Hypothyroidism occurs when the thyroid gland does not produce enough of the thyroid hormone. This deficiency causes different symptoms such as fatigue, sensitivity to cold, constipation or muscle weakness. Hypothyroidism is treated by administering the thyroid hormone in the form of medication.
The thyroid at a glance
The thyroid is a small, butterfly-shaped organ located in the neck area, and is responsible for the production of vital hormones. Among other things, these hormones control the body’s metabolism and influence growth and development.
What is the thyroid important for?
The thyroid hormones regulate heart rate, digestion, mental state and body temperature. The balance of these hormones is essential for health and everyday wellbeing.
Definition and explanation of hypothyroidism
Hypothyroidism occurs when the thyroid does not produce enough of these critical hormones. This leads to a slower metabolism and other symptoms.
The thyroid produces three critical hormones that are essential for regulating various body functions:
- Thyroxine (T4): The main product of the thyroid gland, which is produced in large quantities. It plays a central role in regulating metabolism and influences growth and development.
- Triiodothyronine (T3): This hormone is more active than T4 and has a faster impact on the body. It is mainly produced by converting T4 into T3 in peripheral tissues.
- Calcitonin: Is involved in regulating calcium and phosphate levels in the blood and therefore plays an important role in bone health.
Causes and risk factors for hypothyroidism
Hypothyroidism occurs in different forms, which can result from many causes.
Primary hypothyroidism
This form results directly from problems with the thyroid itself.
Primary hypothyroidism can be caused by several factors that have a direct influence on thyroid function. One common cause is autoimmune thyroid inflammation, also known as Hashimoto’s thyroiditis, in which the immune system mistakenly attacks and damages thyroid cells. Other causes include a low-iodine diet, thyroid surgery, radiation in the neck area or congenital thyroid abnormalities and disorders.
Secondary hypothyroidism
This form often results from a dysfunction of the pituitary gland, which stimulates the thyroid.
Secondary hypothyroidism occurs when the pituitary gland does not produce enough thyrotropin (TSH) to stimulate hormone production by the thyroid. Causes include tumours of the pituitary gland or hypothalamus, head injuries, severe diseases, radiotherapy in the head area and certain medications that impair pituitary function. Genetic factors also play a role.
Tertiary hypothyroidism
This is a rare form that originates from a disorder in the hypothalamus.
Tertiary hypothyroidism is a rare disease caused by a dysfunction in the hypothalamus. Causes may include tumours, trauma or inflammation in the hypothalamus. Genetic diseases or defects in the signalling pathways between the hypothalamus, pituitary gland and thyroid can also trigger this form of hypothyroidism. It often occurs when the hypothalamus does not produce enough TRH, leading to reduced TSH levels by the pituitary gland and as a result, reduced hormone production.
Symptoms in adults
Tiredness, cold intolerance, weight gain despite unchanged eating habits, dry skin, hair loss, slow heart rate, cognitive impairment such as memory impairment or reduced ability to concentrate.
Symptoms in adolescents
Slower development of puberty, irregular menstrual cycles in girls, general states of exhaustion.
Symptoms in children
Delays in physical development, reduced growth rate, late puberty, intellectual impairments or learning difficulties.
If left untreated, hypothyroidism can lead to serious health problems. It can initially manifest itself in the symptoms described, which significantly affect quality of life. In the long term, however, untreated hypothyroidism can lead to more serious complications such as heart disease, peripheral neuropathy and, in rare cases, life-threatening myxoedema coma. A slower heart rate can increase the risk of heart disease, while low metabolism can lead to a build-up of LDL cholesterol in the blood. It is therefore extremely important to diagnose and treat hypothyroidism early on to avoid more serious health problems.
Myxoedema and myxoedema coma
Severe forms of hypothyroidism can lead to myxoedema, a condition characterised by swelling in the tissues. In the worst case, myxoedema coma, a life-threatening condition that requires immediate medical attention, may develop.
Diagnosis of hypothyroidism
Diagnosis is based on a combination of patient history, a physical examination and laboratory results.
History and physical examination
The doctor will ask about symptoms and perform a physical examination. They will pay particular attention to thyroid enlargement or dry, rough skin, as well as checking reflexes and heart sounds.
Blood tests (TSH, T4, T3)
Blood tests are crucial for measuring thyroid function. TSH, the hormone released by the pituitary gland, provides information on thyroid activity. If a subfunction is present, this value is elevated. The values for T4 and T3 are also measured as they directly indicate the function of the thyroid.
Ultrasound of the thyroid
An ultrasound examination (sonography) can help to better identify the cause of hypothyroidism. It allows any changes such as inflammation, cysts or nodes to be seen.
Treatment
Standard treatment usually consists of replacement therapy with synthetic thyroid hormones such as levothyroxine.
The treatment of hypothyroidism aims to compensate for the deficiency of the thyroid hormones and in doing so, to restore the body’s normal metabolic activities. This is usually done through lifelong hormone replacement therapy with levothyroxine, a synthetic thyroid hormone that is identical to the thyroxine (T4) produced by the body. Levothyroxine dosage is adjusted individually based on the patient’s age, weight, symptoms and blood values from thyroid function tests. Regular monitoring is necessary in order to adjust the dose if necessary. In some cases, and especially in secondary or tertiary hypothyroidism, treatment of the underlying cause may also be necessary.
Information on alternative and complementary treatments
Some patients may also benefit from alternative or complementary treatments. These often include a combination of lifestyle changes, such as a healthy diet and regular exercise, along with supplements containing certain nutrients that are important for optimal thyroid function. It is important to note that these methods should not be seen as a substitute for hormone replacement therapy, but rather as supportive measures.
The thyroid at a glance
The thyroid is a small, butterfly-shaped organ located in the neck area, and is responsible for the production of vital hormones. Among other things, these hormones control the body’s metabolism and influence growth and development.
What is the thyroid important for?
The thyroid hormones regulate heart rate, digestion, mental state and body temperature. The balance of these hormones is essential for health and everyday wellbeing.
Definition and explanation of hypothyroidism
Hypothyroidism occurs when the thyroid does not produce enough of these critical hormones. This leads to a slower metabolism and other symptoms.
The thyroid produces three critical hormones that are essential for regulating various body functions:
- Thyroxine (T4): The main product of the thyroid gland, which is produced in large quantities. It plays a central role in regulating metabolism and influences growth and development.
- Triiodothyronine (T3): This hormone is more active than T4 and has a faster impact on the body. It is mainly produced by converting T4 into T3 in peripheral tissues.
- Calcitonin: Is involved in regulating calcium and phosphate levels in the blood and therefore plays an important role in bone health.
Causes and risk factors for hypothyroidism
Hypothyroidism occurs in different forms, which can result from many causes.