Hypothyroidism, is the medical term used to refer to an underactive thyroid gland, a disorder related to the endocrine system in which the gland does not produce sufficient thyroid hormone for essential for a person’s metabolism and development. This is the opposite of hyperthyroidism, wherein the thyroid gland produces a surplus of the said hormone, leading to imbalance.

Symptoms

The thing about hypothyroidism is that there are not so many signs and symptoms to signal it existence. In any case, reported common symptoms would include fatigue, constipation, poor memory, lack of concentration, hoarseness of voice, as well as a combination of weight gain despite poor appetite. Signs would include myxedema, carpal tunnel syndrome, swelling of the limbs, loss of hair, unusually slower pulse rate, as well as coarseness of the skin in some cases. The most common indicator of hypothyroidism, though, would be the delayed reaction in an ankle jerk reflex test, given its effectiveness as an indicator of hormonal deficit in the body.

Causes

The primary cause of hypothyroidism is the lack of hormonal production by the thyroid gland, which is usually blamed on iodine deficiency which is also responsible for goiter cases worldwide. Diseases such as diabetes, rheumatoid arthritis, as well as pernicious anemia are also said to contribute to the development of the disease.

Primary Hypothyroidism

Primary hypothyroidism is the most common form of hypothyroidism found in worldwide, mostly in developing countries, as iodine deficiency has been declared as the main cause of this particular variant of the illness. Other accompanying ailments blamed for the development of primary hypothyroidism include thyroiditis, exposure to radioiodine treatment and external beam radiotherapy for the neck.

Central Hypothyroidism

This particular variant is characterized by pituitary compressing lesions caused by pituitary adenoma, glioma, aneurysm, drug addiction, and other vascular disorders. Inherited congenital diseases such as tuberculosis and syphilis could also contribute to its development.

Congenital Hypothyroidism

As the name would suggest, this particular variant is usually passed from mother to child and still stems from iodine deficiency on the part of the mother during pregnancy. This is primarily considered as a neonatal illness which could be fatal to either the fetus or the new-born.

Other Possible Causes

Iodine deficiency aside, other possible causes of hypothyroidism include a chronic autoimmune disease referred to as Hashimoto’s thyroiditis, which is usually associated with the emergence of goiter. In some rare cases, abrupt hyperthyroidism in women after giving birth could also trigger hypothyroidism later on; this rare phenomenon is called postpartum thyroiditis. While it is considered rare, up to 40% of recorded cases resulted in permanent hypothyroidism for the mothers involved.

Children

While goiter is rare in newly born children, there are some cases in which they are born with hypothyroidism, and without any signs or symptoms signalling the existence of such. Immediate treatment is recommended for infants who suffer from hypothyroidism at birth, given how this ailment could become a huge obstacle in their development and metabolism.

Clinical Diagnosis

As far as diagnosis is concerned, the primary indicators of hypothyroidism would be the body’s hormonal production activity. As such, primary diagnosis is usually carried out through a laboratory evaluation measuring the hormonal levels found in the blood and triggered by production in in the thyroid. Weeks later, a secondary TSH level test us recommended for a more accurate diagnosis. The particular thyroid hormone measured in this regard would be the T4, spikes in levels of which would usually mean insufficient hormonal production by the thyroid gland. The TSH level would determine the severity of hypothroidism.

Treatment and Medication

Levothyroxine is the most commonly prescribed drug to combat hypothyroidism. Also known as L-Thyroxine, the most common brand names of this drug include Eltroxin, Euthyrox, Levaxin, and Thyrax. Generic versions are available and more widespread in developing countries where the incidence of hypothyroidism is relatively higher than most.

Levothyroxine acts as a synthetic thyroid hormone, serving as a significant alternative to thyroxine 4 given their similarities in terms of various characteristics. What the drug basically does is act as a viable replacement for what the thyroid gland would not sufficiently produce, taking over the functions that the said hormones would otherwise carry out themselves.

A variant of Levothyroxine referred to as dextrothyroxine used to be prescribed for the treatment of hypercholesterolemia. However, high incidence of cardiac arrest among the test population prompted the withdrawal of the said drug for the treatment of that particular illness.

Levothyroxine is listed as one of the most important drugs on the World Health Organization’s List of Essential Medicines, and not without reason. Given the high incidence of goiter and hypothyroidism in the developing world, ending up on the said list is more of a necessity that coincidence for this drug which stimulates metabolism and bodily growth.