Hypothyroidism – Symptoms, Causes, Tests, Treatments

Hypothyroidism is the condition of having a thyroid gland which is not producing enough of specific hormones. The normal, and necessary, balance of chemical reactions is thrown off when the thyroid is under producing. When left untreated it can cause a variety of health problems including heart disease, infertility, joint pain, and obesity. Fortunately, tests are available to easily diagnose the condition and treatment is usually safe and effective.


Hypothyroidism is difficult to diagnose in the earliest stages because most patients do not experience symptoms at first. It can take years to develop symptoms as the hormone deficiencies gradually increase. The first signs may simply be increased fatigue which may be attributed to lifestyle, external circumstances, or aging. However, as the disorder progresses additional symptoms will appear.

  • Brittle fingernails
  • Brittle hair
  • Constipation
  • Depression
  • Dry skin
  • Fatigue
  • Heavier menstrual periods
  • Heightened sensitivity to cold
  • Hoarse voice
  • Increased cholesterol levels
  • Joint paint
  • Joint swelling and stiffness
  • Muscle aches
  • Muscle stiffness
  • Muscle tenderness
  • Pale skin
  • Puffy face
  • Unexplained weight gain

When hypothyroidism is not treated it can lead to the development of a goiter, or enlarged thyroid. Patients may also find they are becoming more forgetful and find it increasingly difficult to concentrate.

Myxedema can develop in extreme cases when hypothyroidism is left untreated for an extended period of time. This can cause low blood pressure, difficulty breathing, low body temperature, coma, and even death.


Hypothyroidism can be caused by a number of things. The most common causes include medications, an autoimmune disease, thyroid surgery, treatment of hyperthyroidism, and radiation therapy. Less common causes include congenital diseases, iodine deficiency, pituitary disorders, and pregnancy.

• Autoimmune disease – Autoimmune diseases occur when the body produces antibodies which begin to attack an individual’s own tissue. When the attack focuses on the thyroid gland it can lead to hypothyroidism. Researchers are not sure what triggers this response but some believe it may be due to the introduction of a bacterium or virus but it is likely that more than one factor is responsible.

• Congenital disease – About 1 out of every 3,000 babies born in the United States will have a defective thyroid gland or will be missing the gland altogether. The cause for most of these cases is unknown but some are due to a genetic predisposition. Some children with congenital hypothyroidism will seem normal at birth which is why many states now require screening tests to be performed on newborns.

• Iodine deficiency – Iodine is essential for hormone production in the thyroid. Iodine is naturally found in seafood and seaweed as well as in plants which are grown in soil rich in iodine. In most industrialized countries iodine is added to salt which is why this cause has virtually been eliminated in the United States.

• Medications – Several medications can cause hypothyroidism including lithium and other medications developed to treat psychiatric conditions.

• Pituitary disorder – When the pituitary gland is not able to produce enough TSH hypothyroidism may occur. This is typically caused by a benign tumor located in the pituitary gland. This is an extremely rare cause of hypothyroidism.

• Pregnancy – Some women develop hypothyroidism while pregnant or after giving birth because their antibodies begin attacking the thyroid gland. Left untreated this can result in the termination of the pregnancy or cause problems with fetal development.

• Radiation therapy – Radiation which is utilized to treat cancer of the neck and head may negatively impact the thyroid gland and eventually lead to hypothyroidism.

• Thyroid surgery – Some conditions require the removal of part or all of the thyroid gland which will result in hypothyroidism.


A simple blood test will check the TSH levels and may also check for thyroxine. High levels of TSH and low levels of thyroxine indicate the thyroid is underactive. Newer tests are now able to detect hypothyroidism often before symptoms are present.

Because the condition is frequently seen in older women and causes few symptoms at first, many physicians will routinely screen patients at annual checkups.


The standard treatment for the condition requires the patient take a synthetic thyroid hormone daily. This is an oral medication that typically produces noticeable improvement of symptoms within one to two weeks. It may be necessary to adjust dosage repeatedly throughout the life of the patient so patients typically require retesting on an annual basis.

While hypothyroidism is a chronic condition it is easy to diagnose and relatively easy to treat. Patients who believe they may be suffering from this disorder should consult their physician to learn more about treatment options.

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Julie-Ann Amos

Julie-Ann Amos is a qualified biologist (Genetics) and experienced freelance health and medical writer from Gloucestershire in the UK. She is also a licensed registered homeopath and is particularly interested in new developments in health and medicine.

Amos studied biological science and genetics at the University of East Anglia from 1980 to 1983 and received her BSc degree. She conducted post graduate study at the Institute of Administrative Management and in 1989 received a diploma in administrative management. In 1990 she enrolled at the University of Portsmouth and graduated with an MA degree in manpower studies and human resource management in 1992.

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