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Overview

Thyroxine

Prescription vs.OTC: Prescription by Doctor required

Thyroxine is the primary hormone which is secreted by the thyroid gland. Thyroxine plays an important role in controlling body metabolism and regulates the functions of the heart and the digestive tract. It also keeps the bones strong, helps in development of the brain and controls muscle growth.

In case if an underactive thyroid, the hormone may be replaced with Thyroxine. The dosage of Thyroxine is generally determined by the doctor, who decides the dose depending on the age as well as weight of the individual. A patient?s present health condition and medical history is also kept in mind when determining the dose.

Patients who have medial problems like hypertension, heart disease, problems with cholesterol, diabetes, underactive or overactive thyroid and problems with the functioning of the pituitary gland, should consult their doctors before Thyroxine. The drug is meant to be taken orally, ideally in the morning just before breakfast. In case of a skipped dose, you can take 2 doses at the same time the next day.

Patients taking Thyroxine may experience some side effects like loss of weight, diarrhea, pain in the chest, vomiting, problems with breathing, anxiety and irregular menses.

hypothyroidism
In addition to its intended effect, Thyroxine may cause some unwanted effects too. In such cases, you must seek medical attention immediately. This is not an exhaustive list of side effects. Please inform your doctor if you experience any adverse reaction to the medication.
Anxiety
Vomiting
Diarrhoea
Palpitations
Nervousness
Weight Loss
Tremor.
Is It safe with alcohol?
Interaction with alcohol is unknown. Please consult your doctor.
Are there any pregnancy warnings?
Thyronorm 112mcg tablet is safe to use during pregnancy.
Adequate and well-controlled human studies have shown low or no risk.
Are there any breast-feeding warnings?
Thyronorm 112mcg tablet is probably safe to use during breastfeeding. Please consult your doctor.
Is it safe to drive while on this medicine?
There is no interaction between driving and consuming this drug. So dose alteration is not needed.
Does this affect kidney function?
There is no data available. Please consult doctor before consuming the drug.
Does this affect liver function?
There is no data available. Please consult doctor before consuming the drug.
Are there any missed dose instructions?
If you miss a dose of Thyroxine, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and go back to your regular schedule. Do not double the dose.\n
Whenever you take more than one medicine, or mix it with certain foods or beverages, you're at risk of a drug interaction.

Popular Questions & Answers

Im 28 years old. Height 5.5 ft. Weight 50 kgs. I feel very weak all day along. Feel drowsy whole day. Can not sleep at night. And slept for late noon eg 2 pm. For this reason can not take breakfast regularly. Can not get any energy. I have thyroid problems and take medicine for this. What should I do to get a sound sleep as my life style become regular? please help.

MD, Fellowship in Intergrative Medicine, MBBS
Integrated Medicine Specialist, Kochi
Im 28 years old. Height 5.5 ft. Weight 50 kgs. I feel very weak all day along. Feel drowsy whole day. Can not sleep a...
Thyroid .issues as well as anxiety issues and sleep issues are lifestyle issues which mostly require a lifestyle solution and not chemical cocktail of medicines. You have to address the root cause and not the symptoms and the focus should be on whole patient and not the disease. Hypothyroidism is a misdiagnosed and wrongly treated treated all over the world. Treating only on the TSH level alone is wrong .Dr is treating the labs and not the symptoms .In several cases TSH levels may be normal but patient still has symptoms. Secondly what you have been given is T4 or synthetic thyroxine which is not the active hormone T4 Thyroxine -Inactive hormone T3-Triodothyronine- Active hormone T4 needs to convert to T3 in the liver, kidney and in the thyroid for the conversion to occur you need nutrients which I am sure your Dr. Might not have explained and also you would not have asked. So first thing send me the thyroid profile tests you have done .I am sure they would have left out certain tests that is my usual experience Read up about he disease first and get educated to question your Dr. Do not take your drs words for granted. All your issues are interrelated which can be easily fixed provided you change your lifestyle and eating habits If you want specific advice on what is the correct tests and treatment to be followed and how to make your thyroid working for you and not against you Send a feedback with your name and working phone number and I will call you from abroad and then you can take a consult through Lybrate. Remember you have to treat the root cause and not the symptoms.
1 person found this helpful

I am 25 years female and I have hypothyroidism last 1 year but I take medicine. My question is can Indian gooseberry keep normal thyroid problem? Because I listen this. Can I eat Indian gooseberry mixed with honey at morning?

