Which signs and symptoms would be expected in an individual suspected of hypothyroidism?
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Hypothyroidism is a condition in which the thyroid gland, located in the front of the neck, does not produce enough thyroid hormones, which control overall metabolism and many bodily functions. Hypothyroidism can have several causes, including an autoimmune disorder
(Hashimoto’s disease), in which the body’s immune system mistakenly destructs its own thyroid gland. In teens, this is perhaps the most common cause of underactive thyroid, compared to other causes of the condition. Other causes could be certain medications or pituitary hypothyroidism, in which the pituitary gland, which controls the thyroid gland.
Sometimes, a cause cannot be identified. While the condition typically develops in adult life — its incidence increases with age — congenital hypothyroidism can occur in children and even newborns. One out of every 4,000 to 5,000 thousand babies born in the United States has hypothyroidism. Undiagnosed hypothyroid children may experience slowed growth rate. Additional symptoms include sluggishness, pallor, dry and itchy scalp, increased sensitivity to cold and constipation. If
untreated, the condition may have devastating effects, such as stunted physical growth and mental retardation. Slowed growth rate Puffy face Swollen hands and feet Poor muscle tone Sluggishness, sleepiness Constipation Fatigue Dry, itchy scalp Dry, coarse skin Heavy menstruation in girls Mood swings Weight gain Hoarse cry or voice Dry, coarse skin Enlarged thyroid gland (goiter) DiagnosisA physician will suspect underactive thyroid if several of the above symptoms are present; however, a definitive diagnosis can be easily made by testing the level of a pituitary hormone called thyroid-stimulating hormone (TSH). If the thyroid is producing normal levels of thyroid hormones, TSH will be within normal range. However if the thyroid is underactive, then the pituitary starts secreting more TSH to jump-start the sluggish thyroid. Thus, a higher-than-normal level of TSH indicates an underactive thyroid. Most newborns are tested for hypothyroidism within 72 hours of birth as part of a routine screen for other conditions. When to Call for HelpIf you see any of the above symptoms in your baby, infant or child — particularly slow growth — call your pediatrician. TreatmentReplacement therapy with synthetic thyroid hormones in the form of a single daily tablet is usually given. Thyroid hormones are critical for normal brain development in babies and children, therefore treatment with the correct dose of synthetic hormone is very important. Because the body can require higher doses of synthetic hormone over time, the child should be retested periodically to make sure the right amount of hormone is given and the dose is adjusted as needed. Recent Blog Articles
Harvard Health Blog April 29, 2022
Feeling tired, sluggish and not quite yourself? These symptoms could indicate an underactive thyroid gland (hypothyroidism), but they are just as likely to be related to something else, such as not getting enough sleep, stress or depression. What is hypothyroidism?At the front of your neck lies the thyroid, a butterfly-shaped gland that makes the hormone T4. When released into the bloodstream, T4 converts to T3, the most active form of thyroid hormone. Having sufficient levels of these hormones is important because the thyroid helps regulate body temperature, metabolism, blood pressure, and heart rate. Hypothyroidism occurs when the thyroid is underactive (not working optimally). It affects as many as five in 100 people. Symptoms of hypothyroidism include fatigue, cold intolerance, constipation, dry skin, hair loss, muscle weakness, and weight gain. How is hypothyroidism diagnosed?Most major medical associations recommended diagnosing hypothyroidism through a blood test using a simple two-step approach.
It may help to think of the pituitary gland as a thermostat and the thyroid gland as a heater. The thermostat senses low temperatures outside of the body and turns on the internal heater. When the room temperature reaches a set threshold, the thermostat signals the heater to stop working. In the body, it is the TSH produced by the pituitary gland that signals the thyroid to make more T4. When there is less free T4 in the blood, the pituitary senses the low levels and starts making more TSH. TSH is standard initial screening test for hypothyroidism because the TSH level rises even before the T4 level falls below normal. So, in our analogy, the body’s thermostat is very sensitive to small variations in temperature. That’s why a normal TSH almost always means the thyroid gland is healthy and producing enough thyroid hormones. While a simple TSH blood test is a very accurate way to screen for hypothyroidism, an elevated TSH alone may not be enough to confirm the diagnosis. When TSH doesn’t tell the whole storyA normal TSH level falls between 0.4 and 5.0 milliunits per liter (mU/L). Except for rare circumstances, a TSH of 10 mU/L or higher means the person is hypothyroid. If the TSH is between 5 and 10 mU/L and the T4 level is definitely low, that is also consistent with hypothyroidism and should be treated with thyroid medication. However, many people (including those with and without symptoms) have TSH values between 5.0 and 10 but normal levels of T4. It’s called mild or subclinical hypothyroidism. While most studies suggest that treatment with thyroid pills is not needed for subclinical hypothyroidism, it’s important to note that some people do feel better once treatment starts. A personalized approachAs you and your doctor weigh the pros and cons of starting a low dose of levo-thyroxine for subclinical hypothyroidism, consider the following:
Adapted from a Harvard Health Blog post by Marcelo Campos, MD Image: magicmine/Getty Images About the AuthorDisclaimer:As a service to our readers, Harvard Health Publishing provides access to our library of archived content. Please note the date of last review or update on all articles. No content on this site, regardless of date, should ever be used as a substitute for direct medical advice from your doctor or other qualified clinician. You might also be interested in…  Many people diagnosed with a thyroid condition are surprised that such a small gland can have such a profound impact on overall health and well-being. But the thyroid gland plays an enormous role in human health. Throughout life, this busy gland is constantly producing hormones that influence metabolism. When disease causes your thyroid gland to slack off and underproduce thyroid hormone, or overwork and produce too much of it, you'll know something isn't right. Thyroid Disease: Understanding hypothyroidism and hyperthyroidism will help you recognize the symptoms and find the right treatment before you experience the long-term effects of this common condition. Read More Free Healthbeat SignupGet the latest in health news delivered to your inbox! What are the typical signs and symptoms of hypothyroidism?Symptoms. Fatigue.. Increased sensitivity to cold.. Constipation.. Dry skin.. Weight gain.. Puffy face.. Hoarseness.. Muscle weakness.. What is suspected hypothyroidism?Hypothyroidism is a condition in which the thyroid gland is not able to produce enough thyroid hormone. Since the main purpose of thyroid hormone is to run your body's metabolism, it is not surprising that people with hypothyroidism often have symptoms associated with a slow metabolism.
What are the common assessment findings with hypothyroidism?Overt hypothyroidism is associated with typical symptoms and signs such as the slowing of motor activity, constipation, cold intolerance, menorrhagia, stiff muscles, sleep apnea, dry skin, weight gain, snoring, and a hoarse voice. Less common symptoms involve the heart, muscle, joints, and blood.
What are the two conditions associated with hypothyroidism?The two main types of thyroid disease are hypothyroidism and hyperthyroidism. Both conditions can be caused by other diseases that impact the way the thyroid gland works. Conditions that can cause hypothyroidism include: Thyroiditis: This condition is an inflammation (swelling) of the thyroid gland.
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