Underactive Thyroid

An underactive thyroid gland (hypothyroidism) is where your thyroid gland doesn’t produce enough hormones.
Common signs of an underactive thyroid are tiredness, weight gain and feeling depressed.

About Thyroid Gland

The thyroid is a butterfly-shaped endocrine (hormone secreting) gland in the neck that is found on both sides of the trachea (windpipe). It secretes the hormone Thyroxine which controls the rate of metabolism. Thyroid gland is one of the many endocrine glands such as adrenal, pituitary, pancreas, testes, etc.

The thyroid weighs about 20-25 gms in an adult. It is butterfly shaped and it consists of two lobes which are connected together by a median isthmus as shown in the picture. It is located in the front of the neck and is situated just below the larynx or the Adam’s apple.

The function of the thyroid gland is to take up iodine from the foods that we eat and to convert it into thyroid hormones namely Thyroxine (T4) and Triiodothyronine (T3) and Calcitonin (which is involved in calcium metabolism). The cells of this gland combine iodine and the amino acid tyrosine to make T3 and T4. Later T3 and T4 are then released into the blood stream and are transported throughout the body where they control the general metabolism (conversion of oxygen and calories to energy). The regulation of the metabolism of every cell in the body requires thyroid hormones. The ratio of production of T4 and T3 is 80:20. However, T3 is about 4 times more potent than T4.

The production of thyroid hormones is under direct control of the pituitary gland. Pituitary is an endocrine gland which is situated at the base of the brain and it secretes certain vital hormones which includes TSH (Thyroid stimulating hormone) or Thyrotropin, besides others. When the level of thyroid hormones (T3 and T4) falls below the required amount, the pituitary gland secretes TSH which stimulates increased production of T3 and T4. As the levels of T3 and T4 keep rising in the blood, the pituitary senses this and reduces TSH production.

The hypothalamus is that part of the brain which produces TRH (Thyrotropin Releasing Hormone). TRH regulates the production of TSH by the pituitary, i.e. it has a regulatory control over the pituitary gland.

Underactive Thyroid: What is Hypothyroidism & Types

Deficiency of the thyroid hormone (THYROXINE) is called Hypothyroidism or Hypothyroid. It can affect any age group though it is most prevalent in older women. It is almost 10 to 20 times more common in females as compared to males. It is one of those conditions which are often present for many years before they can be recognized and treated effectively. Estimated one in every 50 females and one in 1000 men tend to suffer with this condition.
Underactive Thyroid is also called Hypothyroidism.

Hypothyroidism can be of two types:

  • Primary hypothyroidism: Here the problem lies in the thyroid gland and hence it fails to produce sufficient hormones due to certain causes.
  • Secondary hypothyroidism: In this type, the pituitary gland is at fault and it is unable to produce sufficient quantity of TSH. Lack of TSH in turn causes decreased production of T3 and T4 by the thyroid gland due to lack of stimulus from the pituitary.
HormoneNormal levels
T3 (Triiodothyronine)80-180 ng/dl
T4 (Thyroxine)4.6-12 ug/dl
TSH (Thyroid Stimulating Hormone)0.5-6 uU/ml

Under active thyroid results from an inability of the Thyroid gland to produce adequate Thyroxine hormone. This could be largely due to genetic tendency. It is important to understand that since there is an inability or sluggishness of the thyroid gland, the treatment should ideally be aiming at stimulating the thyroid gland to do its job, rather than simply supplying deficient Thyroxine hormone from outside.

Causes of Underactive Thyroid (Hypothyroidism)

Primary Hypothyroidism or Underactive Thyroid can be caused due to several reasons such as follows: chronic active hepatitis: Patients of ulcerative colitis may have concurrent hepatitis C infection.

  • Iodine deficiency in food is one of the common causes especially in certain geographic areas of the world.
  • Inflammation of the thyroid gland which causes damage or death of the cells of thyroid leading to insufficient production of the hormones is a major cause of Primary hypothyroidism. The main cause of failure of thyroid gland in this manner is by Auto-immune Thyroiditis also known as Hashimoto’s Thyroiditis. In this disorder, the patients own immune system causes an inflammation of the gland.
  • Post-thyroidectomy: Surgical removal of the thyroid gland or a nodule for treating hyperthyroidism often makes the patient land up with Hypothyroidism after a few years.
  • Post-radiotherapy: Radiotherapy given for hyperthyroidism in order to destroy the hyperactivity of the gland. If larger number of cells are destroyed by the radioactive iodine, the patient may have insufficient hormone production by the remaining cells and this may cause hypothyroidism.

