The Pathophysiology of Hypothyroidism

Hypothyroidism Pathophysiology of the disease development The thyroid, a gland located in the front of the neck, plays a critical role in the body's endocrine system, specifically in regards to cellular metabolism-i.e. how cells use energy (NLM, 2015). In a normal, healthy person the thyroid is in a state of homeostasis with the rest of the body; however, in a number of cases the body can produce too much (hyperthyroidism) or too little (hypothyroidism) of thyroid hormone needed to keep the body in a state of health.

Hypothyroidism can have a number of causes, many of which are poorly understood. The immune system may attack the thyroid gland, mistaking it for a foreign invader. According to the American Thyroid Association (ATA): "autoimmune thyroiditis can begin suddenly or it can develop slowly over years. The most common forms are Hashimoto's thyroiditis and atrophic thyroiditis" (ATA, 2014). A variety of other conditions, including pregnancy and certain kinds of viruses can cause swelling and inflammation.

Certain medications, radiation treatment, surgical removal of the thyroid gland, and even pregnancy (postpartum thyroiditis) can cause hypothyroidism (NLM, 2015). Surgical removal or radiation may be necessitated by cancer or due to hyperthyroidism. "Some people with graves' disease, nodular goiter, or thyroid cancer are treated with radioactive iodine (i-131) for the purpose of destroying their thyroid gland" (ATA, 2014). Unexplained weight gain is often the first and most common symptom which causes individuals with an underactive thyroid to go to the doctor.

Constipation, a feeling of sluggishness, and, as symptoms advance, puffy hands and feet and brittle hair and nails may manifest themselves. Some patients may show no symptoms, however. Diagnosis is confirmed with a TSH (thyroid-stimulating hormone) test, which "measures how much of the thyroid hormone thyroxine (T4) the thyroid gland is being asked to make. An abnormally high TSH means hypothyroidism: the thyroid gland is being asked to make more T4 because there isn't enough T4 in the blood" ATA, 2014).

Treatment The first and foremost objective of treatment is to restore thyroid levels to normal in a hypothyroid patient. This is almost always accomplished with medication. "T4 replacement can restore your body's thyroid hormone levels and your body's function. Synthetic thyroxine pills contain hormone exactly like the T4 that the thyroid gland itself makes" (ATA, 2014). Dosages must be carefully monitored -- any changes in dosing should be verified between 6 to 10 weeks.

Too much synthetic hormone can case the hypothyroid patient to develop hyperthyroidism, which poses its own risks and symptoms (such as weight loss, sweating, high blood pressure). Patients should be careful of ingesting over-the-counter medications such as calcium supplements and iron pills which may interfere with the effects of the drug (Mayo clinic, 2015). Natural remedies are also available for patients that are "derived from the thyroid glands of pigs" (Mayo Clinic, 2015). These products are available via prescription and should not be confused with extracts claiming.