Subclinical Hypothyroidism

May 5, 2011 in Subclinical Hypothyroidism | No comments

Subclinical hypothyroidism is a hidden disease; one that sometimes is difficult to diagnose simply because the symptoms of subclinical hypothyroidism are not that evident.

What exactly is subclinical hypothyroidism?

Broken down into layman’s terms, it really means that your thyroid is not producing or secreting the correct amount of thyroid hormones that your body demands…

And “subclinical” means that it is not easily detected because the problem is “asymptomatic”; in other words, the symptoms are not readily visible or noticeable.

And without an actual blood test, you may never even know that you have subclinical hypothyroidism.

How Common is Subclinical Hypothyroidism?

Subclinical hypothyroidism is more prevalent than most people realize; again, because it is asymptomatic.

In recent studies performed across the United States, it is estimated that (on average) roughly 4% of all men and 8% of all women men are subclinically hypothyroid.

However, these averages rise with age, and it has been estimated that 8% of men over 60 and 15% of women over the age of 60 are subclinically hypothyroid.

In Europe, subclinical hypothyroidism is more prevalent in areas of iodine sufficiency.

There are reports of a high of 23.9% in regions surveyed that have a high incidence of iodine intake; while the numbers drop significantly to around 4.3% in iodine-deficient areas.

However, these are numbers based on actual blood tests; and doctors estimate that the numbers are probably higher since a significant amount of the population are not regularly tested for subclinical hypothyroidism.

Subclinical Hypothyroidism – Also Known As Underactive Thyroid

While subclinical hypothyroidism is usually not life threatening, it can create a multitude of related problems throughout the body.

Thyroid problems obviously begin with the thyroid; the butterfly shaped gland in the middle of the neck.

This is the gland that regulates the hormones triiodothyronine (T3) and thyroxine (T4); and these hormones control exactly how your body stores and uses energy… In other words, how your body’s metabolism runs.

In about 95 percent of cases, hypothyroidism can be traced back to a problem in the thyroid gland itself; which is why it is called “primary hypothyroidism”.

However, certain medications and diseases can also cause an underactive thyroid.

The principle causes of hypothyroidism include…

-“Hashimoto’s thyroiditis” or autoimmune thyroiditis- this is a form of thyroid inflammation caused by the patient’s immune system. It leaves a large part of the thyroid’s cells damaged and incapable of producing the T3 & T4 hormones in the correct levels.

-Any kind of surgical procedure that removes a portion of the thyroid gland (a common treatment that is used to assist with other thyroid problems)

-Certain infections which can temporarily affect the functioning of the thyroid gland.

-Goiters and some other thyroid conditions that are usually treated with a radioactive iodine therapy. And these radioactive iodine treatments may disrupt the normal production of the thyroid hormones.

Goiters are formed because the body is expecting a certain amount of thyroid hormone.

Therefore, the pituitary will make additional thyroid stimulating hormone (TSH) in an attempt to coax the thyroid to produce more hormone.

This constant infusion of high levels of TSH may cause the thyroid gland to become enlarged and form a goiter (often referred to as a “compensatory goiter”); and the most common treatment for these goiters is a radioactive iodine therapy.

The aim of the radioactive iodine therapy (for benign conditions) is to kill a portion of the thyroid to prevent goiters from growing larger or producing too much hormone (hyperthyroidism).

Occasionally, the result of this radioactive iodine treatment will be that too many thyroid cells are damaged so the patient often becomes hypothyroid within a year or two.

-Problems with the pituitary gland or the hypothalamus; these two glands produce hormones that actually control the operation of the thyroid.

In other words, you could have a completely normal thyroid that is not working to produce the T3 & T4 hormones because of an issue with your pituitary gland.

The pituitary gland produces a “thyroid stimulating hormone” (TSH) that forces the thyroid to produce the correct amount of T3 & T4 hormones; however, if the pituitary gland doesn’t produce enough TSH to get the thyroid working….

