Why Choose Cedars-Sinai Marina del Rey Hospital for Hypothyroidism Treatment?
Hypothyroidism, also known as an underactive thyroid gland, means that the thyroid gland can't produce enough hormones to keep the body running normally. The body’s metabolism - or the way the body uses energy - is affected when it's deficient in certain thyroid hormones. When symptoms of a thyroid disorder occur, you should consult an endocrinologist specializing in deficient levels of thyroid hormones. Endocrinologists at Cedars-Sinai Marina del Rey Hospital are among the best in Los Angeles at diagnosing and treating thyroid disorders, including hypothyroidism.
Hypothyroidism exists when the thyroid gland - found in the front of the neck below the larynx, or voice box - does not produce enough thyroid hormones to meet the needs of the body. The thyroid produces the triiodothyronine and thyroxine (T3 and T4) hormones. These affect the following functions:
When there's too little thyroid hormone in the blood, parts of your body slow down, causing mental and physical sluggishness. Untreated hypothyroidism may lead to anemia, obesity, joint pain, low body temperature, and heart failure, among other conditions.
At present, endocrinologists cannot cure hypothyroidism but, in most cases, can help people manage it appropriately. With appropriate treatment, thyroid hormone levels can return to normal.
The patient may need to take medicine that replaces lost thyroid hormones. One of the most commonly used treatments for hypothyroidism is using synthetic versions of thyroid hormones.
Treatment for hypothyroidism depends on the patient's history, symptoms, current thyroid-stimulating hormone (TSH) level, age, and general health. It also depends on how severe hypothyroidism is.
Patients need follow-up blood tests to determine if the dosage of synthetic hormones needs to be adjusted, but the frequency of blood tests will likely decrease over time. The drug dose will likely be required for the rest of the patient's life. Patients should always check with the healthcare provider before switching brands of medicine.
Iodine and Nutrition
Iodine is an essential mineral for thyroid function. Maintaining adequate iodine intake is especially important for those with autoimmune thyroid disease. Those suffering from this condition can be especially sensitive to the effects of iodine, meaning that it can lead to or worsen hypothyroidism. As such, iodine deficiency is one of the most common causes of goiter development or abnormal enlargement of the thyroid gland.
If hypothyroidism is caused by an iodine deficiency, the endocrinologist may recommend an iodine supplement. Additionally, magnesium and selenium supplements may help improve the condition.
People with hypothyroidism should discuss any major dietary changes with their endocrinologist, especially when eating lots of soy and cruciferous vegetables, or starting a high fiber diet.
Diet can affect how the body absorbs thyroid medication. During pregnancy, iodine requirements increase. Using iodized salt in the diet and prenatal vitamins can maintain sufficient iodine intake.
The types of hypothyroidism are classified according to the degree of thyroid failure.
- Grade I hypothyroidism or clinical hypothyroidism is associated with abnormally low levels of the hormone, an enhanced TSH response to thyrotropin-releasing hormone (TRH), and elevated basal TSH levels. This form of hypothyroidism is characterized by evident clinical symptoms of thyroid hormone deficiency.
- Grade II hypothyroidism is not characterized by the classic symptoms of clinical hypothyroidism. Peripheral thyroid hormone levels are within normal limits, but both TRH-stimulated and basal TSH levels are elevated abnormally.
- In grade III hypothyroidism there are no clinical features of hypothyroidism, normal circulating levels of thyroid hormone, and basal TSH, but an abnormally elevated TSH response to TRH.
Symptoms of Hypothyroidism
As thyroid hormones affect multiple organ systems, the symptoms of this condition are diverse and wide-ranging. Symptoms often may go unnoticed for a long time, develop slowly, and vary a great deal between individuals. They may be vague and general and be mistaken for other health problems. A blood test is the only way to get a concrete diagnosis.
Here is a list of the most common hypothyroidism symptoms:
If hypothyroidism develops in children or teenagers, the symptoms are generally the same as in adults. However, children or teenagers may also experience:
Diagnosis of Hypothyroidism
At Cedars-Sinai Marina del Rey Hospital, the patient will meet with an endocrinologist who will ask about their past health and perform a comprehensive physical exam, and sent blood tests to a laboratory for analysis.
Blood tests can measure the amount of thyroid hormone, thyroid-stimulating hormone, and antibodies that attack your thyroid gland.