MBBS, CCEBDM, Diploma in Diabetology
Endocrinologist, Hubli-Dharwad
I am 25 years female and I have hypothyroidism last 1 year but I take medicine. My question is can Indian gooseberry ...
lybrate-user, Thanks for the query. Madam for treating hypothyroidism the only treatment is to supplement the deficient hormone thyroxine in adequate quantity every day. This treatment has to be taken for lifetime. There is no short cut. Amla has no role to play in controlling thyroid related issues. You may still use it along with honey and lemon (amla & lemon both give Vitamin C). But there is no role in relation to hypothyroidism. Thanks.
2 people found this helpful

Which food have to take for thyroid? I have 11. 8 TSH and low T4 value. I have very hair fall problem. I missed took the tablet for 2 weeks. Please give a solution to control my heavy hair fall. Thank you.

MBBS, CCEBDM, Diploma in Diabetology
Endocrinologist, Hubli-Dharwad
Which food have to take for thyroid? I have 11. 8 TSH and low T4 value. I have very hair fall problem. I missed took ...
Lybrate-user, Thanks for the query. Hypothyroidism if not well controlled causes multiple symptoms including hair fall & dry hair, dry skin. With adequate dose of thyroxine, TSH should be brought down around 3 to 4 m/L then only you will be free from all the symptoms. Hair fall takes a bit longer to stop. Treatment is for lifetime. Should not be stopped in between. TSH should be checked periodically to ensure that it is maintained as mentioned earlier. There's no special diet. You have to avoid soy beans, soy containing foods. Consume more of green leafy vegetables, salads & fruits. Always use whole grain flour for roti & chapati. Do not eat items made from maida. Thanks.
6 people found this helpful

I am on diabetes medication for the last four years and now I have grown hypothyroidism last month. My thyroid level is 10.5. I am taking allopathic medicine for that. My weight has increased 10 kg in two months. Please suggest me homeopathic medicine. My age is 51 year old.

MBBS, CCEBDM, Diploma in Diabetology
Endocrinologist, Hubli-Dharwad
I am on diabetes medication for the last four years and now I have grown hypothyroidism last month. My thyroid level ...
lybrate-user, Thanks for the query. For treating diabetes and hypothyroidism only appropriate medications are from modern medicine. No other paties offer any treatment. A lot of false claims are made. In hypothyroidism supplementation of thyroxine hormone in adeuate dose and maintaining TSH around 3 to 4 mU/L is the only remedy. That will help in checking all the symptoms including weight gain. As regards diabetes control it is necessary to maintain fasting glucose < 100 mg, PP 150 to 170 mg & HbA1c% <6.8. Then only you will feel fit and healthy. Thanks.
1 person found this helpful

My wife weight is decreasing continuously since a year, her age is 30 year, 1 year before her weight was 53 kg now her weight is 43, she is suffering from vaginal inflammation also since 4 months, she is facing indigestion problem also, every time feeling weakness, she is taking thyroxine 50 mg for thyroid.

B.A.M.S, MD (Ayu.) Kayachikitsa
Ayurveda,
check with the TFT values as over usage of thyroxine can cause the patient to land up in hyperthyroidism resulting in weight loss. Regarding indigestion, it can be due to the high level of T3 (causing diarrhea) otherwise it could be due to malabsorption syndrome (IBS) As h/o vaginal inflammation is there consult a good OBG/GYN doctor to exclude any pathology of the pelvic tract.

Popular Health Tips

Hypothyroidism - Know Its Homeopathic Remedies!

BHMS
Homeopath, Delhi
Hypothyroidism - Know Its Homeopathic Remedies!

Hypothyroidism refers to the lack of thyroid hormones in your body. Hypothyroidism is caused when the thyroid gland of your body is unable to produce the thyroid hormones like T3 (triiodothyronine) and T4 (thyroxine). Hypothyroidism can occur due to the inflammation of the thyroid gland or as a result of previous thyroid treatments, where a major portion of the thyroid producing cells has been removed. Hypothyroidism is more common in women. But, it can develop in any person irrespective of age or sex.

The symptoms of hypothyroidism are as follows:

  1. Fatigue
  2. Increased feeling of cold
  3. Dryness of skin
  4. Constipation
  5. Depression
  6. Obesity
  7. Increased blood cholesterol level
  8. Your muscles may be become weak and you may suffer from muscle pain
  9. Disruption in menstrual cycle

Though these are the common symptoms, but it may vary from person to person. Hypothyroidism is a very common problem and homeopathy offers a very safe, painless and effective treatment for hypothyroidism.

