Hypothyroidism | When to suspect and how to treat? Dr Mashhood Emergency Medicine
#Hypothyroidism
#HighTSHLevels
#Thyroidhormones
Probably one of the most common if not the commonest undetected medical problem of the developing world is hypothyroidism or low levels of thyroid hormones.
It mostly affects middle age group people but now more and younger age people are getting affected.
Why is it important? It is important because if affects the quality of life by affecting both physical and mental health of the patients.
Some people can suddenly start noticing that over a short period of time they have gained weight even though their diet is the same. This is because they have low levels of thyroid hormones. Thyroid hormones are needed for metabolism. During metabolism, energy is produced by utilizing the food we eat. If there is low metabolism rate, than less food would be utilized resulting in less energy and patient feeling lethargic and easily fatigued. The excess unutilized food would start getting stored up by the body resulting in weight gain. Apart from weight gain, females in particular can suffer from irregular periods, dry skin and swelling of legs due to fluid being retained by the body.
Mental health gets greatly affected and symptoms of depression starts affecting not only the person who is suffering but also his loved ones, relatives and friends. There might be mood swings which sometimes would be difficult to manage.
Reasons are simple – improper / unbalanced diet and unawareness of symptoms.
Thyroid hormone is produced by thyroid gland which are located in the neck. There are three main reasons for low thyroid hormones.
Firstly, to produce thyroid hormone, the glands require iodine and iron. If there is lack of iodine and iron in the diet – than obviously thyroid hormones would be produced in lesser amounts by thyroid gland.
Secondly, apart from the diet, sometimes there is a problem with the thyroid gland itself and when that happens the gland cannot make thyroid hormones. This happens in conditions such as Hashiomoto or Goiter.
Thirdly, there might be no feedback or orders given to the thyroid gland to produce thyroid hormone from pituitary gland which lies in the brain. In such cases, the thyroid gland fails to produce any thyroid hormones.
If there is lack of iodine and iron, than food which are rich in these should be taken. Foods which are rich in iodine include sea food and iodized salts. Foods which are rich in iron such as red meat, beans and dry fruits should be taken. Certain food such as Cabbage and cauliflower should be avoided as these affects thyroid hormone production.
In hypothyroidism, it is recommended to take thyroid tablets, the most common one being Levothyroxine. Levothyroxine has synthetic T3, T4 which the body requires to improve metabolism.
Hypothyroidism is suspected if TSH (Thyroid Stimulating Hormone) levels are high or T3/T4 levels are low.
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Dr Mashhood Qazi, Consultant Emergency Medicine, MBBS, DipPH (UK), MPH (UK), MRCEM (UK), FRCEM (UK)
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