Are you also feeling very tired these days? Do you feel tired even when you wake up in the morning, sleepy all day, and have no energy to do anything? At the same time, do you feel like you are gaining weight even without making any big changes in what you eat and drink? You may think that this is normal, that it is because of too much work. But behind these things, there may sometimes be small changes that occur in our own bodies. That is what we are going to talk about today.
Simply put, what is Hypothyroidism?
Okay, let's put it this way. We have a small butterfly-shaped gland in our neck. This is what we call the thyroid gland . Just like the engine of a car, it controls a lot of things in our body, that is, it determines the speed of our body (metabolism). Its hormones affect many things, such as your heart rate, body temperature, and the speed of digestion.
Hypothyroidism is a condition where the thyroid gland does not function properly and does not produce the required amount of hormones. Then, just like when a car engine slows down, all the processes in our body start to slow down. That's why you feel tired and your body becomes heavy.
Many people think that fatigue and weight gain are normal. But sometimes these can be symptoms of hypothyroidism. The best part is, it can be detected with a simple blood test .
This is a disease that can often be treated and controlled, so there is no reason to be afraid. However, it can be dangerous if left untreated.
What are the main types of hypothyroidism?
There are several main types depending on how this condition occurs. Although this is a bit medical, it is worth knowing in simple terms. Imagine, there is a big boss in our brain (Hypothalamus), which tells another one (Pituitary Gland) to do something, which in turn tells the Thyroid Gland to work. If there is a problem anywhere along this path, Hypothyroidism can occur.
| Type of hypothyroidism | Simply put... |
|---|---|
| Primary Hypothyroidism | This is the most common type. Here, the problem lies directly with the thyroid gland itself . It is diseased and does not produce hormones properly. This can be caused by conditions such as Hashimoto's disease . |
| Secondary Hypothyroidism | The thyroid gland is fine here. But the pituitary gland in the brain, which commands it to work, is not working properly. Therefore, the thyroid does not receive the signal called TSH. |
| Tertiary Hypothyroidism | This is even rarer. Here the problem lies with the biggest boss in the brain. That is, the hypothalamus . Because it does not send signals to the pituitary gland, the whole system becomes confused. |
| Subclinical Hypothyroidism | This is a very mild condition. The TSH hormone in the blood report is only slightly elevated, but other thyroid hormone levels are normal. In most cases, this resolves on its own within a few months. |
What are the symptoms of this condition?
The symptoms of hypothyroidism often don't come on suddenly. They develop gradually, slowly. Sometimes it can take years. See if you have these symptoms too.
| Symptom | What happens with this? |
|---|---|
| Weight gain for no reason | As the body's metabolism slows down, the burning of food decreases and fat accumulation increases. |
| Constant fatigue | Because the body's energy production decreases, you won't feel tired no matter how much sleep you get. |
| Intolerance of the cold | To others, a normal cold feels like an unbearable cold to you. |
| Dry, rough skin and hair | The skin becomes dry and scaly. Hair loss may also increase. |
| Constipation | Constipation occurs because the digestive process is slow. |
| Mental changes | Brain fog, forgetfulness, depression, and anxiety can occur. |
| Muscle pain, weakness | The body hurts, and you may feel numbness in your hands. |
| Effects on women | Things like irregular menstrual cycles and excessive bleeding may occur. |
If you have one or more of these symptoms, the best thing to do is to see your doctor for advice.
Why does Hypothyroidism occur?
There may be several reasons for this.
- Hashimoto's disease: This is the main and most common cause. Simply put, it is an autoimmune condition. This means that the immune system, which is supposed to protect our body, mistakenly starts attacking its own thyroid gland. Over time, the gland is damaged and hormone production decreases.
- Thyroidectomy: When all or part of the thyroid gland is surgically removed due to certain cancerous conditions or conditions such as goiter.
- Radiation Therapy: When radiation therapy is used for head or neck cancers, it can also damage the thyroid gland.