Homeopathic Treatment For Hypothyroidism

Homeopathy is best holistic therapy for hypothyroidism. Homeopathic medicines have been known to correct the imbalance in the thyroid hormones in a very mild and subtle manner.  The homeopathic medicines for hypothyroidism are purely natural in origin and have no side effects at all. They are able to improve the functioning of the thyroid gland permanently. Once cured, one has no need to take medicines and can live a disease free as well as medicine free life.

Doses-

There are excellent remedies in homeopathy for the patients suffering from hypothyroidism symptoms.The homeopathic remedies are prepared from a wide range of substances such as the vegetables, herb, mineral, chemicals and animal products in extremely minute. The homeopathic remedy selected will be based on all the symptoms of the patient including physical, mental and emotional states and family history of the patient.

Homeopathic remedies stimulate the body’s own immune system and offer a long lasting cure rather than giving temporary relief.

There are two ways to treat hypothyroidism-

  1. Supplement body with external thyroid hormone
  2. Administer medicines that could stimulate the thyroid gland

The conventional method is to supplement the hormone. But the problem here is that the body gets used to it and stops producing its own hormone in desired quantity.

In case of homeopathic treatment, it tries to stimulate the gland to make it produce normal production of hormone.

2 people found this helpful

Thyroid and Reproduction (Fertility, Sexual Function and Pregnancy)

MBBS (Gold Medalist, Hons), MS (Obst and Gynae- Gold Medalist), DNB (Obst and Gynae), Fellow- Reproductive Endocrinology and Infertility (ACOG, USA), FIAOG
Gynaecologist, Kolkata

Today 25th May is the World Thyroid Day. Thyroid disorders are one of the most common disorders of hormones in our body. Thyroid is a small gland situated in front of the neck and secretes hormones like thyroxine (T4) and tri-iodo-thyronine (T3). These hormones control various functions of our body like heart, blood pressure, digestion, metabolism, growth, blood formation, brain function etc. But one of the most important function is its association with reproduction.


In both sexes, T3 and T4 are needed for sexual development during puberty so that full maturation from a child to adult occurs. That means development of hair (pubic and axillary hair), beard and moustache in boys, breast in girls, genital organ development in both sexes and menstrual function are dependent on thyroid gland. Finally production of eggs (rather maturation and release) and sperms are also related to it. In adults, thyroid function is needed to maintain the functions of sex glands particularly ovaries and testes. Desire for sex (libido) and performance of sex are also related to thyroid function. 

The thyroid glands in turn is regulated by a hormone secreted from pituitary gland, located inside the brain. That hormone- TSH (thyroid stimulating hormone) controls secretion of T3 and T4., Thyroid gland may be affected by various diseases like autoimmune diseases (body itself destroys its organs), deficinecy of iodine, radiation, tumour, congenital causes (cause present from birth) and certain drugs. The result is that thyroid hormone seceretion may be reduced (hypothyroidism) or increased (hyperthyroidism). As a result, blood tests for TSH, T3 and T4 are commonly done to detect abnormalities of thyroid gland. If abnormalities are detected, further tests may be advised, e.g., ultrasound and scanning of thyroid gland. 

So what can happen to reproduction if thyroid function is affected? Thyroid disorders are particularly common in females. Menstrual cycle may be irregular (comin every 2 or 3 months ) or may be scanty in amount or more commonly very excessive flow. These respond well to correction of thyroid hormone levels by drugs. 

Thyroid diorder is a common cause of anovlation- that is women cannot release eggs in each month. The result is irregular menstruation and infertility- the inability to conceive a child. Often correction of thyroid hormone levels result in pregnancy. Please remember if you are trying for pregnancy, then your TSH value should not be the same like other people. We usually treat such women if TSH is more than 2.5 (this may be normal for labaoratory standrads for other people but not for those who plan for preganncy and who are pregnant). 

It can cause low libido, vaginal dryness, reduced orgasm and painful intercourse.

In case of male, the thyroid disease is not very common but is not rare. It can affect sperm production leading to infertility. Apart from that it can afect sexual performance leading to low libido, easy fatigue and erectile dysfucntion (ED). All these resolve after proper treatment.

Never ignore checking thyroid status for adolescent boys and girls. It may be responsible for delayed puberty (delay in appearance of male like features in boys and female like features in girls) or precocious puberty (early onset of menstruation or breast development in girls; or early development of beard and moustache in boys). These may be associated with serious disorders and need proper attention.