Then the thyroid doesn’t go to work.

The Affects of Subclinical Hypothyroidism

Because this is subclinical or asymptomatic, many times people do not even realize that they have hypothyroidism.

Some of the typical symptoms would include….

  • Constant tiredness
  • An increase in weight or exceptional difficulty in losing weight
  • Depression
  • Constipation
  • Coarse, dry hair
  • Dry, scaly pale skin
  • A cold temperature intolerance (you cannot take the cold like people around you)
  • Muscle cramps and frequent muscle aches that won’t go away
  • Irritability
  • Memory loss
  • Abnormal menstrual cycles
  • A general feeling of “fuzziness” or lack of orientation.

And you may have these in combination; or not at all.

One of these symptoms may be causing you extreme discomfort; while another may be a minor nagging complaint. You may have a combination of these symptoms; but no single one of them is that dominant.

Or you may not have any symptoms at all; or they are simply too minor that they just go unnoticed. And since these symptoms are associated with a myriad of other maladies, without accurate testing, hypothyroidism is quite often simply overlooked.

Subclinical hypothyroidism is often not discovered without specific testing; simply because the disease is very hard to localize.

A rarer condition of hypothyroidism is the so-called “thyroid storm”.

While infinitely more serious, it is also much less common; and is usually brought about as a consequence of a stroke, an injury, or a severe infection.

Symptoms of a thyroid storm may include fever, jaundice (a condition where the skin turns yellow), a rapid heartbeat, dehydration, agitation, confusion and hallucinations.

A thyroid storm demands immediate and urgent treatment as it can lead to coma.

Subclinical Hypothyroidism & Women

Because of the limited visible signs of subclinical hypothyroidism, women are especially cautioned to get tested for subclinical hypothyroidism before or during pregnancy.

Why?

Miscarriage Risk and Low IQs

In a recent report in the Journal of Medical Screening, doctors reported that miscarriages could be significantly reduced if screenings for hypothyroidism were performed as a regular part of pre-natal exams.

The study concluded that pregnant women who were discovered to have hypothyroidism are four times more likely to have a miscarriage in the second trimester than women that have normal thyroid functions.

The study attributed six out of every 100 late miscarriages to an undiagnosed hypothyroid condition in the mother.

The New England Journal of Medicine also reported its findings on the results of a study of women with hypothyroidism during pregnancy.

It found that children born to women with hypothyroidism had below average psychological development.

In addition, they discovered that the children had significantly lower IQ levels, impaired motor skills, and continued difficulties with attention, language, and reading skills.

The study indicated that 19 percent of the children born to mothers with hypothyroidism had IQ scores of 85 or lower; while the baseline for the study showed only 5 percent of children born with a reduced IQ level to mothers without any thyroid problems.

According to the study’s lead author, the range below an 85 IQ level can mean significant impairment for children.

So they have recommended a full blood workup to specifically check for subclinical hypothyroidism for mothers as part of a comprehensive pre-natal doctrine in addition to the usual pre-natal regimen.

Diagnosing Subclinical Hypothyroidism

Diagnosing hypothyroidism usually requires an in-depth analysis of the patient’s complete medical history in conjunction with a careful physical examination.

The most critical step to the diagnosis of any thyroid condition is a blood test to measure the level of thyroid-stimulating hormone (TSH) (which will show up high in hypothyroidism).

It is also necessary to measure the level of two of the thyroid hormones (both T4 and T3) which are low in hypothyroidism.

Other tests can include…

-The measurement of specific antibodies which detect the origin of a specific thyroid problem

-A thyroid scan, which produces images of the thyroid gland and can help to determine its size, shape and position.

-An iodine scan that is used to measure thyroid function by determining how much iodine is taken up by the thyroid gland

More often than not, any thyroid issues like hypothyroidism or hyperthyroidism can be detected by a simple blood test; and if any thyroid problems are discovered after testing, alternate procedures can be performed to isolate the individual problem.

