What is Hypothyroidism?

Hypothyroidism is a condition in which your thyroid gland doesn’t produce enough thyroxine. This leads to an underactive thyroid. It seldom causes symptoms in the early stages, but over time, untreated hypothyroidism can cause several health problems, such as obesity, joint pain, infertility and heart disease. Both men and women can have an underactive thyroid, although it’s more common in women. In the UK, it affects 15 in every 1,000 women and 1 in 1,000 men. Children can also develop an underactive thyroid.  Hypothyroidism is much more common than NETs and so it must be understood that even though the thyroid is an endocrine organ, any thyroid problems diagnosed before or after NET may well be unconnected with NETs. 

What causes Hypothyroidism?

• Autoimmune thyroid disease is sometimes called Hashimoto’s thyroiditis
• Radioactive iodine or surgery to correct hyperthyroidism or cancer
• Over-treatment of hyperthyroidism with anti-thyroid drugs
• Some medicine 
• A malfunction of the pituitary gland

What are the symptoms of Hypothyroidism?

The signs and symptoms of hypothyroidism vary, depending on the severity of hormone deficiency. But in general, any problems you have tend to develop slowly, often over several years. At first, you may barely notice the symptoms of hypothyroidism, such as fatigue and weight gain, or you may simply attribute them to getting older. But as your metabolism continues to slow, you may develop more obvious signs and symptoms. Hypothyroidism signs. Below are major symptoms associated with hypothyroidism:

• • Fatigue
  • Weakness
  • Weight gain or difficulty losing weight (despite reduced food intake)
  • Coarse, dry hair and dry skin
  • Hair loss
  • Sensitivity to cold
  • Muscle cramps and aches
  • Constipation
  • Depression
  • Irritability
  • Memory loss
  • Abnormal menstrual cycles
  • Decreased libido
  • Slowed speech (severe cases)
  • Jaundice (severe cases)
  • Increase in tongue size (severe cases)

Check out this excellent short video from WebMD – click here or the picture below.  It’s based on the USA outlook but most of it is relevant globally.

You don’t have to encounter every one of these symptoms to be diagnosed with hypothyroidism. Every patient’s experience with the disorder is different. While you may notice that your skin and hair have become dry and rough, another patient may be plagued more by fatigue and depression.

When hypothyroidism isn’t treated, signs and symptoms can gradually become more severe. Constant stimulation of your thyroid gland to release more hormones may lead to an enlarged thyroid (goiter). In addition, you may become more forgetful, your thought processes may slow, or you may feel depressed.

Some of these symptoms look very familiar to me mainly because I see these listed many times in threads in my private Facebook group where people automatically related them to NET syndromes, and while that may be right in some cases, it really is that jigsaw thing again.

I guess it’s possible that people are borderline hypothyroidism prior to taking somatostatin analogues and the drug pushes them out of range (similar to what it’s known to do with blood glucose levels and diabetes). I’m not suggesting a direct clinical link in all cases but what I am suggesting is that perhaps some of the answers might be found in checking Thyroid hormone levels.

What are the Thyroid Hormone tests for Hypothyroidism?

A high thyroid-stimulating hormone (TSH) level with a low thyroxine (T4) level indicates hypothyroidism. Rarely, hypothyroidism can occur when both the TSH and T4 are low. A slightly raised TSH with a normal T4 is called subclinical, mild, or borderline hypothyroidism. Subclinical hypothyroidism can develop into clinical or overt hypothyroidism

Routine ‘Thyroid blood tests’ from your doctor will confirm whether or not you have a thyroid disorder. I now test for TSH (thyroid-stimulating hormone), T4 every 6 months. Mostly in range but recently TSH is spiking out of range and T4 is consistently at the lower end of the normal range.

In USA, I have noted that some patients say they also get tested for something called “Free T4”.  While T4 is the main form of thyroid hormone circulating in the blood. A Total T4 measures the bound and free hormone and can change when binding proteins differ (see above). A Free T4 measures what is not bound and able to enter and affect the body tissues. Tests measuring free T4 – either a free T4 (FT4) or free T4 index (FTI) – more accurately reflect how the thyroid gland is functioning when checked with a TSH.  Whether that is routine or not is not clear. 

Can hypothyroidism be treated?

Yes. A synthetic version of thyroxine is taken daily as prescribed. e.g. Levothyroxine tablets