Alternative Names: Hypothyroidism is often referred to as an "underactive thyroid gland".
Hypothyroidism is a condition in which the thyroid gland, which is located in the neck, does not make sufficient thyroid hormone to meet the body's requirements. Caused in almost all cases by autoimmune disease, the result is that the immune system goes awry and begins gradually to destroy the thyroid gland. This process is not usually associated with thyroid gland discomfort but may cause the gland to enlarge or shrink in size.
There is a variation of hypothyroidism
called Wilson's Syndrome, named after E. Denis Wilson, MD. Wilson's Syndrome is also known as Multiple Enzyme Dysfunction or MED. All of the details of this condition can be found in his book Wilson's Syndrome, The Miracle of Feeling Well.
This book is somewhat controversial and although many doctors are using variations of his therapeutic approach, it contains much useful information and many testimonials of people helped by using T3 therapy. Sufficient additional information may be found on the Internet and by conferring with a knowledgeable doctor.
Dr. Wilson reports that when a body is under stress, such as illness, fasting, cortisol
from stress, T4 (thyroxin
– a thyroid
hormone) is converted to Reverse T3 instead of T3 (triiodothyronine – the primary hormone that regulates the metabolic rate). As the T3 hormone levels in the blood drop to low levels, the patient's body temperature can subsequently drop below normal. When the body temperature decreases so does the function of important enzymes, as their activity is determined by temperature.
Wilson's Syndrome is a state of chronic low body temperature
. It may be genetic, or triggered by stress or inactivity, as well as diet, selenium
deficiency, heavy metals or starvation. It appears to be part of the body's method of conserving fuel: Wilson's Syndrome occurs when someone drops into this "conservation" mode and is not able to later recover back to the normal "productive" mode of functioning. An interesting side note is that Dr. Fahrenheit considered normal body temperature to be 100°F. Some say the present average temperature is 98.2°, and may be as much as 1½° lower than it was 150 years ago.
Incidence; Causes and Development; Contributing Risk FactorsHypothyroidism
is relatively common. It affects between 1 in 100 to 3 in 100 women of child-bearing age. It is more common in women than in men, and it becomes more common with age. Hypothyroidism occurs in up to 5 to 10% of older women; up to 20% of women over 60 have evidence of hypothyroidism.
A common cause of hypothyroidism
is the treatment of hyperthyroidism
(an overactive thyroid gland
), which often causes the thyroid gland to fail after a number of years.
With regards to Wilson's Syndrome, difficulty arises when low metabolism conditions continue for too long: various repair functions are deferred too long, and the body begins to show signs and symptoms. For every degree of body temperature lost, biochemists say the loss in efficiency of enzymatic processes can be up to 20%. Chronic low body temperature is related to many syndromes and symptoms, including: allergies, apathy, chronic fatigue
, "brain fog", "personal failure", depression
, dizziness, hypoglycemia
, lethargy, passive/aggressive syndromes, skin and joint conditions, sleep disorders, sexual dysfunction, past sexual abuse, yeast
, and many other poorly-defined chronic low health states. Obviously, not all chronic problems are related to chronic low body temperature but it would be prudent to measure one's body temperature from time to time to see if this is a possibility. It is interesting to note that a common time of death is in the very early morning, when the body temperature is at its lowest.Hypothyroidism
tends to "run in families". If you have a history of either hypothyroidism, or paradoxically, hyperthyroidism
in your family, it increases the chance that you may someday develop the condition. However, except for a few rare disorders, hypothyroidism is not transmitted in a typical dominant or recessive manner. If you have a strong family history of underactive or overactive thyroid
disease, you should mention this to your physician.
Signs and SymptomsHypothyroidism
slows metabolism and affects essentially every system in the body. Symptoms include generalized fatigue
, weight gain, thinning (brittle) hair, dry scaly skin, thin nails that break easily, constipation
, alterations in menses
, aching muscles, and slow heart rate. You may notice changes in behavior, such as decreased ability to concentrate, reading and calculating are more difficult, and you may experience decreased interest in personal relationships or work. Hypothyroidism
can cause or worsen depression
Other symptoms include loss of appetite, painful pre-menstrual periods, muscle weakness, a yellow-orange coloration in the skin (particularly on the palms), yellow bumps on the eyelids, hair loss (including eyebrows), recurrent infections, depression, slow speech, lowering of the voice, premature aging and drooping swollen eyes.