- Certain medications: Some medications used for heart disease and mental illness (e.g., Lithium, Amiodarone) can also cause decreased thyroid function.
- Iodine Deficiency: Iodine is a mineral essential for the production of thyroid hormones. This condition can occur if we do not get enough iodine from our diet. However, in Sri Lanka, this is not seen as often because iodine has been added to the salt we use.
- Congenital conditions: Some babies are born without a thyroid gland, or with a gland that doesn't work properly.
How is the diagnosis made?
When you go to see a doctor, the first thing he or she will do is ask you about your symptoms. Then, they will examine your neck to see if your thyroid gland is swollen.
But to confirm this disease for sure, a blood test is needed.
This blood test mainly looks at:
- TSH (Thyroid-Stimulating Hormone): This is a hormone released by the pituitary gland in the brain. If the thyroid gland is not working, the brain tries to stimulate it by sending more TSH. Therefore, TSH levels are often elevated in hypothyroidism.
- T4 (Thyroxine): This is the main hormone produced by the thyroid gland. In hypothyroidism, the levels of this hormone are reduced .
Sometimes, if necessary, the doctor may also order tests such as an ultrasound scan or a CT scan .
What are the treatments? Is it something to be afraid of?
No, there is nothing to worry about at all. The treatment for hypothyroidism is very simple and effective.
The main treatment is Hormone Replacement Therapy . Simply put, it is the administration of a pill called Levothyroxine , which replaces the thyroid hormone your body cannot produce.
This is a medicine that needs to be taken daily, usually in the morning, about half an hour before breakfast, on an empty stomach. It needs to be taken for the rest of your life.
Initially, your doctor will do blood tests periodically to find the right dose for you. Once you are on the right dose, most of your symptoms will be gone and you can live a normal life.
How long will it take to get better after starting treatment?
Hormone levels will start to return to normal as soon as you start taking the medication. However, it may take a few weeks for your symptoms, such as fatigue and weight gain, to subside. So it's important to be patient.
What happens if you don't get treatment?
This is the most important thing. Although treatment will resolve any problems, if left untreated, serious complications can occur.
- Goiter: The thyroid gland can become enlarged due to continued stimulation.
- Heart disease: Elevated levels of bad cholesterol (LDL) increase the risk of heart disease.
- Mental problems: Conditions such as depression and anxiety can become severe.
- Peripheral Neuropathy: Damage to the nerves can cause pain and numbness in the limbs.
- Infertility: Women may have difficulty conceiving. If left untreated during pregnancy, it can lead to miscarriage or affect the baby.
- Myxedema Coma: This is a very rare, but life-threatening condition. Body functions are severely impaired and unconsciousness can occur.
When should I see the doctor?
If you have any of the symptoms mentioned above (such as constant fatigue, weight gain, dry skin), be sure to see a doctor. He or she will examine you and, if necessary, order blood tests.
If you are already taking medication for hypothyroidism and feel your symptoms returning, let your doctor know. Your medication dosage may need to be adjusted.
Situations when you need to go to the ETU (Emergency Treatment Unit) urgently
If you experience any of the following severe symptoms, go to a hospital's Emergency Department (ETU) immediately . These may be signs of the previously mentioned Myxedema Coma condition.
- Difficulty breathing
- Unbearable drowsiness, confusion
- Hypothermia (low body temperature)
- Hypotension (very low blood pressure)
- Very slow heartbeat (Bradycardia)
Take-Home Message
- Hypothyroidism is an underactive thyroid gland. This is a very common condition.
- If you feel tired for no reason, if you are constantly tired, if your skin is dry, or if you can't stand the cold, then you should be suspicious.
- Don't worry! This can be detected with a simple blood test and managed well with one pill taken daily.
- Treatment is usually lifelong. Do not stop taking medication without your doctor's advice.
- With the right treatment, you can live a healthy, normal life without any problems.
- If you have symptoms, don't hesitate to see a doctor and get advice. That's the best step towards a healthy life.
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