Your thyroid is responsible for providing energy to nearly every organ in your body. It controls functions such as how your heart beats and how your digestive system works. Without the right amount of thyroid hormones, your body’s natural functions begin to slow down. Hypothyroidism occurs when your body doesn’t produce enough thyroid hormones.

Hypothyroidism affects women more frequently than men. To help address the most commonly asked questions about the thyroid gland, its function, the causes of hypothyroidism and ways to reduce the risk of this condition, TC46 connected with Endocrinologist & Diabetologist Dr Sweta Budyal of Fortis Hospital, Mumbai.

1. What is hypothyroidism? What is the difference between hyperthyroidism and hypothyroidism?

A butterfly-shaped gland in our neck is called the thyroid gland. This gland produces thyroid hormones. Thyroid hormones are important for the optimal functioning of all our organs, especially energy and metabolism.

Hypothyroidism is a condition in which the thyroid gland does not produce enough thyroid hormones. People often confuse this with hyperthyroidism, which is a condition where the gland makes an excessive amount of thyroid hormones.

2. How does hypothyroidism affect women? At what age do thyroid problems start for women?

Hypothyroidism can start at any age. When hypothyroidism is present right from birth it is called Congenital Hypothyroidism, and this condition can affect both boys and girls equally. The cause for this is the absence of thyroid gland. When hypothyroidism starts later in life, it is called Acquired Hypothyroidism. Acquired Hypothyroidism is almost 10 times more common in women than in men.

Women with Hypothyroidism can suffer from symptoms such as lack of energy, weight gain, low mood, cold intolerance, constipation, dry skin. They also have symptoms related to the reproductive system very often like irregular periods, scanty or excessive menstrual blood loss, infertility or pregnancy losses. Hypothyroidism can also masquerade as Polycystic Ovarian Syndrome (PCOS) or high prolactin condition leading to milk secretion in non-lactating women. Sometimes hypothyroidism is found incidentally on routine blood check-ups, as well in women with relatively few or no symptoms.

3. What is the role of genetics in thyroid-related health conditions?

Hypothyroidism in adult women is an autoimmune disorder and it generally results from the interaction of multiple genes with environmental factors. Variations in several genes that encode HLA (Human Leukocyte Antigen), CTLA4, PTPN-22 and vitamin D receptor are associated with developed of hypothyroidism from Hashimoto’s Disease, which is the most common cause of hypothyroidism in adult women.   

4. What are some risk factors that women should be aware of?

The risk factors for developing hypothyroidism in women are:

  • Age more than 50 years
  • Family history of thyroid disorders
  • Presence of other autoimmune diseases like type 1 Diabetes, Rheumatoid Arthritis, Celiac Disease
  • Radiation exposure
  • Thyroid surgery
  • Exposure to anti-thyroid medications
  • Certain medications like Amiodarone, Sunitinib, Interferons
  • Recent childbirth

Hypothyroidism can cluster in families. Having a close relative with Hypothyroidism or other autoimmune disease increases the risk of developing Hypothyroidism. According to an Indian study, it was found that the risk of hypothyroidism increased ninefold than the general population when a first-degree relative was affected by hypothyroidism, and the risk increased after the age of 20 years in females.

5. How long can you have hypothyroidism without knowing?

It depends on case to case basis. Occasionally there can be a lag of six months to a couple of years before a person undergoes a thyroid test.

6. Can hypothyroidism be cured? What happens if hypothyroidism is left untreated?

Once hypothyroidism sets in, it cannot be cured. However, it can be very effectively treated with Thyroxine (Thyroid hormone) replacement in the form of oral pills. Thyroxine does not have any side effects if TSH levels are monitored at regular intervals as advised by doctors.

Hypothyroidism, if left untreated, can lead to the progression of signs and symptoms. Patients with severe hypothyroidism who are not treated for a long time can develop serious problems related to heart, lungs and brain like Bradyarrhythmia (low heart rate), Pericardial Effusion, Myxedema coma, and even death on rare occasions.

7. How is hypothyroidism diagnosed?

Hypothyroidism can be diagnosed by a simple blood test called Thyroid Function Test (T3, T4, TSH) which is widely available. In some patients based on medical history and examination, doctors may order more sophisticated tests like testing for thyroid antibodies, Sonography of the neck, Radioisotope Scan of Thyroid or FNAC (mini-biopsy) of the thyroid gland.

8. What are some lifestyle and food habits that can help reduce the risk of hypothyroidism?

Hypothyroidism is an autoimmune disease. A healthy and balanced diet, regular exercise and stress management may help in preventing it. There is no scientifically proven and effective preventive measure as of now. Hence regular monitoring in high-risk individuals as per the doctor’s advice, and timely initiation of treatment is the key.