Pregnancy is a condition where there is tremenous pressure on thyroid gland and it is needed to help in proper development of baby inside uterus. Women with thyroid disorders can have miscarriage, premature delivery, death of baby inside uterus or poor growth of the baby. She can experience bleeding in pregnancy, high blood pressure (preeclampsia) and even heart failure. In initial periods babies depend on mother's thyroid gland for its development. If baby does not get proper amount of thyroid hormones, its brain and body deveopment hampers. Particularly the brain development can be affected leading to mentally handicapped baby,as it may not be corrected even after treatment. So proper diagnosis and treatment of thyroid diseases in pregnancy are essential. After birth baby should be tested for thyroid disease and appropriate treatment should be started without any delay.

So, if you feel any of the above problems, please do not hesitate to consult your doctor and request testing of thyroid functions. If drug treatment is started, do not stop the drug without consulting doctor. Uncontroled thyroid disease can lead to heart attack, stroke and emergency situations like thyrotoxicosis or myxoedema- which can be potentially life threatening if not treated in time.

5 people found this helpful

Health Benefits Of Radish!

M.Sc. in Dietetics and Food Service Management , Post Graduate Diploma In Computer Application, P.G.Diploma in Clinical Nutrition & Dietetics , B.Sc.Clinical Nutrition & Dietetics
Dietitian/Nutritionist, Mumbai
Health Benefits Of Radish!

9 health benefits of radish:

1. Radish can be helpful in treating cancers: 
Radishes are known to fight oral, stomach, intestinal, colon and kidney cancers. They are rich in vitamin c, anthocyanins and folic which help in treating cancers. Also, they are rich in antioxidants and isothiocyanates which make the cancerous cells die and stop their multiplication. Radishes can treat as well as prevent this deadly disease.


2. Radish improves urinary issues: 

 Radishes are known for its high water content. And this makes them great for correcting disorders in urination. A disorder like burning sensation during urination can be treated with radish juices. Its water content cleanses the entire urinary system as well as the kidneys, improving urine excretion.


3. Radish improves hypertension: 

The leaves of radishes are rich sources of potassium while having low levels of sodium. This makes them amazing for controlling the high blood pressure levels.


4. Radish benefits during constipation:

 Besides being helpful in treating urinary issues, radishes can be helpful in constipation too. Since it has fiber content, it helps in digestion of food effectively and also improves the excretion process. Moreover, its high water content helps in the secretion of different digestive juices and makes the elimination of wastes from the body, easier.

5. Radish benefits the respiratory system: 

If you are asthmatic or having sinus issues, including radishes in your diet can help. Radishes are well known to be effective in clearing mucous from the respiratory tracts and hence helps in overcoming breathing issues as in asthma. Radishes are known to provide protection to the inner lining of the respiratory organs, preventing it from allergies and respiratory infections.


6. Radish juices benefit thyroid patients: 

Radish juices are found to have a sulfur component raphanin. This component keeps a balance in the production of the hormones thyroxine and calcitonin. This balance improves the hypothyroid conditions.

7. Radish benefits weight loss: 

Yes, one of the benefits of radishes is that it promotes weight loss. How? a) radishes have low gi: low gi foods keep a control on the blood sugar level. This, in turn, keeps the insulin level balanced in the blood which is necessary for proper fat burning. Hence having radishes can help in weight loss. B) the fiber content: as mentioned earlier, radishes have high fiber content. Fiber makes you feel full for a long time, hence it will make you less hungry and prevent you from eating more. C) have low calories: if you look at the nutritional facts about radishes, you will know that they are low in calories. Hence, eating them won’t make you gain more calories and at the same time can prevent your hunger pangs. All the above three points can be helpful in losing weight. Hence, replacing many of your unhealthy snacks with a radish salad or soup can actually help your diet for weight loss.

8. Radish benefits diabetic patients:


 Although research has been limited to humans, radish has shown sugar lowering signs when tested on diabetic rats. Moreover, they are low on carbs and gi, which is a good factor for them to be included in diets for diabetic patients.

9. Radish benefits skin: 

Radishes provide hydration to the skin cells which make them keep the skin hydrated. Also, radishes are found with components like vitamins, phosphorous, zinc that keep the skin healthy. Raw grated radishes can be applied as face packs to fight problems like rashes, dry skin etc.

7 people found this helpful

Thyroid Disorders - Everything You Wanted To Know!

MD - General Medicine, DM - Endocrinology, MBBS
Endocrinologist, Faridabad
Thyroid Disorders - Everything You Wanted To Know!

Thyroid gland is a butterfly shaped gland in the front of the neck. It encircles the windpipe or the trachea. It is about 4 cms in height and weighs about 18 gms. This gland is responsible for the secretion of thyroid hormones. Hormones are chemicals produced by special glands like thyroid, adrenals, ovaries etc. They act as messengers and are carried by the blood to the various target organs. Thyroid disorders are conditions that affect the thyroid glands. It plays an important role in regulating numerous metabolic processes throughout the body. The Thyroid gland is located below the adam’s apple wrapped around the trachea.