Treatment of Hypothyroidism

Luckily, treatment of subclinical hypothyroidism is relatively easy.

Remember, hypothyroidism is an underperforming thyroid; and you can help replace the hormones the thyroid is not producing with an orally ingested thyroid supplement.

Granted, this would be a daily treatment; and it would have to be continued for life; but regulating the T3 & T4 hormone imbalances with a simple small pill is a minor inconvenience.

The most common treatment for hypothyroidism is a hormone replacement supplement called levothyroxine.

Usually, this treatment is relatively innocuous and non-allergenic.

But like any medication, there is the possibility that it can interact with other medications and/or food supplements; so carefully follow your doctor’s direction.

And remember, that there are several different types of thyroid hormone protocols, and what works well for one patient does not work well for everyone.

Hypothyroidism is different in every patient, and while we have given you some useful information here, do not use it as a substitute for your own doctor’s advice.

Subclinical hypothyroidism is luckily not life threatening; but it can make you feel completely “out of whack”.

The consensus of endocrinologists is a simple blood test every three or four years; especially after you pass 35 years of age.

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FAQ: What are the symptoms of hypothyroidism?

May 5, 2011 in Frequently Asked Questions, Subclinical Hypothyroidism | No comments

Question: I am a 35 year old woman who is moderately active.  I eat pretty healthy (for the most part), although I do enjoy some dessert or an alcoholic beverage on occasion.   The problem is that I have gained about 30 pounds over the last 5 years and I have no idea where the weight has come from!  I do not eat any different than I used to.  Could my thyroid be slowing down?  Besides weight gain, what are symptoms of hypothyroidism?

Answer: Here is a detailed list of symptoms that usually accompany hypothyroidism and (sometimes) subclinical hypothyroidism:

  1. Poor muscle tone:  If your muscles used to have adequate definition and now they are somewhat flat and “mushy” when you touch them.
  2. Fatigue:  Have you noticed a noticeable decrease in energy levels and motivation?
  3. Menstrual Problems:  Are your periods regular or are they sporadic… A menstrual cycle should be in the 20 to 30 day range.
  4. Sensitivity to cold:  Are you cold when everyone else in the room is hot?  Do you often need a sweater or a coat when everyone else is in short sleeve shirts and shorts?
  5. Constipation:  A healthy bowel movement is AT LEAST once per day.  Not having a bowel movement at least once per day can often be the result of not having enough fiber in your diet, and may not necessary be a sign of subclinical hypothyroidism.
  6. Depression:  When the thyroid hormones in your body are out of balance, it can also throw many of your other hormones into a tailspin, causing depressed feelings and sadness.  Unfortunately with this particular symptom, depression itself can cause many of the symptoms on this list.
  7. Joint pain:  Although there is typically more joint pain (especially when first getting out of bed in the morning) as you get older.  But, this should go away as you begin to move around during the day.  If joint pain continues throughout the day, it may be symptom of a slow thyroid.
  8. Muscle cramps:  This is similar to joint pain.  Having a few light muscle cramps in the morning is natural.  The body  has been almost completely inactive for 6 to 8 hours.  A small cramp here or there is natural, especially when we hit our 30′s.
  9. Brittle Fingernails or Nails that Break Easily:  Some people naturally have thicker nails.  Other people have thinner, more brittle nails.  However, when talking about a symptom of hypothyroidism, if your fingernails used to be happy and healthy but are now thin and brittle it may be sign of a major hormonal shift in the body.
  10. Course Hair:  If you hair used to be healthy, shiny, smooth and silky, but now it’s “wiry” or course it could be a sign that your hormones are out of balance due to decreased thyroid hormones or imbalanced hormones.  It could also mean, however, that you are malnourished in some way too.  Smokers also tend to have (in many cases) hair that is course.
  11. Itchy and Dry Skin:  This symptom, by itself, could be caused by anything from inadequate water intake to an allergic reaction.  To ensure that this is an actual symptom of hypothyroidism (or any other disorder for that matter), try increasing your water intake while taking an antihistamine for a few days.
  12. Weight gain:  You had already mentioned weight gain, so you already know that this is a symptom of subclinical hypothyroidism.  This is usually the symptom that alarms people the most, as we (as a society) tend to focus more on outside appearances than what is actually going on inside our bodies.  Weight gain, however, can be caused by many factors and not exclusive to people suffering from the various stages of hypothyroidism.

