The thyroid gland is a small, butterfly-shaped gland located at the base of your neck. It produces thyroid hormones that regulate your metabolism. When the thyroid is underactive (a condition called hypothyroidism), it doesn’t make enough thyroid hormone. This can cause a variety of symptoms, such as fatigue, weight gain, feeling cold, and muscle weakness.
If left untreated, hypothyroidism can lead to serious health problems over time. Here’s an overview of what can happen if hypothyroidism goes untreated:
Cardiovascular Effects
Untreated hypothyroidism can negatively impact your cardiovascular health:
– High cholesterol levels. Thyroid hormones play a role in regulating cholesterol levels. Low thyroid hormone levels can lead to increased “bad” LDL cholesterol.
– Atherosclerosis. High cholesterol levels accelerate the buildup of fatty deposits (plaques) in your arteries, leading to atherosclerosis. This narrows the arteries and increases heart disease risk.
– Heart failure. Hypothyroidism weakens the heart muscle over time, potentially leading to heart failure.
– Pericardial effusion. This is a buildup of fluid around the sac surrounding the heart (pericardium). It can cause chest pain and heart palpitations.
Mental Health Effects
Thyroid hormones also influence brain function and mood. Not having enough can lead to:
– Depression. Hypothyroidism is associated with a higher risk of depression. The lack of thyroid hormones slows brain function.
– Dementia. Untreated hypothyroidism raises the chances of developing dementia as you age. It may impair memory, thinking skills, and attention.
– Cognitive impairment. Thyroid hormone deficiency can cause forgetfulness, slowed thinking, and difficulty concentrating. It may mimic early Alzheimer’s disease.
– Anxiety and mood disorders. The hormonal changes of hypothyroidism can contribute to anxiety, irritability, and mood swings.
Reproductive Health Effects
For women, untreated hypothyroidism can cause:
– Irregular periods. Thyroid hormones regulate the menstrual cycle. Low levels can cause absent, heavy, frequent, or irregular periods.
– Infertility. Hypothyroidism can prevent ovulation, which impairs fertility. About 5-10% of female infertility cases may be attributed to thyroid problems.
– Increased risk of miscarriage. Women with untreated hypothyroidism during pregnancy have a greater chance of miscarriage in the second trimester.
– Preterm delivery. There’s an increased risk of preterm labor and delivery if you have uncontrolled hypothyroidism while pregnant.
Growth and Developmental Effects
Untreated hypothyroidism can impair growth and development:
– Stunted growth in children. Thyroid hormones are critical for normal bone growth and development. kids with chronic hypothyroidism may have short stature.
– Delayed puberty. Low thyroid levels can delay the onset of puberty in both boys and girls.
– Birth defects. Untreated hypothyroidism during pregnancy raises the risk of birth defects, especially brain and neurological abnormalities.
– Impaired brain development. Thyroid deficiency early in life causes irreversible effects on brain function. Kids can develop learning disabilities and intellectual disability.
Gastrointestinal Effects
The thyroid helps control digestive function. Without enough thyroid hormone, you may experience:
– Constipation. Low thyroid levels can slow transit time and cause constipation.
– Poor nutrient absorption. Hypothyroidism reduces the absorption of nutrients like vitamin D, calcium, and glucose from your gut.
– Weight gain. Sluggish metabolism leads to accumulation of fat, causing weight gain. This is a classic symptom of hypothyroidism.
– Nausea and vomiting. Some people with hypothyroidism experience abdominal pain, nausea, or vomiting. The exact reason is unclear.
Musculoskeletal Effects
Thyroid hormone deficiency can weaken your muscles, joints, and bones:
– Muscle cramps, aches, and tenderness. Hypothyroid myopathy causes muscle pain, stiffness, cramps, and weakness.
– Joint pain. Low thyroid levels may contribute to joint stiffness and pain, especially in the shoulders and hips.
– Carpal tunnel syndrome. Fluid accumulation in the wrist joint from hypothyroidism can put pressure on the median nerve, causing carpal tunnel syndrome symptoms like hand numbness.
– Delayed wound healing. Poor circulation and nutrient delivery slows wound healing in people with hypothyroidism.
– Osteoporosis. Untreated hypothyroidism accelerates bone mineral loss, increasing your risk of osteoporosis and fractures.
Metabolic Effects
Since thyroid hormones control metabolism, low levels wreak havoc on your body’s metabolic processes:
– Fatigue. Thyroid dysfunction is a leading cause of chronic fatigue. Your cells can’t produce energy efficiently without enough thyroid hormone.
– Sensitivity to cold. Hypothyroid people are more prone to feeling cold, due to reduced heat generation.
– Fluid retention. Low thyroid hormone turns down sodium excretion, leading to fluid retention, puffiness around the eyes and face, and swollen hands and feet.