Thyroid disease is a common problem that can cause symptoms because of over- or under-function of the thyroid gland. The thyroid gland is an essential organ for producing thyroid hormones, which maintain our body metabolism. The thyroid gland is located in the front of the neck below the Adam's apple. Thyroid disease can also sometimes lead to enlargement of the thyroid gland in the neck, which can cause symptoms that are directly related to the increase in the size of the organ (such as difficulty swallowing and discomfort in front of the neck).

Thyroxine T4 is the primary hormone developed by the Thyroid gland. A small portion of the T4 released from the gland is converted to Triiodothyronine (T3) which is the most active hormone.

Hyperthyroidism: Too much thyroid hormone results in a condition known as hyperthyroidism. Affects about 1 percent of women. It's less common in men.

Grave’s disease is the most common cause of hyperthyroidism.

Symptoms:

Causes:

  1. Toxic adenomas: Nodules develop in the thyroid glands and begin to secrete thyroid hormones upsetting the body's chemical balance.
  2. Subacute thyroiditis: Inflammation of the thyroid that causes the gland to leak excess hormones, resulting in temporary hyperthyroidism that lasts a few weeks but may persist for months.
  3. Pituitary gland: Malfunctions or cancerous growths in the thyroid gland. Although rare, hyperthyroidism can also develop from these causes.

Treatments for hyperthyroidism: destroy the thyroid gland or block it from producing its hormones.

  1. Antithyroid drugs: such as methimazole (Tapazole) prevent the thyroid from producing its hormones.
  2. Radioactive iodine: a large dose of it damages the thyroid gland. A pill is given by mouth. As thyroid gland takes in iodine, it also pulls in the radioactive iodine, which damages the gland.
  3. Surgery: Surgery can be performed to remove your thyroid gland.

Hypothyroidism: Inadequate production of hormones by the thyroid gland is termed as hypothyroidism. This is also called Underactive thyroid state. Hypothyroidism can make the body’s development to slow down and reduces metabolism rates. Since the body needs some amount of thyroid for energy production and drop in hormone production leads to lower energy levels.

Symptoms:

What are the causes of Hypothyroidism?

Hypothyroidism can be caused by a number of factors:

  1. Hashimoto's thyroiditis: This is the commonest cause. This is an autoimmune disorder (normally body’s defence system fight against external infections. In autoimmune disorder the defence system attacks the healthy cells of the body by mistake). In Hashimoto’s thyroiditis the immune system/defence system produces antibodies that attack the thyroid gland and destroy it.
  2. Iodine deficiency in diet: For the production of thyroid hormones iodine is very important. The body does not produce iodine normally, so it needs to be supplemented from outside. Iodine is mainly present in the food we eat. It is mainly present in shellfish, salt-water fish, eggs, dairy products. If a person does not eat iodine rich foods, he may end up with iodine deficiency leading to hypothyroidism. Currently, this causative factor is on the decline due to government initiative of table salt with iodine.
  3. Surgery: Surgery to remove thyroid gland (for e.g. thyroid cancer treatment, overactive thyroid etc.)
  4. Radiation to the neck (to treat cancer in the neck area): The thyroid gland cells are damaged due to the radiation.
  5. Treatment with radioactive iodine: This treatment is used for managing hyperthyroidism/overactive thyroid, where the thyroid gland produces excessive thyroid hormones. One of the treatment modalities is by radioactive iodine. Sometimes this radiotherapy destroys normal functioning cells which lead to hypothyroidism.
  6. Certain medicines: Certain medicines used to treat heart conditions, cancer, psychiatric conditions etc. – for e.g. amiodarone, lithium, interleukin-2, interferon-alpha.
  7. Pregnancy: Pregnancy (the reason is unclear but it has been noticed that the thyroid may get inflamed after delivery – this is called Postpartum thyroiditis.
  8. Damage to the pituitary gland: Pituitary gland is a gland which is present in the brain. It produces a hormone called TSH (Thyroxine-Stimulating hormone).The TSH tells the thyroid gland how much thyroid hormone it should make. If the levels of thyroid hormone in the blood are low, then the TSH will stimulate the thyroid gland to produce more Thyroid hormone.
  9. Hypothalamus disorders: This is an organ in the brain. This produces a hormone called TRH (Thyrotropin Releasing Hormone) which acts on the Pituitary gland to secrete TSH. So any disorder of Pituitary gland will indirectly effect the production and secretion of Thyroid hormones. These are very rare disorders.
  10. Congenital thyroid defects: Some babies are born with thyroid problems. This is due to the thyroid not being developed normally during pregnancy. Sometimes the thyroid gland does not function normal. This can be identified by screening for thyroid disorders in the first week after delivery. This is usually by a blood test using a small drop of blood from the baby’s heel.

