Thyroid: Causes, diagnoses and treatment

By: Lifestyle Reporter

World Thyroid Day falls on the 25th of May, a day dedicated to raising awareness about thyroid disease, which can have a serious impact on one’s quality of life if not managed correctly.

The thyroid gland is located in the front of the neck and is responsible for making hormones that are important for different systems in the body to function properly. Thyroid disease is a common health problem and can affect anyone, although some people are more likely to get thyroid disease, such as those who have a relative with thyroid disease and those who have type 1 diabetes mellitus or autoimmune arthritis.

What causes thyroid disease?

There are many types of thyroid disease. When the thyroid is overactive and makes too much thyroid hormone, it can result in a condition called hyperthyroidism, and when the thyroid is underactive, too little thyroid hormone is made and this is called hypothyroidism.

The most common cause of hypothyroidism is when the immune system damages the thyroid gland, called autoimmune thyroiditis or Hashimoto’s thyroiditis. Iodine deficiency is another reason for the development of hypothyroidism and as many as nine percent of women will have an underactive thyroid for a while after giving birth. However, this is usually temporary.

Dr Sindeep Bhana, Head of Endocrinology at Chris Hani Baragwanath Hospital, says that he is soon to publish the results of a recently conducted clinical study in South Africa on the prevalence of hypothyroidism, which shows a local demographic variability in thyroid disease.

What are the signs and symptoms of hypothyroidism?

Signs and symptoms of an underactive thyroid usually develop slowly and are the same as those for many other health conditions. Some symptoms include tiredness, weight gain, constipation, depression, muscle aches and cramps, dry and scaly skin, brittle hair and nails, hair loss, irritability, loss of the outer third of the eyebrows, and abnormal menstrual cycles.

How is hypothyroidism diagnosed and treated?

It is very important that an underactive thyroid is diagnosed as soon as possible. This cannot be diagnosed by symptoms only, because these are easily confused with those of other health conditions, and it is for this reason that a blood test is needed to see how well the thyroid is working. High levels of thyroid stimulating hormone in the blood show that the thyroid is underactive and this is usually treated by taking daily thyroid hormone replacement tablets, called levothyroxine. Levothyroxine starts to work straight away, but it takes a few weeks before symptoms improve. Usually, a low dose of levothyroxine is prescribed and this may be increased depending on how well the symptoms improve.

Dr Sundeep Ruder, an Endocrinologist in practice at Life Fourways Hospital, says: “The patient who has recently been diagnosed with hypothyroidism and is starting treatment should be under the guidance of a doctor who is experienced in thyroid medicine and who will give advice on when and how to take the medicine. Those starting levothyroxine will have to have their blood levels checked after six to eight weeks of treatment so that the doctor can make sure to get the thyroid hormone levels right.” Levothyroxine will usually need to be taken for the rest of your life. “Side effects are rare, and generally, the treatment is well tolerated by most people,” says Dr Ruder.

READ: Is your thyroid gland overactive? – It could be Hyperthyroidism

The importance of knowing how to take thyroid hormone replacement therapy properly

Levothyroxine must be taken regularly and at the same time each day to keep the hormone levels stable. If a dose is missed or not taken properly, changes in hormone levels may cause symptoms to come back. Levothyroxine should be taken on an empty stomach with water, one hour before breakfast, because food and beverage, especially coffee, can interfere with its absorption.

Similarly, taking thyroid treatment at the same time as medicines for other conditions may cause changes in thyroid hormone levels. It is always important, when using more than one medicine, to ask the pharmacist or doctor about how to take them properly and safely. Common medicines to watch out for are iron and calcium supplements, many natural remedies and medicines that are used for stomach acid and reflux.

If damage to the thyroid gland continues over time, the dose of the levothyroxine will have to be adjusted regularly. There are many factors that can affect thyroid hormone levels and Dr Bhana therefore recommends checking thyroid hormone blood levels two or three times a year.

Patients who are already taking levothyroxine may get symptoms of hypothyroidism or hyperthyroidism (heart beats faster, weight loss without trying to lose weight, and a feeling of nervousness). In this case, Dr Bhana advises that they contact their doctor and do a thyroid hormone blood test. Dr Bhana says: “The blood test will confirm whether the symptoms are because the levothyroxine dose needs changing or if there is a different reason such as poor diet, stress or a lack of the vitamins D and B12 or iron.”

If you are currently on treatment for hypothyroidism and are experiencing any symptoms, speak to your doctor for advice.

Written by: Poelano

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