Diagnosis and TestsHypothyroidism
is more common than is typically diagnosed. It is possible to have some laboratory values be returned in the normal range when you have low thyroid
symptoms. Oral temperatures during the day of less than 98.0°F (36.7°C) are very suspicious.
Diagnosis involves a simple blood test which measures your thyroid hormone (thyroxine
or T4) and TSH (Thyroid-stimulating hormone) levels. An elevation of TSH is a very sensitive index of reduced thyroid function. Somewhat like the thermostat in your home, when thyroid hormone levels fall, TSH (the furnace) is switched on to stimulate the thyroid gland
. When thyroid hormone levels are low for a long time, TSH levels remain high. Thus, hypothyroidism
is characterized by a TSH level that is above the normal range and a thyroxine
level that is below or at the low end of the normal range (everyone's set point is a little different). Your physician can assist in the interpretation of these results, or you may wish to see a physician (an Endocrinologist) who specializes in hormonal disorders.
Treatment and Prevention
A medication called L-Thyroxine (L-T4) is used to replace the missing thyroid
hormone. Some preparations also include a second form of thyroid hormone, tri-iodothyronine (L-T3). These hormones are chemically identical to those made by your own thyroid gland
. Consequently, when the correct doses are prescribed and restore your metabolism to normal, the treatment is not accompanied by side-effects. The medication is in the form of a tablet, taken once a day. Taking too much thyroid hormone will, of course, speed up metabolism and can cause rapid or irregular heart rate and loss of calcium
from the bone. However, excess thyroid hormone levels are unlikely to occur when the treatment is carefully prescribed and monitored.
is diagnosed, most doctors will prescribe thyroid medication and many use Synthroid (T4). However, a recent blinded study demonstrated that T4 and T3 in combination produced greater benefits than T4 alone, especially in the area of mental functioning.
Hypopituitarism (low functioning pituitary
) and hypothyroidism (low functioning thyroid) can both result in deficient production of T4, which is the raw material the body uses to produce the active thyroid hormone T3. Your doctor should be able to help determine which medications are best for you.
The treatment of choice preferred by conventional doctors is T4 (Synthroid) because of its long half-life in the body (which helps provide steady T3 levels), once-a-day administration, and effectiveness in the treatment of such cases. Patients with hypopituitarism and hypothyroidism
may, however, suffer with Wilson's Syndrome at the same time. In such cases, T4 therapy may not be adequate because impaired conversion of the T4 to the active compound T3 may prevent sufficient normalization of body temperature patterns and, in some cases, can even feed the vicious cycle of Wilson's Syndrome. The simultaneous use of T4 with T3 may be the best approach for hypothyroidism, especially if Wilson"s Syndrome is suspected. Many doctors prefer using the standard T4/T3 combination found in desiccated thyroid
products such as Armour thyroid and other generic brands. Additional adjustments in the T4/T3 ratio can be made to meet the needs of individual patients.
Aside from taking a daily tablet, containing L-thyroxine, you should not have to change your lifestyle.
Is there a way to prevent hypothyroidism
deficiency can cause hypothyroidism but this is very unlikely in North America where the iodine supply is abundant. There are no other preventative measures you can take to avoid hypothyroidism.
The underlying cause of hypothyroidism
) is not reversible. However, the consequences of hypothyroidism can be treated very effectively by taking thyroid
hormone replacement medication. The dose of thyroid hormone can be carefully regulated so that your body's metabolism is restored to normal. You should have your blood tested at least once a year, or more often if necessary, to be certain that the thyroid hormone dose you are taking is satisfactory.
Recognition and proper daily treatment of low thyroid function using thyroid hormone replacement therapy will result in resolution of deficiency symptoms usually beginning within the first month of therapy and reaching a maximum at 6-12 months of treatment. Nevertheless, it is probable that the patient will require thyroxine
replacement for the rest of his or her life.
Problems with the thyroid
can be the cause of many recurring illnesses and fatigue
Patients diagnosed with hyperthyroidism
) and treated with radioactive iodine
are more likely to develop hypothyroidism
. Approximately 50% of patients treated with radioiodine, and many treated with antithyroid drugs, eventually develop hypothyroidism and should be tested at about yearly intervals.
Hypothyroidism can cause carpal tunnel syndrome
and Raynaud's phenomenon
; it can also lead to significant increases in cholesterol
levels and homocysteine levels and is implicated in about 10% of cases of high cholesterol levels. Correcting hypothyroidism can lead to a 30% drop in cholesterol and homocysteine levels.