Who are at risk of developing Hypothyroidism?

  1. Women have a higher risk of suffering from hypothyroidism than men.
  2. Older people are at increased risk.
  3. People suffering from other autoimmune diseases like Coeliac disease, Type-1 Diabetes Mellitus, Vitiligo, Pernicious anemia, Multiple sclerosis, Rheumatoid arthritis, Addison’s disease etc.
  4. People with psychiatric conditions such as bipolar disorder
  5. People with Chromosomal abnormalities like Down syndrome, Turners syndrome also have a high risk of suffering from hypothyroidism.

How to diagnose hypothyroidism?

Blood tests:

  1. TSH: This hormone is made in the pituitary gland and it stimulates the thyroid gland to produce thyroxine. If the thyroxine levels are low in the blood, the pituitary gland produces and secretes more TSH into the blood to act on the thyroid gland to produce more thyroxine. A raised TSH level indicates hypothyroidism. Other tests are not usually necessary unless a rare cause of hypothyroidism.
  2. T4: A low level of thyroxine indicates hypothyroidism.
  3. T3: these levels are generally not needed to diagnose hypothyroidism
  4. Anti-Thyroid peroxidase antibodies (anti-TPO antibodies) or Anti- thyroglobulin antibodies are present in 90-95% of patient with autoimmune thyroiditis.
  5. Other blood tests include Creatinine Kinase, Serum Lipids, Complete blood picture etc.
  6. Ultrasound of the neck is done if the patient presents with a thyroid swelling.

What is the treatment of hypothyroidism?

Overt hypothyroidism is treated by synthetic Thyroxin hormone which should be taken every day on an empty stomach at least 30 – 45 minutes before breakfast. The treatment is continued for the rest of the patient’s life. Regular thyroid function tests are done once every 8 weeks-12 weeks to adjust the dose of the thyroxine in the initial period of diagnosis. Once the thyroxine dose is stabilised, the tests can be done even once a year. This treatment is quite effective.

Sub-clinical hypothyroidism is only treated if the patient is a woman and is contemplating pregnancy, in patients with symptoms or if the TSH is quite high.

What are the side-effects of thyroxine medication?

There are few side effects if any. Most people tolerate these medications quite well. An important consideration before starting medication is to check if the patient has chest pain/angina. These people are started on the least available dose. If these patients are started on a higher dose they notice a worsening of their angina pains.

Side effects mainly occur if the thyroxine dose is high which leads to hyperthyroidism. The symptoms of this could be palpitations 9increased heart beat), weight loss, profuse sweating, anxiety, irritability etc.

There are some tablets which increase with thyroxine tablets. These include carbamazepine, iron supplements, calcium supplements, rifampicin, phenytoin, warfarin etc.

What are the complications of hypothyroidism?

If untreated hypothyroidism can lead to:

  • heart problems like heart attack due to increased levels of bad cholesterol like LDL, or heart failure due to fluid retention
  • obesity
  • infertility
  • joint pains
  • depression
  • A pregnant woman with hypothyroidism is at increased risk of giving birth to a baby with congenital hypothyroidism, also known as cretinism. Further, the woman may have pregnancy related complications like pre-eclampsia, premature delivery, low birth weight baby, anemia, post-partum haemorrhage (bleeding after delivery) etc.
  • Myxoedema is another complication where the patient has extremely low levels of thyroid hormone. The body temperature drops drastically making the person lose consciousness or go into a coma. If you wish to discuss about any specific problem, you can consult an Endocrinologist.
2952 people found this helpful

Hypothyroidism: What You Need to Know About an Underactive Thyroid

MBBS, MD - Paediatrics, FRACP - Pediatrc Endocrinology, SCE, Endocrinology
Endocrinologist, Kanpur
Hypothyroidism: What You Need to Know About an Underactive Thyroid

Hypothyroidism is a condition in which the thyroid gland is not producing the thyroid hormones adequately. This is a fairly common condition.

What is thyroid gland?

The thyroid gland is a small butterfly-shaped gland located just below Adam’s apple. It encircles the windpipe or the trachea. It is about 4 cms in height and weighs about 18 gms. This gland is responsible for the secretion of thyroid hormones. Hormones are chemicals produced by special glands like thyroid, adrenals, ovaries etc. They act as messengers and are carried by the blood to the various target organs.

