Hypothyroidism: Understanding Facts and busting the Myths

Guwahati: The thyroid is a vital gland that helps regulate many functions of the body by continuously releasing thyroid hormones called thyroxine (T4) and triiodothyronine (T3) into the blood. This butterfly-shaped gland is located at the base of the neck and is crucial for metabolic activities and overall growth and development. When this gland makes either too much or too little of the hormones, it leads to thyroid disorders.[1]These disorders affect almost 200 million people worldwide.[2]In India, almost 42 million people suffer from thyroid disorders.[3]One of the key reasons for these disorders is iodine deficiency, a nutrient that is vital to produce thyroid hormones.

Hypothyroidism, also known as an underactive thyroid, is one of the most common thyroid disorders. It occurs when the gland fails to produce sufficient hormones. It affects up to 5% of the general population, with an additional 5% remaining undiagnosed.[4] The prevalence of hypothyroidism in India stands at 11%, compared with 2% in the UK and 4·6% in the USA.[5] Hypothyroidism is diagnosed via a simple test that measures the levels of thyroid-stimulating hormone (TSH) in the blood.[6]

Symptoms and risk factors: Hypothyroidism may not cause any visible symptoms in its initial stages. Over time, untreated hypothyroidism can lead to other health problems such as high cholesterol and heart complications. Some of the common symptoms of hypothyroidism include tiredness, constipation, memory problems, dry skin, weight gain, puffy face, thinning hair, coarse skin, muscle aches, tenderness and stiffness, and irregular or heavy menstrual cycles in women.[7] Hypothyroidism is a treatable condition and can be managed with regular medication and routine check-ups.

Hypothyroidism can affect people of all ages. However, it is more common in women than men and those over 60 years of age are more likely to develop it. Women who are pregnant or have had a baby in the past 6 months are also more prone to hypothyroidism.[8],[9].

An individual’s risk for hypothyroidism increases if he/she[10] -

· has a family history of thyroid disease.

· has type 1 diabetes or other autoimmune disorders.

· has been exposed to radiation treatment on the neck or chest.

· has undergone thyroid surgery.

Managing hypothyroidism and debunking myths: In most cases, hypothyroidism is treated by substituting the missing amount of hormone, typically as an oral medication. Eating a balanced diet rich in vitamins and nutrients can help in the proper functioning of the gland. Adequate iodine and selenium supplementation are also necessary. Hence, the consumption of iodised salt and selenium-rich food such as mushrooms, garlic, onions, eggs, beef liver, shellfish, wheat germ, sunflower and sesame seeds can help prevent thyroid dysfunction.[11]Avoiding goitrogens (substances that interfere with the production of thyroid hormones) such as broccoli, cabbage, spinach, kale, cauliflower, and brussels sprouts can also be beneficial.[12]

Though hypothyroidism is labeled as a lifelong disease, it can be managed. In the case of subclinical or mild hypothyroidism, the doctor may modify or cease medication under specific circumstances after regular testing of TSH levels. Also, though hypothyroidism is associated with weight gain, most of the gain is due to the accumulation of salt and water and not excess fat.[13]

If you notice any of the above symptoms, contact your healthcare provider at the earliest. Understanding the signs of hypothyroidism and regular screening is the first step to preventing further complications.

The Article is written by Dr Pankaj Patawari, DM (Endocrinology Diabetes), Apollo Excelcare, Guwahati.