Hypothyroidism


T3, T4 & TSH are thyroid hormones. T3 & T4 are thyroid gland hormones while TSH (Thyroid Stimulating Hormone) is a pituitary gland hormone. As name suggests TSH stimulates thyroid gland. TSH is more sensitive hormone for thyroid sufficiency than T3 & T4. Hence it is more used than T3 & T4 for diagnosis and monitoring of thyroid disorders. It has inverse relation with T3 & T4.

All hypothyroidism patients will have classical symptoms of hypothyroidism. Classical symptoms of hypothyroidism like puffiness of face, swelling all over the body, lethargy, dullness, weakness, muscle pain, leg cramps, dry and rough skin, excess hair fall, weight gain, menstrual problems etc are seen mainly with moderate to severe hypothyroidism (Serum TSH more than 15 miu/l).

Hyothyroidism leads to continuous weight gain. Moderate to severe hypothyroidism (Serum TSH more than 25 miu/l) when first time detected is associated with moderate weight gain of 2-6 kgs. However after using thyroxine when Serum TSH is stabilized hypothyroidism does not contribute to weight gain.

A lady with thyroid cannot conceive: On the contrarily hypothyroidism is the commonest treatable cause for female infertility. Chances of pregnancy increase several fold once hypothyroidism is corrected. Lady must continue thyroxine even during pregnancy. Thyroxine requirement often increase during pregnancy.

A lady with hypothyroidism gives birth to hypothyroid baby: It generally does not happen. Baby can have increased risk of hypothyroidism in future due to genetic factors. But vertical transmission does not happen.

Once you get thyroid, it is for ever: By & large it is correct but not always true. Some of the hypothyroidism cases are reversible like borderline (sub clinical) hypothyroid cases, hypothyroidism during critical illness and drugs related hypothyroidism.

Thyroxine medicine can be taken anytime of the day. Ideal time for thyroxine medicine is early morning, empty stomach. At least ½ hour – 1 hour gap should be given between medication and breakfast. More than ½ hour gap is alright. Some studies are there to show equal efficacy of thyroxine when taken bed time.

Thyroxine has lot of side effects: Right dose of thyroxine is virtually side effects free. Over dosage of thyroxine can cause hyperthyroidism like features e.g. palpitation, increased sweating, weight loss and irritability. Rapidly corrected hypothyroidism can sometimes precipitate angina in elderly people and increased intra cerebral pressure in children.

Thyroid medicines are risky during pregnancy: Thyroid medicines are absolutely safe during pregnancy. In hypothyroid lady thyroxine has several beneficial effects for mother as well as baby like reducing risk of abortion and other pregnancy related complication while it improves IQ (intelligence) in baby if mother takes right dose of thyroxine.

Thyroid surgery can cure any thyroid disorder, including hypothyroidism: Surgery is usually not required in hypothyroidism cases. There is no surgical cure for primary hypothyroidism.

Children with thyroid deficiency cannot live normal adult life: With right dosage of thyroxine and regular treatment, children get normal height, pubertal development and normal future adult life.