What are the hormones produced by thyroid gland and what do they do?

The thyroid hormones are of two types – T3 (Tri iodo thyronine) and T4 (Thyroxine). These hormones are mainly responsible for the body’s metabolism - a process in which food is converted into energy in the cells. They influence growth and development and regulate various bodily functions which are mentioned below:

  • Heartbeat
  • Body temperature
  • Breathing
  • Body weight
  • Metabolism of fat
  • Menstrual cycles in females
  • Functioning of Nervous system
  • Digestion
  • Burning calories etc.

What is Hypothyroidism?

Inadequate production of hormones by the thyroid gland is termed as hypothyroidism. This is also called Underactive thyroid state. Hypothyroidism can make the body’s development to slow down and reduces metabolism rates.

What are the causes of Hypothyroidism?

Hypothyroidism can be caused by a number of factors:

  1. Hashimoto's thyroiditis: This is the commonest cause. This is an autoimmune disorder (normally body’s defence system fight against external infections. In autoimmune disorder the defence system attacks the healthy cells of the body by mistake). In Hashimoto’s thyroiditis the immune system/defence system produces antibodies that attack the thyroid gland and destroy it.
  2. Iodine deficiency in diet. For the production of thyroid hormones iodine is very important. The body does not produce iodine normally, so it needs to be supplemented from outside. Iodine is mainly present in the food we eat. It is mainly present in shellfish, salt-water fish, eggs, dairy products. If a person does not eat iodine rich foods, he may end up with iodine deficiency leading to hypothyroidism. Currently, this causative factor is on the decline due to government initiative of table salt with iodine.
  3. Surgery: Surgery to remove thyroid gland (for e.g. thyroid cancer treatment, overactive thyroid etc.)
  4. Radiation to the neck (to treat cancer in the neck area): The thyroid gland cells are damaged due to the radiation.
  5. Treatment with radioactive iodine: This treatment is used for managing hyperthyroidism/overactive thyroid, where the thyroid gland produces excessive thyroid hormones. One of the treatment modalities is by radioactive iodine. Sometimes this radiotherapy destroys normal functioning cells which lead to hypothyroidism.
  6. Certain medicines: Certain medicines used to treat heart conditions, cancer, psychiatric conditions etc. – for e.g. amiodarone, lithium, interleukin-2, interferon-alpha.
  7. Pregnancy: Pregnancy (the reason is unclear but it has been noticed that the thyroid may get inflamed after delivery – this is called Postpartum thyroiditis.
  8. Damage to the pituitary gland: Pituitary gland is a gland which is present in the brain. It produces a hormone called TSH (Thyroxine-Stimulating hormone).The TSH tells the thyroid gland how much thyroid hormone it should make. If the levels of thyroid hormone in the blood are low, then the TSH will stimulate the thyroid gland to produce more Thyroid hormone.
  9. Hypothalamus disorders: This is an organ in the brain. This produces a hormone called TRH (Thyrotropin Releasing Hormone) which acts on the Pituitary gland to secrete TSH. So any disorder of Pituitary gland will indirectly effect the production and secretion of Thyroid hormones. These are very rare disorders.
  10. Congenital thyroid defects: Some babies are born with thyroid problems. This is due to the thyroid not being developed normally during pregnancy. Sometimes the thyroid gland does not function normal. This can be identified by screening for thyroid disorders in the first week after delivery. This is usually by a blood test using a small drop of blood from the baby’s heel.

What are the different types of hypothyroidism?

One classification is based on whether the defect is with the thyroid gland or not:

  1. Primary hypothyroidism: The problem is in the thyroid gland itself and thus there is reduced production /secretion of thyroid hormones.
  2. Secondary hypothyroidism: Here the problem is with the Pituitary gland or the Hypothalamus. This results in abnormal production of TSH or TRH, which indirectly leads to less production and secretion of thyroid hormones.

Another classification is based on the symptoms and levels of the thyroid hormones and TSH:

  1. Overt hypothyroidism: Here the patient is having the symptoms. Further the T3/T4 are low and TSH is high
  2. Subclinical hypothyroidism: Here patient may or may not have symptoms. The T3/T4 levels are normal but TSH is high. In this situation the patient is at an increased risk of developing overt hypothyroidism in the future especially if he has Thyroid peroxidase antibodies on testing.

Who are at risk of developing Hypothyroidism?

