Hypothyroidism is a disease characterized by an abnormally low production of thyroid hormones (triiodothyronine and thyroxine).


What are the possible complications of hypothyroidism?

If hypothyroidism is not treated, 
an increased risk of developing heart disease may occur . This is because a low thyroxin level causes the increase of lipids in the blood (for example cholesterol).


During pregnancy , there is an increased risk of developing complications such as pre-eclampsia, anemia, preterm birth, low birth weight, stillbirth and severe postpartum haemorrhage.

Signs and symptoms of untreated hypothyroidism may become more severe gradually. 
The constant stimulation of the thyroid gland to release more hormones can cause an enlarged thyroid (goiter). In addition, if memory can be partially lost, some brain functions may slow down including thinking and can also cause depression. 
Advanced hypothyroidism (known as myxedema) is rare, but when it occurs it can be dangerous. 
Signs and symptoms include low blood pressure, decreased respiratory rate and body temperature, apathy and even coma. In extreme cases, myxedema can be deadly.

Coma with hypothyroidism or myxomatosis (coma due to myxedema) is a very rare complication. 
However, with the treatment, the prospective is excellent. 
With treatment, the symptoms usually go away and it is very rare to develop complications.


What happens to thyroid disease in pregnancy?

During pregnancy, hypothyroidism is usually caused by Hashimoto’s thyroiditis and occurs in 3/5 in 1,000 women.

Untreated hypothyroidism can cause miscarriage, premature delivery and preeclampsia, a dangerous increase in blood pressure, edema and proteinuria during pregnancy. 
Untreated hypothyroidism during pregnancy can also affect the growth and development of the child’s brain. 
Thyroid medications can help prevent these problems and are safe during pregnancy. 
Women with hypothyroidism should talk about the disease with their doctor before getting pregnant.

Post-partum thyroiditis
This thyroid inflammation affects about 4-9% of women in the first year after giving birth. 
Doctors think this is an autoimmune disease that causes hyperthyroidism lasting 1 to 2 months. 
Women with postpartum thyroiditis often develop hypothyroidism before the thyroid gland completely heals. The disease probably returns in future pregnancies. 
Postpartum thyroiditis is not diagnosed at times because the symptoms are confused with postpartum depression , tiredness, and moodiness that sometimes follow the child’s birth. 
If symptoms such as tiredness and fatigue do not pass within a few months, or if a woman has developed postpartum depression, talk to the doctor.
If the symptoms of hypothyroidism are causing a lot of discomfort, the doctor may prescribe medications for the thyroid.


Diagnosis, exams and tests for hypothyroidism

The doctor does a physical examination and checks if the thyroid is enlarged. Sometimes the gland is normal in size or smaller than normal. The exam may also reveal:

  • Nails weak and brittle,
  • Cruder facial features,
  • Pale or dry skin that may be cold to the touch,
  • Swelling of the arms and legs,
  • Fine and fragile hair,

Blood tests are ordered to measure the thyroid hormones, TSH and T4. 
Tests may be done to check:

  • Cholesterol levels,
  • Complete blood count (CBC),
  • Liver enzymes,
  • prolactin,
  • Sodium.


What is the treatment for hypothyroidism?

The treatment involves taking levothyroxine (Sinthroid) in tablets daily, among the most prescribed medications are Eutirox. 
This replaces the thyroxine that the thyroid gland is not producing. Many people feel much better immediately after starting treatment. It is best to take the tablet on an empty stomach (before coffee) because some foods rich in calcium or iron may interfere with the absorption of levothyroxine in the intestine. 
For the same reason, we can not take levothyroxine tablets at the same time as taking calcium or iron supplements.


When is it necessary to start treatment?

The doctor recommends starting the treatment as soon as possible after the diagnosis, but only if the doctor prescribes it.


What is the correct dose of levothyroxine?

Most adults need a dose of 50 and 150 micrograms per day. 
Sometimes a low dose is prescribed at the start, especially over the age of 60 or for people with heart problems, but over time gradually increases. 
Blood tests are usually done every 2-3 months and the dose can be adapted accordingly. 
Blood tests measure TSH.