– Anemia. Impaired red blood cell production causes anemia, which contributes to fatigue and weakness.
– Dry skin and hair. Poor circulation and nutrient deficiency from hypothyroidism lead to dry, flaky skin and brittle, thinning hair.
What are the long term complications of hypothyroidism?
Here are some of the most serious long term consequences of leaving hypothyroidism untreated:
– Heart disease. Chronic high cholesterol, atherosclerosis, and hypertension from hypothyroidism significantly increase your risk of heart attack, heart failure, and stroke.
– Goiter. Constant thyroid stimulation due to low hormone levels can cause thyroid gland enlargement over time (goiter). A large goiter may obstruct breathing and swallowing.
– Myxedema coma. This is an emergency, life-threatening form of longstanding severe hypothyroidism. It involves low body temperature, drowsiness, hypotension, and eventually unconsciousness and death without treatment.
– Peripheral neuropathy. Uncontrolled hypothyroidism occasionally leads to peripheral nerve damage, causing numbness and tingling in the extremities.
– Cognitive impairment. Prolonged lack of thyroid hormones being delivered to the brain may result in irreversible dementia or deficits in thinking and memory.
– Infertility. The longer hypothyroidism goes uncorrected, the higher the risk of permanent fertility problems.
– Birth defects. If hypothyroidism continues through pregnancy, it is more likely to cause fetal abnormalities and complications.
– Emotional disorders. Chronic untreated hypothyroidism may trigger treatment-resistant depression and anxiety.
– Comorbidities. Over time, untreated hypothyroidism can contribute to other diseases like diabetes, kidney disorders, and autoimmune conditions.
What Are the Symptoms of Hypothyroidism?
Hypothyroidism develops slowly, so symptoms may be subtle at first. Symptoms include:
– Fatigue
– Increased sensitivity to cold
– Constipation
– Dry skin and hair
– Weight gain
– Puffy face
– Hoarse voice
– Muscle weakness
– Elevated blood cholesterol level
– Muscle aches, tenderness and stiffness
– Pain, stiffness or swelling in your joints
– Heavier than normal or irregular menstrual periods
– Thinning hair
– Slowed heart rate
– Depression
– Impaired memory
Symptoms in infants may include:
– Swollen tongue
– Persistent feeding problems
– Persistent jaundice
– Hoarse cry
– Enlarged fontanelles
– Excessive sleepiness
– Body temperature below 97.7°F (36.5°C)
– Constipation
– Floppiness
– Umbilical hernia
What Causes Hypothyroidism?
Hashimoto’s Thyroiditis
The most common cause of hypothyroidism is Hashimoto’s thyroiditis, also called chronic lymphocytic thyroiditis. This is an autoimmune disorder in which your immune system attacks your thyroid gland. The attack damages the gland and interferes with its ability to produce thyroid hormones.
Hashimoto’s tends to run in families and is much more common in women. It usually starts around age 30-50 but can occur at any age. There is no cure, but thyroid hormone replacement can successfully treat the hypothyroidism.
Hyperthyroidism Treatment
Some cases of hypothyroidism are caused by previous hyperthyroidism treatment. Medications and radioactive iodine used to treat an overactive thyroid can render the gland underactive over time.
Thyroid Surgery
Removing all or part of the thyroid gland can sometimes lead to hypothyroidism. After complete thyroidectomy, you will always need to take thyroid hormone daily.
Radiation Therapy
Radiation used to treat cancers of the head and neck can affect thyroid function and result in hypothyroidism. The higher the radiation dose, the higher the risk. This can occur decades after treatment.
Medications
Certain drugs like lithium, amiodarone, interferon alpha, and interleukin-2 can interfere with thyroid hormone production and cause hypothyroidism. On the other hand, surprisingly plenty of thyroid medications just like Tirosint, NP Thyroid, Armour and Synthroid too can help hypothyroid patients secretes thyroxine.
Congenital Hypothyroidism
Some babies are born with a thyroid gland that is absent, underdeveloped, or not functioning properly leading to congenital hypothyroidism. With early detection through newborn screening and treatment, the affected infants can grow and develop normally.
Pituitary Disorder
The pituitary gland produces TSH to stimulate the thyroid. If the pituitary gland is damaged or diseased, it may not be able to release enough TSH to trigger normal thyroid production.
Pregnancy
Hypothyroidism occurs in about 2-5% of pregnancies. The main cause is Hashimoto’s thyroiditis. Some women may develop hypothyroidism during or after pregnancy due to dietary iodine deficiency.
Who Is at Risk for Hypothyroidism?
Certain factors increase your risk of developing hypothyroidism:
– Female sex. Women are much more likely to have hypothyroidism.
– Age over 60 years. Thyroid problems increase with age.
