Hypothyroidism is a disorder of the thyroid gland that can have few symptoms but, left untreated, can cause a number of health problems such as obesity, joint pain, infertility and heart disease.

The thyroid gland
The thyroid gland is a small, butterfly-shaped gland located in the middle of the lower neck, just below your Adam’s apple. Hormones produced by the thyroid gland have an enormous impact on one’s health, affecting all aspects of our metabolism. The two main hormones produced by the thyroid gland are thyroxine (T-4) and triiodothyronine (T-3). As long as the thyroid gland releases the proper amounts of thyroid hormones, the body functions normally. When enough hormones are not produced hypothyroidism results while excess hormone production results in hyperthyroidism.

What are the symptoms of hypothyroidism?
There might be very few symptoms in the early stages of hypothyroidism. When symptoms and signs do develop they may vary tremendously and may take months to years to become pronounced.
Signs and symptoms include the following:
• Fatigue and sluggishness
• Increased sensitively to cold
• Pale, dry skin
• A puffy face
• Unexplained weight gain
• Heavier than normal menstrual periods
• Hoarse voice
• Depression
• Muscle aches and muscle weakness
• Constipation
• Enlarged thyroid gland (goitre)

Who develops hypothyroidism?
Women, especially those older than 50, are more likely to develop hypothyroidism, but anyone can develop this disorder, including infants and teenagers. Some babies may born without a thyroid gland and may not have any symptoms but they later begin to have symptoms that include jaundice (yellowing of the skin), frequent choking and a large, protruding tongue. Children with hypothyroidism have signs and symptoms similar to adults as well as they often have poor growth, delayed puberty and poor mental development.

What causes hypothyroidism?
A number of different factors might cause the thyroid gland not to produce enough hormones. These include the following:
Autoimmune disease - This occurs when the immune system produces antibodies that attack the thyroid gland. A virus or bacteria might trigger this response.
Radiation therapy -Radiation used to treat cancers of the head and neck can affect the thyroid gland.
Thyroid surgery
Medications
Congenital disease
Iodine deficiency

How is hypothyroidism diagnosed?
The diagnosis of hypothyroidism is mainly based on signs, symptoms and blood tests. TSH tests are the best screening tests for this disorder. Your doctor will explain to you the other tests that are needed to confirm the diagnosis of hypothyroidism.

Treatment
Once the diagnosis is made your doctor will prescribe synthetic thyroid hormone and soon after starting treatment you will notice improvement in your symptoms. Treatment is usually lifelong, but the dosage might change from time to time. Your doctor will monitor you so that the correct dosage is found. Some medications and supplements might affect absorption of levothroxine.

Complications
Once correctly treated, hypothyroidism has few complications. Untreated hypothyroidism can lead to a number of health disorders that include the following:
• Goitre
• Heart problems - enlarged heart and heart failure
• Myxoedema (this can be life-threatening)
• Birth defects in offspring

Conclusion
Hypothyroidism is a disorder of the thyroid gland that can have adverse effects on one’s health if not diagnosed and correctly treated. There might be few symptoms in the early stages of this disease but individuals who constantly feel tired for no reason, or have any of the symptoms attributed to this disorder, are advised to see their doctor and have a test of the thyroid gland function. Such testing can be done in Anguilla. This disorder can be successfully treated in the vast majority of cases.

Ask Your Doctor is a health education column and is not a substitute for medical advice from your physician. Dr. Brett Hodge is an obstetrician/gynaecologist and family doctor who has over twenty years in clinical practice. Dr. Hodge has a medical practice in the Johnson Building in The Valley.

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