Secondary hypothyroidism is commonly caused by the following:

  1. Failure of the pituitary gland to secrete Thyroid Stimulating Hormone (TSH). This may be caused due to:
    • Tumor in the pituitary region
    • Infiltration of the pituitary by inflammatory cells from the immune system
    • Infiltration of the pituitary by foreign substances (such as iron in Hemochromatosis)Hypothalamic dysfunction
    • Risk factors for secondary hypothyroidism include being over 50 years old, being female, and having a history of pituitary or hypothalamic dysfunction.

Symptoms of Underactive Thyroid (Hypothyroidism)

The symptoms of hypothyroidism are frequently missed out and especially in elderly females these are mistaken to be symptoms of menopause. The beginning of the symptoms is often not noted markedly and hence the condition remains under-diagnosed.

Patient may experience few of the following symptoms:

  • Fatigue, exhaustion
  • Weakness, sluggishness
  • Unexplained weight gain or increased difficulty losing weight
  • Coarse, dry hair and/or thinning of hair
  • Hair loss
  • Dry, rough, pale and itchy skin
  • Cold intolerance (can’t tolerate the cold like those around you)
  • Constipation
  • Depression, mood swings
  • Irritability
  • Memory loss
  • Abnormal menstrual cycles, increased menstrual flow
  • Decreased libido
  • Infertility, miscarriages
  • Difficulty in concentrating
  • Thinning and/or falling out of sides of eyebrows
  • Puffy, swollen face and dull facial expressions
  • Hoarse voice and slow speech
  • Goiter (swelling of the thyroid gland)
  • Non-pitting edema (swelling)
  • Pitting edema (swelling) of the feet

Patient may have any kind of combination of the symptoms mentioned above depending on the duration and severity of the condition. Occasionally patient may be asymptomatic or may be having very subtle symptoms.

Diagnosis of Underactive Thyroid (Hypothyroidism)

Diagnosis of hypothyroidism can be established based on the results of tests done to measure the levels of these hormones in the blood. Commonly T4 and TSH in blood are measured. Since hypothyroidism is about deficiency or low levels of thyroid hormones, T4 (and T3) levels in the blood are below normal. TSH levels are high in case of Primary hypothyroidism and this can be explained as follows. Since the thyroid is not able to produce adequate amounts of T4 and T3, the pituitary senses this and increases TSH (Thyroid stimulating hormone) production which stimulates the thyroid to increase T4and T3 production.

In case of secondary hypothyroidism, the pituitary gland itself fails to produce enough TSH and hence the levels of TSH as well asT4 and T3 will be below normal in the blood.

HormoneNormal levels
T3 (Triiodothyronine)80-180 ng/dl
T4 (Thyroxine)4.6-12 ug/dl
TSH (Thyroid Stimulating Hormone)0.5-6 uU/ml

Some important points to remember are:

  • Symptoms may not always correspond to the severity of the lab test abnormalities i.e. some patients may have severe hypothyroidism as revealed by their laboratory values but they may have very mild symptoms.
  • On the other hand, some patients may not have significantly abnormal values but they may be having significant symptoms.
  • It is important to remember that the treatment must not only correct the laboratory values but also make the patient feel better.
  • During the initial stages of Hypothyroidism, increased conversion of T4 to T3 occurs and hence T3 levels are maintained but T4 levels may be low to normal.

In order to diagnose Hashimoto’s Thyroiditis (as an etiology of primary thyroid failure), Anti-TPO antibody testing may be done. The Anti-TPO Ab which was previously referred to as the Antimicrosomal antibody (AMA) is a useful marker for the diagnosis and management of autoimmune thyroid disease.

Ultrasonography (USG) of the neck and thyroid can be used to detect nodules and infiltrative disease.

Complications of Underactive thyroid

If left untreated, hypothyroidism can lead to several other health issues.

