Hypothyroidism and Hashimoto’s Thyroiditis

thyroid-gland-anatomy

These two things, I have recently found out, I’ve been fighting pretty much all of my life. But I didn’t know it! Well, to be honest, I did know about the hypothyroidism when I was in my late 30’s, but the Hashimoto’s disease was another story. It was “mentioned” in my initial diagnosis, but was not definitive.

I recently posted an article of Facebook about the thyroid gland and these problems, and stated a fact: Men are also affected by these things, just not as frequently. Statistically speaking women are affected 10 times more than men, but they can also be affected.

What to look for? Fatigue; depression; weight gain; hair loss; dry skin, nails, and hair; sensitivity to cold; weakness; irritability; memory loss; constipation; muscle cramps and aches; reduced libido. That’s quite a list, but you don’t have to have all of these, just a few.

What to do about it? See your doctor and get TSH testing done. What’s that? That is the Thyroid Stimulating Hormone test that can determine if you have hypothyroidism. But, these are not the only markers that need to be checked (take it from me). You should also request a test for T3 and Free T4 markers. Once it has been determined that you have this disorder/disease, the doctor will put you on a hormone balancing medication that will help to get your body back in a somewhat normal state.

The following is from the Endocrine web site on how the thyroid works:

“The function of the thyroid gland is to take iodine, found in many foods, and convert it into thyroid hormones: thyroxine (T4) and triiodothyronine (T3). Thyroid cells are the only cells in the body which can absorb iodine. These cells combine iodine and the amino acid tyrosine to make T3 and T4. T3 and T4 are then released into the blood stream and are transported throughout the body where they control metabolism (conversion of oxygen and calories to energy).

Every cell in the body depends upon thyroid hormones for regulation of their metabolism. The normal thyroid gland produces about 80% T4 and about 20% T3, however, T3 possesses about four times the hormone “strength” as T4.

/hypothalamus secretes TRH, Pituitary secretes TSH, Thyroid secretes T3 and T4.The thyroid gland is under the control of the pituitary gland, a small gland the size of a peanut at the base of the brain (shown here in orange). When the level of thyroid hormones (T3 & T4) drops too low, the pituitary gland produces Thyroid Stimulating Hormone (TSH) which stimulates the thyroid gland to produce more hormones. Under the influence of TSH, the thyroid will manufacture and secrete T3 and T4 thereby raising their blood levels.

The pituitary senses this and responds by decreasing its TSH production. One can imagine the thyroid gland as a furnace and the pituitary gland as the thermostat.

Thyroid hormones are like heat. When the heat gets back to the thermostat, it turns the thermostat off. As the room cools (the thyroid hormone levels drop), the thermostat turns back on (TSH increases) and the furnace produces more heat (thyroid hormones).

The pituitary gland itself is regulated by another gland, known as the hypothalamus (shown in the picture above in light blue). The hypothalamus is part of the brain and produces TSH Releasing Hormone (TRH) which tells the pituitary gland to stimulate the thyroid gland (release TSH). One might imagine the hypothalamus as the person who regulates the thermostat since it tells the pituitary gland at what level the thyroid should be set.”

I know this information is a bit technical for most people, but it’s important to understand why you need to take care of your thyroid gland! I remember when I was in my teens and my mother’s thyroid gland almost failed. She laid on the couch for about 8 weeks while the doctors determined what her problem was. It seemed to take forever and as it turned out it was hypothyroidism. Once they got her medication settled, she was fine, but that also took a very long time. Fortunately, medical science has come a long way since then and it would only take a couple of blood tests to find out today and get you on a treatment plan that will help.

So, what causes hypothyroidism? It seems that Hashimoto’s Thyroiditis is the cause and there is no “known cause” of Hashimoto’s. Hashimoto’s is why the immune system attacks the thyroid gland in your body, because it considers your thyroid gland to be a foreign invader and causes the immune system to attack and decay it which in turn reduces the glands ability to produce the appropriate amount of hormones. (As in my case, via an ultrasound in 2016, my Endocrinologist found that half of my thyroid gland is gone and what’s left is full of holes!)

