Do you sometimes just feel tired? Or do you feel like you're gaining weight without making any major changes to your diet? Perhaps the cause of this is a small malfunction in your thyroid gland. Today we're going to talk about one such condition, called 'Subclinical Hypothyroidism'.
Okay, now you're wondering what subclinical hypothyroidism is. Simply put, it's when your blood levels of thyroid-stimulating hormone, or TSH (Thyroid-Stimulating Hormone), are slightly elevated. However, your levels of the other important thyroid hormone, thyroxine (T4), are normal.
The word 'subclinical' means that this is a condition that does not show any symptoms at all, or the symptoms are not very severe . This means that you do not actually have hypothyroidism, which is an underactive thyroid gland. However, it does mean that there is a possibility that it could develop into that condition.
This condition can sometimes be temporary, meaning it can get better on its own in a few days. But for some people it can last a long time. It may or may not require treatment.
So what could be the symptoms of this?
Most of the time, this condition of subclinical hypothyroidism does not show any specific symptoms. That is what makes it special. However, some people may experience some minor symptoms. See if these sound familiar to you:
- Constantly feeling tired and exhausted. As if there is no life in the body.
- Weight gain for no reason, even without any change in what you eat or drink.
- Constipation.
- Mental conditions like depression. Feelings of sadness.
- Lack of attention, inability to concentrate properly on work.
- Inability to tolerate cold. Feeling colder than others.
- Dry, rough skin and hair.
- Diastolic Hypertension, which means that only the bottom number of your blood pressure reading is elevated.
- For women, frequent and heavy menstrual bleeding.
Why is this happening? What is the reason?
Subclinical hypothyroidism is usually caused by an underlying problem with your thyroid gland. For example, an autoimmune disease like Hashimoto's thyroiditis can cause inflammation of the thyroid gland.
Now let's look at how these hormones work in our bodies. Our endocrine system is made up of various hormones and glands that work together to control the level of TSH (Thyroid-Stimulating Hormone) in our blood. This TSH hormone stimulates the cells of the thyroid gland to release the hormones thyroxine (Thyroxine or T4) and triiodothyronine (Triiodothyronine or T3) into the blood. When the levels of these T4 and T3 hormones increase in the blood, it sends a signal to the pituitary gland in our brain to 'stop making more TSH'. This is like an automatic control system.
However, in subclinical hypothyroidism, even though TSH levels are elevated, the amount of hormones released by the thyroid gland does not increase as much as normal. That is why TSH levels are elevated and T4 levels are normal.
Who is more likely to develop this condition? (Risk factors)
Some people are more likely to develop this condition called subclinical hypothyroidism. Let's take a look at who they are:
- Women over 60 years of age.
- If you or someone in your family has thyroid disease.
- Thyroid antibodies are positive. This means that there are substances in the blood that work against the thyroid.
- If you have previously used or are currently using medications such as Amiodarone or Lithium.
- Iodine deficiency (This is a little less common in our country now, because we use iodized salt).
- If you have had radiation exposure to the head or neck area.
- Obesity.
- For people with type 1 diabetes.
- If you have previously received treatment for a condition such as Graves' disease, such as antithyroid drugs or ablation.
What complications can this cause?
The main thing that is often seen is that this condition of subclinical hypothyroidism can eventually turn into full-blown hypothyroidism. That is, the thyroid gland's function decreases significantly and symptoms begin to appear.
In addition, some studies have shown that this condition slightly increases the risk of cardiovascular diseases. For example, things like high blood pressure and high cholesterol. But this connection is not yet fully confirmed. So there is nothing to worry about, but it is good to be aware.
Does this affect pregnancy?
In the United States, less than 1 in 5 pregnant women are affected by this condition called subclinical hypothyroidism.
The evidence is somewhat conflicting about whether this condition causes problems during pregnancy. Some older studies have shown that if this condition is present during pregnancy, the following things can happen:
- Gestational high blood pressure and gestational diabetes.
- Preterm labor.
- Miscarriage.
However, this is important: these findings have not been confirmed by more recent studies.
Therefore, doctors usually only test for this condition during pregnancy if you have risk factors for developing it.
How do doctors diagnose this? (Diagnosis)
Doctors can only diagnose this condition of subclinical hypothyroidism through thyroid blood tests.