– Family history. Having a first-degree relative with autoimmune thyroid disease puts you at higher risk.
– Other autoimmune disorder. People with rheumatoid arthritis, pernicious anemia, lupus, or type 1 diabetes have a greater chance of hypothyroidism.
– Radiation exposure. Past radiation treatment around the head, neck or chest area can cause hypothyroidism later on.
– Pregnancy. Some women develop Hashimoto’s thyroiditis or postpartum thyroiditis after giving birth.
– Removal of thyroid gland. Total or partial thyroidectomy always leads to hypothyroidism.
– Certain medications. Drugs like lithium, amiodarone, interferons, interleukin-2, and tyrosine kinase inhibitors can trigger hypothyroidism.
– Iodine deficiency. Consuming inadequate dietary iodine may cause hypothyroidism.
– Obesity. People with a BMI over 40 have a higher prevalence of hypothyroidism.
How Is Hypothyroidism Diagnosed?
Your doctor will start by reviewing your symptoms and performing a physical exam. They may be able to feel an enlarged thyroid gland or find dry skin, sluggish reflexes, and muscle weakness – signs associated with low thyroid levels.
If hypothyroidism is suspected, the next step is blood tests. This allows your doctor to measure your actual thyroid hormone levels. Common lab tests include:
– TSH test. This measures your blood concentration of thyroid stimulating hormone (TSH). Elevated TSH indicates your pituitary is working overtime to stimulate more thyroid hormone production. The higher your TSH, the more underactive your thyroid gland.
– Free T4. This test measures your blood levels of free thyroxine (T4), the main hormone secreted by the thyroid gland. Low levels confirm hypothyroidism.
– Free T3. This measures free triiodothyronine (T3), the active form of thyroid hormone in your tissues. Low free T3 provides additional evidence of hypothyroidism.
– Thyroid autoantibodies. Testing for Hashimoto’s may involve measuring levels of thyroid peroxidase (TPO) antibodies or thyroglobulin antibodies. High antibody concentrations indicate autoimmune thyroiditis.
Your doctor may order additional tests such as cholesterol testing, or an ultrasound or nuclear scan to evaluate your thyroid gland. The goal is to pinpoint the underlying cause, determine the severity, and rule out other conditions that can mimic hypothyroidism.
What Is the Treatment for Hypothyroidism?
The treatment of hypothyroidism involves taking daily thyroid hormone replacement medication. This is usually levothyroxine (Synthroid, Levoxyl, Unithroid, Tirosint) and restores normal thyroid hormone levels.
Here is an overview of hypothyroidism treatment:
– Dosage is personalized based on factors like your age, weight, and thyroid lab results. Expect frequent monitoring and dosage adjustments to keep levels optimized.
– It may take weeks to months to start feeling better once you begin medication.
– Take levothyroxine on an empty stomach and avoid food for at least an hour after taking it. This improves absorption.
– Schedule your pill at the same time each day and be consistent. Skipping doses can allow symptoms to return.
– You may be able to switch brands, from tablets to capsules, or try a compounded formulation if you have trouble tolerating the medication.
– Expect to stay on levothyroxine indefinitely. Stopping it will cause hypothyroid symptoms to return.
– See your doctor regularly to evaluate your thyroid labs and medication dose. Your needs may change over time.
– Inform your doctor of any new medications or supplements, as they could affect your thyroid treatment.
Can Hypothyroidism Be Prevented?
It’s difficult to prevent most cases of hypothyroidism, but here are some tips that may help lower your risk:
– Carefully manage hyperthyroidism. Overtreating hyperthyroidism is a preventable cause of hypothyroidism later on.
– Avoid radiation exposure. Get medical tests involving radiation only when necessary. Wear a thyroid shield during dental x-rays.
– Maintain good iodine intake. Include ocean fish, dairy, eggs, and iodized salt in your diet to prevent iodine deficiency.
– Monitor thyroid during pregnancy. If you develop hypothyroidism during or after pregnancy, get it treated promptly to prevent it from becoming permanent.
– Limit certain drugs. Avoid medications linked to hypothyroidism (lithium, amiodarone, interferon alpha) if possible.
– Discuss family planning. If you have Hashimoto’s or other autoimmune thyroid disease, talk to your doctor before trying to conceive. Monitoring and management of your thyroid is important during pregnancy.
– Get regular wellness exams. Routine screening can catch hypothyroidism early when it’s easiest to treat.
Conclusion
Hypothyroidism is a common disorder involving an underactive thyroid gland and inadequate production of thyroid hormones. Left untreated, it can cause cholesterol abnormalities, heart disease, depression, weight gain, fatigue, and many other problems over time. The good news is that with early diagnosis and proper treatment with medications like levothyroxine, people with hypothyroidism can avoid complications and feel completely normal. Maintaining thyroid health is important for overall well-being.