Hypothyroidism: Causes, Symptoms, and Treatments

Hypothyroidism: Causes, Symptoms, and Treatments

Are you tired of being tired? That sluggish feeling that’s been following you around for the last few years may actually be a symptom of thyroid deficiency. Chronic fatigue doesn’t have to be a natural part of aging, neither does brain fog, muscle weakness, or weight gain. All of these might be the result of hypothyroidism.

The good news is there are plenty of natural ways to treat thyroid deficiency. Nutritional choices that reduce inflammation can be a huge help. The thyroid plays a major role in your overall health. By being aware of the causes and symptoms of hypothyroidism, you can start taking steps towards a healthier and more energetic life.

What Is Hypothyroidism?

Hypothyroidism is a condition where the thyroid gland is underactive. When your thyroid doesn’t produce enough thyroid hormones (TS3 and TS4), you can start to feel depressed, exhausted, experience muscle weakness, and have a hard time sleeping. TS3 (triiodothyronine) and TS4 (thyroxine) affect nearly every organ in the body, including the heart.

Thyroid hormones control metabolism (energy production) and regulate many of your body’s functions, including:

  • Body temperature
  • Heart rate
  • Body weight
  • Cholesterol levels
  • Central and peripheral nervous systems
  • Breathing
  • Cholesterol levels

It’s easy to see how thyroid disease can affect your health in so many different ways.

If you think you might have a thyroid deficiency, you’re not alone. Hypothyroidism affects roughly 4.6% of the U.S. population ages 12 and older. Rates may be even higher among women — affecting as much as 10%. [1]

How the Thyroid Works

Your thyroid doesn’t produce hormones on its own. It gets help from the pituitary gland and the part of the brain called the hypothalamus.
Here’s how these three parts of the body work together to produce thyroid hormones:
  1. The hypothalamus regulates the pituitary gland.
  2. The pituitary gland produces a hormone called thyroid-stimulating hormone (TSH). [2]
  3. TSH tells the thyroid how much TS3 and TS4 to produce.
  4. The thyroid synthesizes TS3 and TS4 from the amino acid tyrosine and iodine, a mineral found in certain foods. Thyroid cells are the only cells in the body that can absorb iodine.
  5. TS3 and TS4 are released into the bloodstream where they’re used throughout the body to control metabolism.

What Causes Hypothyroidism?

Before you start to correct hormonal imbalances and treat symptoms, it helps to understand how hypothyroidism develops in the first place. Thyroid deficiency can upset the chemical reactions in the body, but it doesn’t just happen overnight.

Hypothyroidism has two main causes:

1. Chronic inflammation: Inflammation can damage or kill thyroid cells. Inflammation from autoimmune disease is the most common cause of thyroid gland failure.
2. Poor reaction to medical treatments: This can include surgical removal of part of the thyroid, radiation therapy, treatments for hyperthyroidism (overactive thyroid), and other medications.

Other potential causes of hypothyroidism include:

  • Postpartum pregnancy (side effects of childbirth)
  • Iodine deficiency
  • Pituitary disease
Now let’s take a closer look at the most common causes of hypothyroidism.

1. Inflammatory Disorders

Chronic inflammation can be the underlying cause of many health problems. Thyroiditis, or inflammation of the thyroid, can cause thyroid hormones to leak out of the thyroid gland.
Inflammatory autoimmune conditions “…account for approximately 90% of adult hypothyroidism, mostly due to Hashimoto’s disease.” (3) When someone has Hashimoto’s disease, their immune system attacks the thyroid, causing the thyroid to become inflamed.
Why on Earth would your own antibodies attack your thyroid?
For some reason, the antibodies think that your thyroid cells aren’t actually part of your body, so they try to destroy them. The result is high levels of thyroid inflammation. Over time, chronic inflammation can damage and kill thyroid cells. Although inflammatory disorders are one of the most common causes of hypothyroidism, there are many others.

2. Thyroid Surgery

When doctors remove a piece of the thyroid, sometimes the body responds by developing hypothyroidism. [4]
Your doctor may decide to remove part of your thyroid to treat:
  • Thyroid cancer
  • A large goiter (growth on the neck due to thyroid dysfunction)
  • Thyroid nodules (non-cancerous lumps that produce too much thyroid hormone)
  • Hyperthyroidism
If too much of the thyroid is removed, you can develop a permanent thyroid deficiency.

3. Poor Diet

The thyroid gland needs nutrient-dense food in order to stay healthy. Iodine and selenium are especially important for producing thyroid hormones. Not only are these nutrients important for thyroid function, but you need them to reduce inflammation and manage oxidative stress in the body.
Iodine is essential for making thyroid hormones, so not having enough of it can lead to thyroid deficiency. Hypothyroidism due to iodine deficiency is rare in the United States, but is more common in less developed parts of the world.
Selenium has antioxidant properties in the body. If selenium levels fall too low, the master antioxidant glutathione may stop functioning properly. [5] Eating a diet full of nutrient-rich fruits and vegetables, fish, and healthy fats can support thyroid health.

