Treatment of hypothyroidism

Hypothyroidism is a condition characterized by insufficient production of thyroid hormones (triiodothyronine and thyroxine).


What are the possible complications of hypothyroidism?

If hypothyroidism is not treated, this can have consequences:
The risk of developing heart disease increases because a low thyroxine level causes an increase in blood lipids (for example, cholesterol).

The signs and symptoms of untreated hypothyroidism are becoming increasingly severe.
Continued stimulation of the thyroid gland to release more hormones can lead to enlargement of the thyroid gland (goiter). In addition, you can become more forgetful, some brain functions can slow down, including thinking, or you can fall into depression.
Advanced hypothyroidism (known as myxedema) is rare, but when it does occur, it can be dangerous.
Signs and symptoms include decreased blood pressure, decreased breathing rate and body temperature, apathy, and finally coma. In exceptional cases, myxedema can be fatal.

Hypothyroid or myxedematous coma (myxedema coma) is a very rare complication.
However, the prospects are excellent with proper treatment.
With therapy, the symptoms usually pass and complications develop very rarely.

Hypothyroidism in pregnancy

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

Untreated hypothyroidism can lead to spontaneous abortion, anemia, low birth weight, stillbirth of the child, detachment of the placenta, congenital malformations and severe bleeding after birth, premature birth and preeclampsia, i.e. a dangerous increase in blood pressure.
Untreated hypothyroidism during pregnancy can also affect the child’s growth and brain development. Thyroid medications help prevent these problems and can be taken safely during pregnancy.
Women with hypothyroidism should talk to the doctor about their condition before becoming pregnant.

Postpartum thyroiditis
This inflammation of the thyroid gland affects about 4-9% of women in the first year after childbirth.
It is believed to be an autoimmune disease that provokes hyperthyroidism for a period of 1 to 2 months.
Women with postpartum thyroiditis often develop hypothyroidism before the thyroid gland is completely healed. It is possible that the condition will recur in further pregnancies.
Postpartum thyroiditis is sometimes undiagnosed because the symptoms are confused with postpartum depression, such as fatigue and mood swings that sometimes follow the birth of a child.
If the signs of fatigue do not pass within a few months or if the woman develops postpartum depression, she should talk to the doctor.
If the symptoms of hypothyroidism cause great discomfort, the doctor may prescribe medication for the thyroid gland.

Diagnosis, examinations and tests for hypothyroidism

The doctor performs a physical examination and determines whether the thyroid gland is enlarged. Sometimes the thyroid gland is a normal size or smaller than usual. The investigation may show:

  • brittle nails,
  • coarser facial features,
  • pale or dry skin that feels cold,
  • arm and leg swelling,
  • fine and brittle hair.

Blood tests are also arranged to measure the thyroid hormones TSH and T4.
Investigations may also be carried out for:

  • Cholesterol
  • complete blood count,
  • liver enzymes,
  • Prolactin
  • Sodium.

What is the therapy for hypothyroidism?

Treatment consists in the daily administration of levothyroxine (thyroxine) in the form of tablets, among the most common prescribed drugs is Euthyrox.
This replaces thyroxine, which the thyroid gland does not produce. Many people feel much better at the beginning of treatment. It is best to take the tablet on an empty stomach (before breakfast), because some calcium or iron-rich foods may interfere with the absorption of levothyroxine in the intestine.
For the same reason, the levothyroxine tablet should not be taken at the same time as calcium and iron supplements.

When to start treatment?
Doctors recommend starting therapy as early as possible after diagnosis, but only as directed by a doctor.

What is the right dose of levothyroxine?
Most adults need a dose between 50 and 150 micrograms per day.
Sometimes a low dose is initially prescribed, especially for people over 60 years of age or for people with heart problems, but over time the dose is gradually increased.
The blood tests are usually done every 2-3 months and then the dose can be adjusted accordingly.
The blood analyses measure the TSH (thyroid stimulating hormone).

