What Is Hypothyroidism?
Meet Ms. J: She is an advertising executive in her late 30s trying to balance her career aspirations with raising three young children. Recently, she has been feeling incredibly tired and run-down, which is in stark contrast to her usual high energy levels. She just cannot seem to figure out why she is so tired all the time. Assuming it is just the trials of work-life balance finally catching up to her, Ms. J does not take her lack of energy too seriously.
But soon, her husband notices their bathroom floor seems to be accumulating a lot more of her loose hairs than usual; they even have to call in a plumber to unclog the shower drain. Chalking the hair loss up to aging, Ms. J again does not try to figure out what is going on—after all, she can explain away everything she has felt so far. Then, Ms. J notices how bloated she always feels. She has never struggled with constipation before, but now all she can do is pray for her system to regulate itself. At long last, Ms. J decides to pay her doctor a visit.
Any idea as to what could cause Ms. J’s symptoms? I will give you a hint: It has to do with my favorite organ system, the endocrine system.
Our endocrine system has eight major glands that are responsible for releasing key hormones directly into our bloodstream. The largest of these glands, and perhaps the most well-known to the general public, is the thyroid gland. The thyroid gland is located right below the Adam’s apple, its two lobes wrapped around the windpipe. But despite the prime placement, it’s only as important to us as the hormones it releases.
The thyroid hormones that apply to Ms. J’s case are triiodothyronine and thyroxine, also known as T3 and T4. These two hormones are closely connected, as they help regulate the body’s metabolism. Metabolism, in this sense, is a bit of a catch-all term that encompasses the fact that the thyroid hormones impact the use of energy in every single cell in our body. From our brain, to our heart, to our skeletal muscles, every single cell processes proteins, fats, and carbohydrates with the help of T3 and T4. Seems like a lot of work for such a small and daintily shaped gland, no? Yet this is why the thyroid gland and precise regulation of its hormones are so important.
Too little thyroid hormones, and our bodies can become sluggish; too much and our bodies can go into overdrive—sometimes dangerously so in either direction. When your body doesn’t produce enough thyroid hormone, the condition is known as hypothyroidism. There are many different causes of hypothyroidism, but the end result is the body does not get as much T3 and T4 as it needs. With this deficiency, the body is unable to process energy efficiently. This is problematic for anyone, but especially for pregnant women, whose thyroid hormones not only support the mother’s metabolic needs, but also play a critical role in the cognitive development of the fetus.
Hypothyroidism, or low thyroid hormone levels, most often manifest with symptoms that include fatigue, constipation, cold intolerance, weight gain, irregular periods, slow heart rate, poor memory or concentration, dry skin, swelling of the legs, or hair loss. Some of these may be familiar from the case of our Ms. J. Like her, if you are experiencing any of the above symptoms, seek a medical opinion. Your doctor will likely initiate some routine blood work that can help differentiate a thyroid condition from other conditions with similar symptoms.
Thyroid function can be abnormal with or without discernable changes to the thyroid gland itself, so this blood test is the only option for diagnosis. The good news is it’s a quick diagnosis, and the condition itself can be managed with simple medicine. Levothyroxine, a synthetic form of thyroid hormone, is a once-daily tablet that replaces the hormone the body is no longer producing. Despite being such an easy disease to diagnose and treate, hypothyroidism remains a significant challenge in India, largely because both patients and practitioners are unaware. In 2013, a study to determine the prevalence of hypothyroidism across India found that 1 in 10 adults in Bangalore, Chennai, Delhi, Goa, Mumbai, Hyderabad, Ahmedabad, and Kolkata had hypothyroidism without knowing it. The study also found that women and elderly people of both sexes were more likely to have hypothyroidism. Some expert opinions suggest certain factors unique to India – such as iodine deficiency (iodine is critical in the formation of thyroid hormones), pesticide exposure, and polluted drinking water – could be contributing to the country’s hypothyroidism rates.
So if, like our fictional friend Ms. J, you are experiencing one or more of the symptoms above, consult your doctor about the possibility of hypothyroidism. If you have it, you’ll likely return to feeling normal quickly after starting medication. Your doctor will require periodic blood tests to ensure the medicine is keeping your thyroid hormones are at the most appropriate level, but otherwise, you’ll be able to get on with your life like before.