Laboratory tests to determine thyroid function include:
- The TSH test. This detects the amounts of TSH in the blood and helps indicate whether the thyroid is working correctly. When the test results are above normal, the patient may have hypothyroidism. When the results are below normal, the patient may have hypothyroidism or hyperthyroidism.
- Measurements of the two forms of thyroid hormone, T4, and T3 to fully establish the health and activity of the thyroid gland.
- Autoantibody testing can further confirm the diagnosis or determine its cause.
The doctor may also run tests to check cholesterol levels, liver enzymes, prolactin, and sodium.
Risk Factors for Hypothyroidism
The likelihood of hypothyroidism increases when the patients:
Although hypothyroidism affects mostly women from middle age onward, it can occur at any age.
Causes of Hypothyroidism
Hypothyroidism can occur if the thyroid gland does not work properly or is not stimulated by the pituitary gland or the hypothalamus.
- Hashimoto’s thyroiditis. This is the most common cause for hypothyroidism in the U.S. Hashimoto’s is an autoimmune disease, a disorder in which the immune system attacks the body’s organs and cells, including the thyroid, leading to inflammation and interfering with its ability to produce hormones. The immune system makes antibodies against the thyroid gland, and white blood cells and scar tissue overrun the normal thyroid cells.
- Thyroid surgery and treatment for an overactive thyroid gland. Including radioactive iodine therapy or surgery. Several conditions such as thyroid cancer, hyperthyroidism, goiters, and thyroid nodules can be treated by removing the thyroid gland partially or fully. This may cause hypothyroidism. Radioactive iodine therapy is a common treatment for hyperthyroidism, head and neck cancers, Hodgkin’s disease, and other lymphomas, but it can lead to damage of the thyroid gland.
- Hypothyroidism may develop shortly after pregnancy.
- Congenital hypothyroidism. In cases of congenital hypothyroidism, the child is born with a thyroid that does not function properly. This can lead to physical and mental growth problems, affecting the baby’s brain and nervous system but early treatment can prevent these complications. Most newborns in the U.S. are screened at birth for hypothyroidism.
- Thyroiditis. This is an inflammation of the thyroid gland that causes thyroid hormones to leak into the blood, raising their overall levels and leading to hyperthyroidism. After one to two months, this may develop into hypothyroidism. Viral or bacterial infection, an autoimmune condition, or pregnancy can lead to thyroiditis.
- Medication. Several drugs can interfere with thyroid hormone production, including interferon-alpha, amiodarone, interleukin-2, lithium, and tyrosine kinase inhibitors.
- Pituitary gland abnormalities. Pituitary tumors or pituitary surgery can affect the function of the pituitary gland, and the thyroid gland may not produce the correct amount of thyroid hormone. For example, Sheehan’s syndrome involves damage to the pituitary gland. When a woman has severely low blood pressure during or after childbirth or loses a life-threatening amount of blood, the thyroid can be damaged, causing it to under-produce pituitary hormones.
- Iodine imbalance. Iodine from food is necessary for the production of thyroid hormones. However, too much or too little iodine can lead to hypothyroidism or hyperthyroidism. Therefore, the level must be balanced.
Although they won't help patients control hypothyroidism, natural remedies can make them feel better and lower their stress. Patients need to make sure to keep up with the medication prescribed by the endocrinologist. Here are some recommended natural treatments:
- Keep up a healthy diet. For a well-balanced diet follow the healthy eating guide recommended by the American Association of Clinical Endocrinologists. The key to eating well is balance and it can ward off disease.
- Acupuncture. This may improve symptoms. It can also help the body respond to regular treatment and it's good for the immune system.
- Yoga. This practice is good for relaxation. Although it hasn't been scientifically proven, yoga could improve blood flow to the thyroid.
- Meditation: This may also help with relaxation. There's no risk as long as patients continue with their regular hypothyroidism treatment.
The FDA doesn't regulate natural thyroid products. So it's better to stay away from these products. What's more, dosing is not consistent.
There is no way to prevent hypothyroidism, but people who may have a higher risk of thyroid problems, for example, women over 60 or pregnant women should check with their doctor about the need for additional iodine.
For any questions, information, or guidance related to hypothyroidism, consult the endocrinologists at Cedars-Sinai Marina del Rey Hospital.