Once the TSH level in the blood is normal, it means that the correct dosage of levothyroxine has been reached.
It is then sufficient to check the TSH level once a year. The dose must be adjusted in the first stages of pregnancy. Older people may also need a lower dose of levothyroxine.

What to do if a tablet is forgotten?
Every now and then, everyone forgets to take the tablet. There is no need to worry about this, because it is not dangerous to skip a tablet once.
If you forget to take a dose, you should take it if you notice that only 2 or 3 hours have passed since the usual time of taking.
At the end of this period, the tablet should be omitted altogether and the next dose should be taken at the usual hour.
One should not take two doses together to replace the forgotten tablet. However, one should try to take levothyroxine regularly every morning to get the most benefit from it.

Age-related treatment of hypothyroidism for children and pregnant women
For most people, treatment lasts a lifetime. Rarely, hypothyroidism passes on its own, with the exception of the following cases:

  1. Sometimes hypothyroidism in children and adolescents is a temporary condition (this does not apply to children born with hypothyroidism).
  2. Some women develop an imbalance of the thyroid gland after the birth of the child.
    When this occurs, it usually happens three to six months after birth. Often this condition lasts only a few months and then passes again.
    Therapy is only required in a few cases. However, an annual blood test is indicated because there is a greater risk of developing autoimmune thyroiditis and long-term hypothyroidism in the future.

The sea
Sea air has a higher concentration of iodine, but to affect the thyroid gland, you have to swallow it. The sea air does not favor the thyroid gland.

Are there side effects or problems with the therapy?

Usually not.
The levothyroxine tablets replace a natural hormone of the body, so side effects are rare. However, with existing angina pectoris at the beginning of treatment with levothyroxine, anginal pain may worsen.

If too much levothyroxine is taken, symptoms and problems of an overactive thyroid gland may occur, for example, palpitations, diarrhea, irritability, sweating and an increased risk of developing osteoporosis.
The blood tests are used to determine whether the dose taken is correct.

Other drugs may interfere with the action of levothyroxine, for example: iron preparations, carbamazepine, phenytoin and rifampicin.
If you start taking one of these medications or change the dose of a medication, it may be necessary to change the dose of levothyroxine as well.
The doctor recommends the correct dose.
If warfarin is taken, it may be necessary to change the dose if the amount of levothyroxine is changed.

Natural remedies for hypothyroidism

There are no natural remedies to treat hypothyroidism, but diet can help.

What should you eat? Diet and nutrition for hypothyroidism
There are different diets. This article describes the basics of the blood type diet of Dr. D’Adamo and Dr. Mozzi. In addition, some advice from conventional medicine is integrated.

According to Dr. Mozzi and Dr. D’Adamo, one should choose certain foods based on a person’s blood type and avoid others.

In general, the most harmful foods to the thyroid gland are cereal products, especially if they contain gluten. But desserts and fruit can also be harmful.
The inventors of the blood group diet recommend avoiding or limiting these foods as much as possible, especially as dinner. In addition, if you take them, you should be physically active in order to be able to process them.

Academic medicine
Experts recommend that people eat a balanced (and possibly weight loss-promoting) diet to absorb the most nutrients.

Dietary supplement
Iodine is an essential mineral for the thyroid gland. However, people with an autoimmune thyroid disease may be sensitive to the damaging side effects of iodine.
Taking iodine drops or foods that are high in iodine, such as algae, can worsen or cause hypothyroidism or hyperthyroidism.

Pregnant women need more iodine, about 250 micrograms a day, as the child removes iodine from the mother’s diet.
In the United States, about 7 percent of pregnant women do not absorb iodine from food or through supplemental vitamin supplements.
In order to meet the iodine requirement, iodized table salt, i.e. salt enriched with iodine, and iodine-containing prenatal vitamins should be used.

Long-term expectations (prognosis) in hypothyroidism

In most cases, with proper treatment, thyroid hormone levels return to normal.
You’ll probably have to take thyroid hormones for the rest of your life.

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