  1. Goiter A goiter is an enlargement of the thyroid gland. The symptoms of goiter include:
    • Swelling in the throat, ranging from a small lump to a huge mass.
    • Swallowing problems, if the goiter is large enough to press on the oesophagus (food pipe).
    • Breathing problems, if the goiter is large enough to press on the trachea (windpipe).
  2. Heart ailments: Hypothyroidism may also be associated with an increased risk of heart disease, primarily because high levels of low-density lipoprotein (LDL) cholesterol- the ‘bad’ cholesterol can occur in people with an Underactive thyroid. Hypothyroidism can also lead to an enlarged heart and heart failure.
  3. Mental health: It may lead to slowness of the mental activity. Depression may occur early in hypothyroidism and may become more severe over time.
  4. Myxedema: This is a rare, life-threatening condition, which results due to prolonged, severe, untreated hypothyroidism. The symptoms include intense cold intolerance and drowsiness followed by profound lethargy and unconsciousness. The skin becomes dry and puffy.
    A more severe condition referred to as Myxedema coma, if occurs in any case, would call for immediate medical help.

Concerning females and child birth related issues

Infertility as well as miscarriage are the commonly encountered complications seen in females with untreated hypothyroidism. The babies born to women with untreated thyroid disease may have a higher risk of birth defects. These children are also more prone to serious intellectual and developmental problems.

Infants with untreated hypothyroidism present at birth are also at risk of serious problems with both physical and mental development. But if the condition is diagnosed within the first few months of life, the chances of normal development are excellent.

Myths and Facts about Underactive Thyroid (Hypothyroidism)

Homeopathy is simply herbal medicine.Not really. Homeopathy is much more than herbal medicine. It has medicines sourced from herbs, minerals, chemicals, animal products, organisms, etc. And, very importantly, it is backed by a sophisticated method of medicine preparation, sound scientific principles and deep philosophy.
Homeopathy cures all diseases.No system of medicine can cure all the diseases.
Homeopathy is a placebo therapy.Homeopathy is a proven therapy, used successfully for last 200 years in over 170 countries; supported by scientific studies. It shows once ignorance if one believes that homeopathy is placebo.
Homeopathy increases the disease before curing.Not really. Only some disease such as eczema might worsen, that too in less than 5% of cases, if medicines are not professionally prescribed. The whole idea of increase of disease before cure, is exaggerated.
Homeopathic medicines contain steroid or cortisone!It is absurd to even think that homeopathy may contain cortisone.
Homeopathy is very slow.Homeopathy is little slower than the convectional medicines; but not very slow. Since it deals with chronic and difficulty diseases, the course of treatment may seem slow and long.
Homeopathic medicines cannot be taken with the conventional (allopathic) medicines.Conventional medicines and homeopathic medicines can safely be taken together, with advantage, without any harm.
Homeopathy is very fast!It is not even very fast. It all depends on the nature of disease that is under treatment.
Homeopathy cures all diseases permanently.Not always, to be honest. Homeopathy gives lasting results for sure. The word permanent is theoretical, which cannot be promised for, in difficult diseases.
Coffee and onion cannot be taken during homeopathic treatment.Can be taken, keeping a gap of about half an hour.
Homeopathy can cure cancer, mental retardation, heart blocks, baldness (MPB), all surgical diseases, cataract, hernia, hydrocele, etc.Not true.
Investigations such as x-ray, blood test, MRI, etc. are not required for homeopathic treatment.All sort of investigations are required and useful for better and effective homeopathic treatment.
Diagnosis is not required for homeopathic treatment.Diagnosis helps to make better prescription of homeopathic medicines.
Homeopathic medicines are prescribed only on the mind symptoms of the patient.Not correct. Study of disease, diagnosis and mental attributes are studied in homeopathy.
Vitamins, iron-tonic, etc. should not be taken during homeopathic treatment.Can be taken. Tonics and supplements are part of homeopathic treatment!
Homeopathy is against surgery.Not really. Surgery is a part of homeopathy. Interestingly, some of the surgical diseases (life piles, fissure, tonsillitis, etc.) can be cured without surgery.

Best Homeopathic Doctor & Treatment for Underactive Thyroid in India. Just Call at +91 8264408264 and make an appointment. Get homeopathic treatment with Dr. Vikas Singhal. At Dr. Singhal Homeo, you can get an online video consultation in India, as well as in Lithuania, France, Spain, Italy, Macau, Thailand, Hong Kong, Nigeria, Australia, the United States, the United Kingdom, Scotland, Austria, Canada, and Singapore.

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