4. Gut Inflammation

A poor diet can lead to leaky gut syndrome. Bacterial imbalances, toxin overload, high stress, and eating too much sugar can weaken the gut lining. When the gut lining is compromised, inflammatory agents can leak into the bloodstream and affect the thyroid.
The gut is your body’s first line of defense against inflammation. If it isn’t strong enough to act as a barrier against inflammation, autoimmune activity may increase. For this reason, people with autoimmune disorders tend to respond well to a low-inflammation diet.

5. Overreaction to Hyperthyroidism Treatment/Radiation Therapy

Radioactive iodine is a common treatment for hyperthyroidism, or overactive thyroid.
The goal of radioactive iodine is to kill just enough thyroid cells to return hormone levels to normal. However, too much radioactive iodine can cause hypothyroidism. In fact, a large percentage of patients who receive radioactive iodine treatment eventually develop thyroid deficiency. (6)
Radiation therapy for cancers in the neck, chest, and head can also damage the thyroid and cause hypothyroidism.

6. Medications

Several medications can contribute to hypothyroidism by interfering with thyroid production, including:
  • interferon alpha (cancer medication)
  • interleukin-2, (cancer medication)
  • lithium (bipolar disorder medication)
  • amiodarone (heart medication)
Make sure to ask your doctor if any of your medications can lead to thyroid deficiency.

7. Genetics

What causes hypothyroidism in infants? Doctors aren’t sure, but at least some children inherit it from their parents.
Babies born with hypothyroidism can develop intellectual disabilities and growth issues later in life. (7)
Many babies who are born with congenital hypothyroidism don’t display any signs at birth. With early treatment, most hypothyroidism complications can be prevented, which is why in the U.S. most infants are tested for hypothyroidism.  

8. Pregnancy

In the months following childbirth, some women experience postpartum thyroiditis (thyroid inflammation) that results in decreased thyroid hormone production. This condition is often triggered by antibodies produced in the thyroid gland.
“Especially at 3 to 8 months postpartum, the prevalence of hypothyroidism is very high, up to 2-4%…” (8)
Hypothyroidism can also occur during pregnancy. Thyroid disease increases the risk of miscarriage, premature delivery, and preeclampsia — a condition that can put the mother’s life at risk and endanger the health of the developing fetus.
Your doctor may prescribe thyroid medications to treat hypothyroidism during pregnancy.

Hypothyroidism Risk Factors

Anyone has the potential to develop hypothyroidism, but the elderly and people with a history of certain medical conditions are most at risk.
Hypothyroidism risk factors include:
  • Being a woman
  • Recent pregnancy
  • Older than 60 years of age
  • Radiation treatment to the thyroid, neck, chest, or head
  • Treatment with radioactive iodine
  • Treatment with hyperthyroid medications
  • History of a goiter or other thyroid-related conditions
  • Family history of thyroid disease
  • Type 1 diabetes
  • Turner syndrome (genetic disorder that affects women)
  • Anemia that’s caused by vitamin B12 deficiency
  • Sjögren’s syndrome (disease that causes dry mouth and eyes)
  • Lupus (chronic inflammatory disease)
  • Rheumatoid arthritis (autoimmune disease of the joints)
  • Celiac disease (autoimmune disease)
  • Partial surgical removal of the thyroid (9)

Symptoms of Hypothyroidism

For most patients, symptoms develop gradually over the course of several years, but they can also come on suddenly.

Common symptoms of hypothyroidism include:

  • Brain fog
  • Memory loss
  • Fatigue
  • Weight gain
  • Muscle weakness
As your metabolism continues to slow due to poor hormone production, you may begin to experience:
  • Difficulty concentrating
  • Depression
  • Getting cold easily
  • Muscle and joint pain
  • Dry skin and thinning hair
  • Heavy and frequent menstruation
  • Difficulty sleeping
  • Puffy face
  • High blood cholesterol
  • Bradycardia (slow heart rate)
  • Enlarged thyroid (goiter)
  • Constipation
  • Infertility
It can take a long time to be diagnosed with hypothyroidism because so many of the symptoms can be attributed to other causes, especially when it comes to fatigue, weight gain, brain fog, and depression.
One fact, however, almost always holds true — the longer your body goes without adequate thyroid hormones, the worse your symptoms may become. Although hypothyroidism is most common among the elderly, infants and young children can also be affected.