Unfortunately, there is no cut and dried method of determining if you have subclinical hypothyroidism without getting a blood test to check your TSH levels.  Although the symptoms hypothyroidism are easy to list off, it’s possible to have subclinical hypothyroidism without experiencing any of these symptoms.  Then again, you could have some of these symptoms along with perfectly normal levels of T3 and T4 thyroid hormones.

In another article, I will be discussing these symptoms from the perspective of alleviating them… even if they are caused by hypothyroidism or subclinical hypothyroidism.

 

 

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FAQ: What is a good diet for hypothyroidism?

May 5, 2011 in Frequently Asked Questions, Subclinical Hypothyroidism | No comments

Question: After having my TSH levels tested, I have been diagnosed with subclinical hypothyroidism.  I really do not like the idea of taking medicine, so I was thinking that if I altered my diet or started a special diet formulated for hypothyroidism then I could avoid having to take something with crazy side effects.  What is a good diet for hypothyroidism?  – Julie, Branson, MO.

Answer: To start with, there is no diet that will cure hypothyroidism.  None.  Zilch.  It’s what all of the doctors will tell you.  It’s a fact.

No matter what you eat, it will not change the TSH levels of your blood test.

However, with that being said, you can certainly alter your diet in such a way that you will lower the negative symptoms of hypothyroidism.

If you are just have borderline hypothyroidism, I would say that it’s safe enough to try the diet without starting any medication just yet.

First of all, start with a healthy base of fruits and vegetables.  I know that doctors always say that, but truth be told DOCTORS don’t even eat enough fruits and vegetables.  Try to add as many different colors to a meal as possible.  Here is an example.

  1. Lean Meat – Brown
  2. Red Bell Peppers – Red
  3. Baby Carrots – Orange
  4. Purple Cabbage – Purple
  5. Broccoli – Green
  6. Banana for Dessert – Yellow

If you do this, and drink at least 8 glasses of water per day (more is better… aim for a gallon per day) you should be able to boost your metabolism and not have to worry so much about weight gain as you will probably be eating healthier than you ever have.

Also, with constipation being one of the symptoms of hypothyroidism, it is absolutely vital to get enough fiber in your diet.  Eating vegetables and fresh fruits like apples (with the skins) on will provide enough fiber to keep things moving normally.

Another addition to your daily life should be coconut oil.

Yes, you heard me right… I said coconut oil.

No, it’s not a cure for hypothyroidism, either.

But, coconut oil has been shown to increase your metabolism and decrease many of the symptoms of hypothyroidism.

Coconut oil will increase your body temperature, give you softer and healthier-looking skin, help with constipation, help alleviate dry hair, and give you more energy.

There are numerous books that go into the amazing power of coconut oil.  If you start researching coconut oil, it will not take you very long to be absolutely amazed.

You can use coconut oil instead of butter or olive oil for most meals… but, you can also just take it by the spoonful.  It has a nice taste and goes down easy.  3 to 6 tablespoonfuls should be your goal per day.

My recommendation is to try this diet for a month and see how it goes.  If you see fewer symptoms, you should consider making this type of eating your new way of life.

However, if your body fails to respond to this new and healthier lifestyle, you should consider talking to your doctor about starting a low dosage of thyroid hormone supplementation to correct the deficiency.

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