Hypothyroidism Diagnosis: The Best Way to Go About It

The leading cause of hyperthyroidism is an autoimmune disease called Graves’ Disease.

The leading cause of hypothyroidism is an autoimmune disease called Hashimoto’s thyroiditis.

Autoimmune diseases in general

Autoimmune diseases tend to run in families. In other words, there is a strong genetic predisposition to develop one or more autoimmune diseases. Females are affected five times more than men by autoimmune disease. Patients with other autoimmune diseases are more likely to develop autoimmune thyroid diseases.

Researchers are trying to unlock the mysteries of autoimmune diseases, but there are still many unanswered questions. Basically an autoimmune disease occurs when the immune system produces antibodies that attack healthy tissues. In Graves’ disease, the immune system produces anti-thyroid antibodies that cause the thyroid gland to make too much thyroid hormone. In Hashimoto’s thyroiditis, antithyroid antibodies damage the thyroid gland and prevent it from producing enough thyroid hormone.

Autoimmune diseases associated with a higher than normal rate of thyroid autoimmune diseases

• vitiligo (patchy loss of skin coloration)
• alopecia areata (sudden, circular hair loss)
• premature gray hair
• pernicious anemia (inability to absorb B₁₂)
• rheumatoid arthritis
• myasthenia gravis (episodic muscle weakness that can affect vision, speech, swallowing, and breathing )
• Lupus erythematosus ( connective tissue disorder)
• insulin-dependent diabetes
• Addison’s disease (adrenal insufficiency)
• premature ovarian failure

Tests for antibodies present in autoimmune thyroid disease

• TPOab (thyroperoxidase antibodies)
• TGab (thyroglobulin antibodies)

One of these two types of antibodies is found in nearly all patients with Hashimoto’s thyroiditis and in approximately 50% of patients with Graves’ disease.

• TRab (thyrotropin receptor antibodies; also called thyroid stimulating immunoglobulins or thyroid stimulating antibodies.)

Hypothyroidism causes the body to slow down. It occurs when there is too little thyroid hormone in the blood (“hypo” means “not enough”). Hypothyroidism affects more than 5 million people, many of whom don’t know they have the disease. Women are more likely than men to have hypothyroidism.

Also, one out of every 4,000 infants is born with the condition. If the problem is not corrected, the child will become mentally and physically retarded. Therefore, all newborns in the United States are tested for the disease.

Symptoms in adults include:

• feeling slow or tired
• feeling cold
• drowsy during the day, even after sleeping all night
• slow heart rate
• poor memory
• difficulty concentrating
• muscle cramps
• weight gain
• husky voice
• thinning hair
• dry and coarse skin
• feeling depressed
• heavy menstrual flow
• milky discharge from the breasts
• infertility
• goiter

Many of the symptoms of hypothyroidism can occur normally with aging, so if you have one or two of them, there is probably no reason to worry. However, if you are concerned about any of these symptoms, you should see your doctor.

Most patients with hypothyroidism have some degree of associated depression, ranging from mild to severe. 10% – 15% of the patients with a diagnosis of depression may have thyroid hormone deficiency. Patients with depression should be tested to determine if they have a thyroid disorder.

• Several research studies have been done and continue to be done on the association between depression and thyroid disease. Although all forms of depression, including bipolar disorders like manic depression, can be found in either hypothyroidism or hyperthyroidism, depression is more often associated with hypothyroidism. Many patients with hypothyroidism have some degree of associated depression, ranging from mild to severe.
• If a large population of depressed patients was screened, a significant percentage, perhaps 10% – 15%, would be found to have thyroid hormone deficiency. For this reason, patients with a diagnosis of depression should be tested to determine if they have too little thyroid hormone. If they do, thyroid medication should be prescribed.
• Thyroid hormone is sometimes prescribed for depressed patients with normal thyroid function because it magnifies the beneficial effects of certain antidepressants.
• Lithium, a commonly prescribed drug for certain types of depression, has profound effects on the size and function of the thyroid gland. Patients taking lithium need periodic examinations of their thyroid gland and thyroid function.