Symptoms of Hypothyroidism in Children and Infants

When babies are born with an underdeveloped thyroid, they may present with the following symptoms:
  • Difficulty breathing
  • Large, protruding tongue
  • Hoarse, rough-sounding cry
  • Jaundice (yellow skin and eyes)
  • Umbilical hernia
  • Chronic fatigue
  • Poor muscle tone
  • Constipation
  • Delayed teeth development
If left untreated, hypothyroidism in children can lead to mental disabilities, growth retardation, and delayed sexual development.

Hypothyroidism Diet

It’s never too early to start a diet that improves thyroid function. What are the best foods and supplements for a healthy thyroid? These foods support the thyroid and reduce inflammation.

1. Wild-Caught Fish

Fish like salmon and sardines are packed with iodine and other essential minerals that benefit the thyroid. Not only that, but they’re one of the best sources of the omega-3 fatty acids EPA and DHA. These nutrients are not only important for thyroid health, but they’re potent antioxidants. Omega-3’s improve mood stability and fight depression. EPA and DHA support the immune system while increasing neurotransmitter activity for a healthier brain and body.

2. Seaweed

Seaweed like kelp, nori, wakame, and kombu are high in iodine and have antioxidant properties. They taste great in soups and on sushi. Seaweed is one of the best food sources of iodine and can be an effective treatment for some types of hypothyroidism.

3. Fermented Foods

Fermented foods like kimchi, kefir, kombucha, sauerkraut, and other fermented veggies contain living probiotic cultures that are great for the gut. Probiotics are strains of bacteria that improve digestive health. A weak gut lining can exacerbate thyroid issues by allowing inflammation to seep into the bloodstream. Boost good gut bacteria and reduce inflammation with fermented foods.

4. Bone Broth

Bone broth is another food that supports thyroid health by reducing gut inflammation. It’s an excellent source of amino acids that help repair damage to the gut lining. Bone broth also contains high levels of minerals like phosphorous, calcium, and magnesium that heal the digestive tract. Bone broth has been shown to increase energy, reduce joint pain, and improve immunity all by healing the gut and reducing inflammation in the body.

5. Fruits and Vegetables

Fruits and vegetables contain vitamins and minerals that reduce oxidative damage. Just don’t go overboard with high-sugar fruits. Too much sugar, even from natural sources, can be bad for gut bacteria.

6. Coconut Oil

Coconut oil is an important food for any hypothyroidism diet. It nourishes the digestive system and reduces inflammation with its antibacterial, antimicrobial, and antibacterial properties. Coconut oil is also one of the best sources for medium-chain fatty acids, which have been shown to fight fatigue and support a healthy metabolism.

Foods to Avoid for a Healthy Thyroid

Foods that are low in nutrients, damage the gut lining, and increase inflammation are bad for thyroid health. Here are some of the top foods you should avoid on a hypothyroidism diet:

1. Gluten

A lot of people who have thyroid issues are also sensitive to foods that contain gluten. In fact, gluten can be problematic for a variety of health conditions, including mental health issues like autism. In people who are sensitive, gluten can cause hormonal imbalances, nutrient deficiencies, and increase inflammation. Foods that contain gluten include bread and pasta products made from wheat, barley, and rye.

2. Brassica Vegetables

Dense leafy greens like kale, chard, spinach, and other Brassica vegetables are excellent for gut health, but eating them raw may be bad for your thyroid. Brassica vegetables contain goitrogens — molecules that can impair thyroid function.

3. Tap Water

Tap water contains chlorine and fluorine, which inhibit iodine absorption. Your thyroid needs iodine to create thyroid hormones. Even if you eat plenty of iodine-rich foods, drinking tap water can prevent your body from using it.

4. Sugar

Sugar is fuel for bad gut bacteria that weakens the gut lining, increases inflammation, and promotes obesity. People with thyroid issues have higher rates of weight gain due to hormonal imbalances. Eating sugar only makes things worse by increasing food cravings, depression, mood swings, and chronic fatigue.

Supplements for a Healthy Thyroid

Not all of your nutritional needs will be met by the foods you eat. Try these supplements to support your thyroid and reduce inflammation:
  • L-tyrosine: An amino acid used to make thyroid hormones in the body. It also plays a role in the production of dopamine in the brain. Supplementing with L-tyrosine may help fight chronic fatigue and stabilize mood.
  • Fish oil: Fish oil is high in the omega-3 fatty acids EPA and DHA, which can reduce thyroid deficiency symptoms. Omega-3’s also fight depression, high cholesterol, and inflammation issues related to autoimmune disease.
  • Probiotics: Probiotics protect the thyroid from inflammation by healing the gut and balancing the microflora in the digestive tract. They have also been shown to increase the effectiveness of vitamin B12.
  • Vitamin B-Complex: B vitamins are important for neurological function and hormonal balance. One study found that patients with Hashimoto’s hypothyroidism experienced a significant increase in energy after just a few days of treatment with a vitamin B-complex. (10)
  • Selenium: Necessary for thyroid hormone production. Powerful antioxidant qualities.
  • Iodine: Essential to thyroid hormone production. Should not be taken by patients with Hashimoto’s disease due to an increased risk of developing an overactive thyroid.