  1. Women have a higher risk of suffering from hypothyroidism than men.
  2. Older people are at increased risk.
  3. People suffering from other autoimmune diseases like Coeliac disease, Type-1 Diabetes Mellitus, Vitiligo, Pernicious anemia, Multiple sclerosis, Rheumatoid arthritis, Addison’s disease etc.
  4. People with psychiatric conditions such as bipolar disorder
  5. People with Chromosomal abnormalities like Down syndrome, Turners syndrome also have a high risk of suffering from hypothyroidism.

What are the symptoms of hypothyroidism?

Symptoms vary from person to person. They may also mimic other conditions and hence be difficult to diagnose. Symptoms may also develop very slowly over a span of moths-years. Some of the characteristic symptoms of this disease are:

  1. Depression
  2. Constipation
  3. Hair loss
  4. Dry hair
  5. Dryness of the skin
  6. Tiredness
  7. Body pains
  8. Fluid retention in the body
  9. Irregular menstrual cycle
  10. Increased sensitivity to cold
  11. Reduced heart rate
  12. Increase in size of the thyroid gland – called Goitre. This is due to constant stimulation of the thyroid gland by TSH.
  13. Weight gain
  14. Carpal tunnel syndrome
  15. Hoarse voice
  16. Infertility
  17. Loss of libido/sex drive
  18. Confusion or memory problems especially in the elderly

What are the symptoms to look for in a baby if you suspect hypothyroidism?

Infants suffering from congenital hypothyroidism may show no symptoms or exhibit signs of excessive drowsiness, cold hands, cold feet, constipation, hoarse cry, poor growth or absent growth, poor appetite, bloating of abdomen, puffiness of face, swollen tongue, persistent jaundice.

How to diagnose hypothyroidism?

Blood tests:

  1. TSH: This hormone is made in the pituitary gland and it stimulates the thyroid gland to produce thyroxine. If the thyroxine levels are low in the blood, the pituitary gland produces and secretes more TSH into the blood to act on the thyroid gland to produce more thyroxine. A raised TSH level indicates hypothyroidism. Other tests are not usually necessary unless a rare cause of hypothyroidism.
  2. T4: A low level of thyroxine indicates hypothyroidism.
  3. T3: these levels are generally not needed to diagnose hypothyroidism
  4. Anti-Thyroid peroxidase antibodies (anti-TPO antibodies) or Anti- thyroglobulin antibodies are present in 90-95% of patient with autoimmune thyroiditis.
  5. Other blood tests include Creatinine Kinase, Serum Lipids, Complete blood picture etc.
  6. Ultrasound of the neck is done if the patient presents with a thyroid swelling.

What is the treatment of hypothyroidism?

Overt hypothyroidism is treated by synthetic Thyroxin hormone which should be taken every day on an empty stomach at least 30 – 45 minutes before breakfast. The treatment is continued for the rest of the patient’s life. Regular thyroid function tests are done once every 8 weeks-12 weeks to adjust the dose of the thyroxine in the initial period of diagnosis. Once the thyroxine dose is stabilised, the tests can be done even once a year. This treatment is quite effective.

Sub-clinical hypothyroidism is only treated if the patient is a woman and is contemplating pregnancy, in patients with symptoms or if the TSH is quite high.

What are the side-effects of thyroxine medication?

There are few side effects if any. Most people tolerate these medications quite well. An important consideration before starting medication is to check if the patient has chest pain/angina. These people are started on the least available dose. If these patients are started on a higher dose they notice a worsening of their angina pains.

Side effects mainly occur if the thyroxine dose is high which leads to hyperthyroidism. The symptoms of this could be palpitations 9increased heart beat), weight loss, profuse sweating, anxiety, irritability etc.

There are some tablets which increase with thyroxine tablets. These include carbamazepine, iron supplements, calcium supplements, rifampicin, phenytoin, warfarin etc.

What are the complications of hypothyroidism?

If untreated hypothyroidism can lead to:

  • heart problems like heart attack due to increased levels of bad cholesterol like LDL, or heart failure due to fluid retention
  • obesity
  • infertility
  • joint pains
  • depression
  • A pregnant woman with hypothyroidism is at increased risk of giving birth to a baby with congenital hypothyroidism, also known as cretinism. Further, the woman may have pregnancy related complications like pre-eclampsia, premature delivery, low birth weight baby, anemia, post-partum haemorrhage (bleeding after delivery) etc.
  • Myxoedema is another complication where the patient has extremely low levels of thyroid hormone. The body temperature drops drastically making the person lose consciousness or go into a coma. If you wish to discuss about any specific problem, you can consult an Endocrinologist.
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