Hypothyroidism

This is under-activity of the thyroid gland. Blood thyroxine levels are low and TSH levels are high. 1-2% of the population are affected. Women are affected 10 times more than men. Older patients are affected and the condition is rare before 30 years of age.

Clinical features may include:

  1. lethargy.
  2. sleepiness.
  3. poor appetite.
  4. constipation.
  5. weight gain.
  6. dry skin (possibly with a yellow tinge).
  7. dry hair and hair loss.
  8. puffiness around the eyes.
  9. stiff or aching muscles.
  10. cold intolerance.
  11. other disorders include heavy periods and carpal tunnel syndrome.

Causes include:

bulletCongenital - present in 1 in 4,000 births and is associated with delayed mental and physical growth.
bulletLack of iodine in diet - was a common problem ('Derbyshire neck').
bulletChronic autoimmune thyroiditis (Hashimoto's thyroiditis).
bulletDestructive treatment for hyperthyroidism or goitres.
bulletDrugs such as lithium and amiodarone.
bulletAs a result for pituitary disease (low blood levels of TSH)

 

TREATMENT

Thyroxine is given as a daily dose. Blood tests on a regular basis ensure that enough is being given.

Symptoms should improve within 3 weeks of treatment. When patients with angina start treatment their angina may worsen - they must start at very low doses and build up.

Mr. H.S. Khaira  MD, FRCS.
Copyright © 2001  [H.S. Khaira]. All rights reserved.
Revised: October 24, 2004 .