Medical Treatment of Hypothyroidism

Thyroid replacement therapy with a medication like levothyroxine is usually standard treatment for hypothyroidism. The body recognizes and uses levothyroxine as if it was a naturally-produced thyroid hormone. (11)
For certain types of thyroid disease, like Hashimoto’s hypothyroidism, your doctor may advise you to avoid foods that are high in iodine.

Diagnosing Hypothyroidism

In many cases, the doctor will make a diagnosis with a simple blood test, but it’s up to you to be aware of hypothyroidism’s causes and risk factors.
Make an appointment with your doctor if you start feeling chronically fatigued or suddenly have a puffy face, hoarse voice, dry skin, and constipation. While it may be easiest to ignore symptoms like these, it’s best to see a doctor and let them determine the cause.
An endocrinologist is a doctor who specializes in thyroid diseases. When you see your primary care physician, be sure to mention that you suspect a thyroid issue and request a referral. Doctors usually can’t diagnose thyroid conditions based off of symptoms alone, so you might have to take a few more tests.

Common thyroid tests include:

  • TSH
  • T4
  • T3
  • Thyroid antibody
For these tests, the phlebotomist will draw blood from your arm and send it to a lab for analysis.  
Your doctor may also order imaging tests such as:
  • Ultrasound
  • Thyroid scan
  • Radioactive iodine uptake
For these tests, a radiologist will analyze the images and report to your doctor.
Keep in mind that as you age, the risk of thyroid disease increases. Women have a greater overall risk of developing hypothyroidism, especially in the first six months after childbirth.
An unhealthy thyroid has the potential to wreak havoc on your quality of life. In many cases, inflammation is part of the problem. To get the best treatment for your thyroid disease, contact us at Complete Care Health Centers and see one of our providers today.

References:

[1] Garber JR, Cobin RH, Garib H, et al. Clinical Practice Guidelines for Hypothyroidism in Adults: Cosponsored by the American Association of Clinical Endocrinologists and the American Thyroid Association. Endocrine Practice. 2012;18(6):988–1028.
[2] Informed Health Online [Internet]. How does the thyroid gland work?Cologne, Germany: Institute for Quality and Efficiency in Health Care (IQWiG); Created: November 17, 2010; Last Update: April 19, 2018.
[3] Amino N. Autoimmunity and hypothyroidism. Baillieres Clin Endocrinol Metab. 1988 Aug;2(3):591-617. Review.PMID:3066320
[4] Kuan-Chen Chen, PhD,b,f,g Usman Iqbal, PharmD, MBA, PhD,b,h Phung-Anh Nguyen, PhD,a,b Chung-Huei Hsu, MD,d,e,∗ Chen-Ling Huang, MD,d Yi-Hsin Elsa Hsu, PhD,f Suleman Atique, PhD,a,b Md. Mohaimenul Islam, MS,a,bYu-Chuan (Jack) Li, MD, PhD,a,b,c and Wen-Shan Jian, PhDb,f,g,∗. The impact of different surgical procedures on hypoparathyroidism after thyroidectomy. Medicine (Baltimore). 2017 Oct; 96(43): e8245.
[5] Richie JP Jr1, Das A2, Calcagnotto AM1, Sinha R2, Neidig W3, Liao J1, Lengerich EJ1, Berg A1, Hartman TJ4, Ciccarella A5, Baker A2, Kaag MG6, Goodin S7, DiPaola RS7, El-Bayoumy K8. Comparative effects of two different forms of selenium on oxidative stress biomarkers in healthy men: a randomized clinical trial. Cancer Prev Res (Phila). 2014 Aug;7(8):796-804.
[6] Maha Abd El-Kareem El-Sayed Husseni. The Incidence of Hypothyroidism Following the Radioactive Iodine Treatment of Graves’ Disease and the Predictive Factors Influencing its Development. World J Nucl Med. 2016 Jan-Apr; 15(1): 30–37.
[7] Rovet JF. Congenital hypothyroidism: long-term outcome. The Hospital for Sick Children and University of Toronto, Ontario, Canada. Thyroid. 1999 Jul;9(7):741-8.
[8] Amino N. Autoimmunity and hypothyroidism. Baillieres Clin Endocrinol Metab. 1988 Aug;2(3):591-617. Review.PMID:3066320
[9] Leonard Wartofsky, M.D. Hypothyroidism (Underactive Thyroid).  M.A.C.P. Washington Hospital Center and Georgetown University Hospital. National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK). https://www.niddk.nih.gov/health-information/endocrine-diseases/hypothyroidism.
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