If your blood test results show an elevated TSH (Thyroid-Stimulating Hormone) level (usually between 5 and 10 milli-international units per liter (5 to 10 mIU/L) ) and your thyroxine (T4) level is in the normal range, it means you have subclinical hypothyroidism.
Sometimes doctors classify this further. If the TSH level is between 4.5 and 9.9 mIU/L, it is called Grade 1 , and if the TSH level is 10 mIU/L or higher, it is called Grade 2 .
Does this need to be treated?
It really depends on a few factors. Your doctor will decide based on things like your TSH level, your symptoms, and your overall health.
On the one hand, treatment can prevent some people from developing into true hypothyroidism. On the other hand, treatment can put some people, especially those over the age of 65, at risk of developing a condition called thyrotoxicosis , which is an increase in thyroid hormones in the body. Moreover, many people with subclinical hypothyroidism do not have symptoms and do not need treatment.
Therefore, doctors recommend a 'wait and see approach' for many people. They don't panic and start treatment.
However, doctors may recommend treatment in the following cases:
- Those with a TSH level of 10 mIU/L or higher.
- If young and middle-aged people have symptoms.
- If young and middle-aged people have other risk factors.
So, what is the treatment for this?
If your doctor decides that you need to treat subclinical hypothyroidism, he or she will prescribe you a thyroid hormone pill called levothyroxine . This is a medicine that you take by mouth.
However, before starting this levothyroxine treatment, your doctor may want to do another blood test to check your TSH level within three months of the first abnormal TSH test result. This is because most people's TSH levels return to normal on their own within three months without any treatment.
While you are taking the medication, your doctor will also recommend regular blood tests to check your thyroid levels, as an overdose of levothyroxine can lead to hyperthyroidism, a condition in which the thyroid gland produces too much thyroid hormone.
What do you do about this when undergoing fertility treatment?
If women with subclinical hypothyroidism are undergoing fertility treatments such as IVF (In Vitro Fertilization) or ICSI (Intracytoplasmic Sperm Injection) , the American Thyroid Association recommends taking levothyroxine to control TSH levels to 2.5 mIU/L.
When do I need to see the doctor again?
Most of the time, doctors follow a 'wait and see' approach.
But if you start to experience symptoms of hypothyroidism, such as fatigue and unexplained weight gain, see your doctor right away. He or she will do another thyroid blood test to see if you have overt hypothyroidism.
Is there a way to prevent this from happening?
To be honest, in most cases, there is nothing you can do to prevent this condition from occurring.
However, if you don't get enough iodine in your diet, you can develop this condition. This is because iodine is essential for the thyroid gland to make thyroid hormones. Although this has decreased a bit in our country because we now use iodized salt, iodine deficiency is the main cause of hypothyroidism in other countries of the world.
What should I expect with this situation?
Subclinical hypothyroidism affects each person differently, and in most cases, it resolves on its own within three months without any treatment.
The risk of this condition developing into overt hypothyroidism is between 2% and 6% per year .
Therefore, it's best to talk to your doctor about what to do specifically for your condition and how often you should have blood tests.
There is still debate about whether or not to treat subclinical hypothyroidism, as different studies have conflicting opinions. Since everyone's situation is different, it's best to talk to your doctor about your concerns and the options available. They are more than happy to help you.
So, what are the things we need to remember from all of this?
Okay, let me summarize some of the most important points from what we've talked about:
- Subclinical hypothyroidism is a condition in which your TSH hormone levels are slightly elevated, but your T4 hormone levels are normal.
- Most of the time, there are no major symptoms, but some people may experience things like fatigue and weight gain.
- This is not true hypothyroidism, but there is a small chance that it could turn out that way.
- Most of the time, doctors follow a 'wait and see' approach. They don't give everyone medicine at once.
- Treatment is only considered if the TSH level is very high, if there are symptoms, or if there are other risk factors.
- Levothyroxine is the main treatment, but it must also be taken exactly as directed by a doctor.
- If you have any doubts or questions about this, the best thing to do is to see your family doctor and talk to him. Don't worry, this is a manageable condition.
Remember, you are the one who should be most aware of your health. So never be afraid to ask questions and talk to your doctor!
` subclinical hypothyroidism, thyroid, TSH, thyroxine, hypothyroidism, hormones, symptoms
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