine is taken on an empty stomach in the morning each day. The medicine is available in different dosages and is prescribed according to your symptoms and the levels of TSH hormone present in your blood at present. Thus, regular monitoring of the TSH hormone levels is done so that the dosage of the medicine can be determined on the basis of your reports.

Iodine

Iodine is the key mineral required by the body for the proper functioning of the thyroid hormone. Iodine deficiency leads to the enlargement of the thyroid gland (goitre) which is one of the main causes of the development of hypothyroidism. In the case of autoimmune thyroiditis as well, iodine plays a significant role. Minute variations in the levels of iodine in such people can negatively affect their health. Iodine also facilitates the absorption of thyroid medicines making them work better. Therefore, it is essential to maintain optimum levels of iodine in your diet through adequate diet and supplements. In pregnancy as well, it is essential for the women to use iodized salt in their diet and take vitamin tablets that will help maintain the optimum levels of iodine in the body.

Takeaway 

Hypothyroidism is a prevalent disorder in India. Hypothyroidism cannot be treated completely but its levels can be maintained within an optimum range to prevent future complications. The early diagnosis and treatment of the condition is an effective way of managing hypothyroidism. Now that you know the symptoms, causes, and treatment of hypothyroidism, you will better be able to manage the disorder and maintain the levels of the hormone effectively.

Frequently Asked Questions (FAQs)

1. Can hypothyroidism be cured?

Hypothyroidism cannot be cured completely but its levels can be maintained by prescribing medicines at an adequate dosage and including iodine-rich food and supplements in your diet.

2. What does hypothyroidism do to a person?

Hypothyroidism represents the diminished activity of the thyroid gland that may lead to future complications like the development of goiter, mental health issues, heart problems, myxedema, peripheral neuropathy, birth defects, and infertility.

3. Hypothyroidism vs hyperthyroidism, what’s the difference?

Hypothyroidism refers to the reduced activity of the thyroid gland, that is, the levels of thyroid hormone in your body decrease whereas hyperthyroidism refers to an increased activity of the thyroid glands that leads to high levels of the thyroid hormone in your body.