Since the blood TSH level is normal, it means that you are taking the right amount of levothyroxine . 
Then it is sufficient to check the level of TSH in the blood once a year. 
The dose should be adjusted in the early stages of pregnancy. 
In addition, the elderly may need a reduced dose of levothyroxine.


When you forget a pill, what should I do?

Almost everyone forgets to take a pill once in a while. 
Do not worry because forgetting a pill is not dangerous. 
When a person forgets to take a dose, take it immediately as soon as it comes into your mind if it has only been 2 or 3 hours past the normal time. 
During this time, skip the missed dose and take the next one at the usual time. 
Do not take two doses together to make up for a forgotten tablet. 
However, it is best to try to take levothyroxine regularly every morning for maximum benefit.

Treating Hypothyroidism According to Age for Children and During Pregnancy
For most people, treatment lasts a lifetime. Rarely, hypothyroidism passes by itself. 
This event is rare except in the following cases:

1. Children. Sometimes hypothyroidism is a temporary condition in children and adolescents. (This does not occur in children who are born with hypothyroidism.) 
2. Pregnancy. Some women develop thyroid imbalance after childbirth. This usually occurs about three to six months after birth. Often this only lasts a few months and then passes. 
Treatment is only necessary in some cases. However, it is best to take an annual blood test because there is a greater risk of developing autoimmune thyroiditis and hypothyroidism in the long run in the future.

The sea Sea
air has a higher concentration of iodine, but to influence the thyroid, this mineral must be swallowed, so the sea air does not give benefits to the thyroid.


Are there side effects or problems for treatment?

Usually not. 
Levothyroxine tablets replace a natural hormone in the body, so side effects are rare. 
However, in case of angina when starting to take levothyroxine, pain caused by angina worsens.

When you take too much levothyroxine, you may have symptoms and problems with an overactive thyroid, such as palpitations, diarrhea , irritability, sweating, and increased risk of developing osteoporosis. 
For this you need to have blood tests to see if you are taking the correct dose. 
Other medications may interfere with the action of levothyroxine, for example: iron supplements, carbamazepine, phenytoin, rifampicin. 
If you start taking any of these medicines, or change the dose, you may need to change the dose of levothyroxine.

The doctor will recommend the right dose. 
In addition, anyone who takes warfarin may need to change the dose when the amount of levothyroxine taken changes.


Natural Remedies for Hypothyroidism

There are natural remedies to treat hypothyroidism, but diet can help.


What to eat? Diet and food

There are different types of food, in this article are the guidelines of the blood type diet of Dr. D’Adamo and Mozzi , are also included the advice of conventional medicine.

According to Dr. D’Adamo and Mozzi, depending on the blood type of the person, one must choose certain foods, but avoid others. 
In general, foods that are most harmful to the thyroid are cereals, especially those with gluten, but also sweets and fruits. 
Creators of the blood-type diet advise to avoid or minimize these foods, especially for dinner, so people who eat them should also do physical activity to eliminate them.

Conventional Medicine
Experts recommend following a balanced  (and possibly slimming) diet  to ingest most nutrients .

During pregnancy and lactation it is not possible to take medicines, so be careful about the following diet.

Food supplements
Iodine is an essential mineral for the thyroid. However, people with autoimmune thyroid disease may be susceptible to harmful side effects of iodine. 
Taking drops of iodine or eating foods that contain large amounts of iodine, such as algae, can cause or worsen hypothyroidism.

Women need more iodine when they are pregnant, about 250 micrograms per day, given that the child takes iodine from the mother’s diet. 
In the United States, about 7 percent of pregnant women do not absorb iodine from food or vitamin supplements. 
To meet the need for iodine, you need to take iodized salt, salt supplemented with iodine and prenatal vitamins containing iodine.


How long, expectations, recovery and prognosis

In most cases, thyroid hormone levels return to normal with proper treatment. 
You probably have to take thyroid medications for life.

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