If your thyroid has been surgically removed, this will cause hypothyroidism. Fortunately, your doctor will help you overcome this with medications to help regulate your hormones properly. They will start you on thyroid medication even if you don’t exhibit symptoms, so you don’t have to go through that anxiety. If a child is born without their thyroid gland, they will be placed on medication right away.

Medications can also cause hypothyroidism: Amiodarone (which my father was on and did develop hypothyroidism) is used to treat heart rhythm issues; Anti-thyroid medications used to treat overactive thyroid gland – you must be under a doctor’s supervision if using these drugs to help avoid hypothyroidism; Interferon-alpha is used with certain malignant tumors and hepatitis B and C and can cause hypothyroidism; Interleukin-2 (IL-2) prescribed to patients with metastatic cancers and leukemia (some will develop a thyroid disorder); and Lithium which is used to treat depression.

Other possible problems? Abnormal growths that replace healthy tissue in the thyroid gland can be added to the list of causes. Rarely problems in the Pituitary gland (like a tumor) can inhibit the ability of the thyroid to produce TSH because the signal from the Pituitary is being blocked. Or you might have a Genetic Defect that can damage thyroid hormone regulation.

If you “think” you might have a problem with any of these, get your Thyroid checked out as soon as possible.

What other risks factors are involved?  Your risk factors increase with age and sex. As you age, your risk of being hypothyroid increases, and are greater if you are a female. Hypothyroidism usually occurs in women older than 50. Heredity: In my mother’s case – she was in her early 40’s, and I was in my late 30’s. You have another autoimmune disease such as rheumatoid arthritis or type 1 diabetes. Other medications that can cause hypothyroidism as mentioned above. Removal of your thyroid gland via surgery or it was missing at birth. You have been exposed to radiation of your neck (dental Xrays) or upper chest.

How is it diagnosed? There are tests that must be done should your doctor think you have a thyroid issue. This includes TSH testing, which will show if your thyroid hormones are diminished. Although this is the “standard” for checking for thyroid issues, it is not the be all and end all. Free T4 testing is important for understanding if the pituitary gland recognizes the thyroid gland is producing enough hormone. If your TSH is high and you have low free T4, it is a possible indicator of hypothyroidism, even if previous tests for TSH have come back normal. Another test is the Anti-thyroid Microsomal Antibodies testing (anti-TPO) – this test can determine the presence of antibodies that are produced by the immune system which may attack the cells in the thyroid. If a blood test shows the presence of these antibodies, it indicates there has been damage done to the thyroid which could lead to hypothyroidism and indicates Hashimoto’s Thyroiditis. This is a test that is typically done by a specialist, not your GP unless they are really good.

What complications can arise if untreated? Birth defects can occur if you are hypothyroid and it has gone untreated. A Goiter can form if your thyroid over-exerts itself trying to produce adequate hormones, which may cause the thyroid gland to enlarge and cause a bulge in your neck. Heart problems can occur due to the possible increase of levels in bad cholesterol. It can also cause buildup of fluid around the heart, making it harder for the heart to pump blood. Infertility – If your hormone levels are too low, it will lower your ability to ovulate and decrease the possibility of conceiving. Mental health issues are also possible if your hypothyroidism goes untreated, in the form of depression. It has also been connected to gradual decrease in mental functioning. Myxedema is the term for extreme hypothyroidism and is very rare, as you would likely be aware of the symptoms well before it gets to this stage.

If you want to prevent hypothyroidism, there is little you can do. But you can prevent it from becoming a serious health issue by understanding the risk factors and recognizing any symptoms that may contribute to the possibility of you having this disease. See your doctor if you suspect any of the symptoms above may be an issue.

Have a wonderful day and week ahead.

Louise