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Hypothyroidism is the most common thyroid disorder. Hypothyroidism occurs when the thyroid is not able to produce enough thyroid hormone to keep up with the body's thyroid hormone requirements. Hypothyroidism is usually caused by Hashimoto's thyroiditis, but other common causes include surgical removal of the thyroid and radiation treatment to the thyroid.

Hashimoto's thyroiditis, also called autoimmune or chronic lymphocytic thyroiditis, is the most common thyroid disease in the United States. It is an inherited condition that affects approximately 14 million Americans and is about seven times more common in women than in men. Hashimoto's thyroiditis is characterized by the production of autoantibodies and immune cells by the body's immune system, which can damage thyroid cells and compromise their ability to make thyroid hormone. Hypothyroidism occurs if the amount of thyroid hormone which can be produced is not enough for the body's needs. The thyroid gland may also enlarge in some patients, forming a goiter.

Signs and Symptoms
Many patients with Hashimoto's thyroiditis may have no symptoms for many years, and the diagnosis is made incidentally when an enlarged thyroid gland or abnormal blood tests are discovered as part of a routine examination. When symptoms do develop, they are either related to local pressure effects in the neck caused by a goiter, or to the low levels of thyroid hormone. Signs and symptoms of Hashimoto's thyroiditis in patients who develop hypothyroidism include fatigue, drowsiness, forgetfulness, difficulty with learning, dry hair and nails, brittle hair and nails, dry and itchy skin, puffy face, constipation, sore muscles, weight gain, heavy menstrual flow, increased frequency of miscarriages, and an increased sensitivity to many medications.
Detection and Diagnosis
Hypothyroidism may be difficult to detect because its often vague signs and symptoms are easily confused with other conditions, such as the natural aging process, menopause or stress. Many patients remain undiagnosed and untreated for years due to their lack of awareness of hypothyroidism and its signs and symptoms.
Several tests can be performed to determine the health of your thyroid. Those tests include TSH (Thyroid-Stimulating Hormone), antithyroid antibodies, free T4 (Thyroxine), free T3 (Triiodothyronine), and fine needle aspiration.
The goal for treating hypothyroidism is to restore normal blood levels of thyroid hormone by replacing the missing hormone. Most commonly this is accomplished using a medication called Levothyroxine, a small pill that is taken once daily. This is an exact, bio-identical, copy of the T4 made by your thyroid. Levels of T4 are monitored by your body and your body regulates the conversion of T4 to T3 to ensure balanced levels of these hormones. Occasionally, a combination of T4 and T3 medications may be helpful to address the symptoms of hypothyroidism.
Other Associated Disorders
As noted above, Hashimoto's thyroiditis is a common disorder of the immune system which affects the thyroid gland. Much less often however, the immune system can also mistakenly target virtually any other part of the body, causing it to malfunction; this tendency runs in families. Although the majority of patients with Hashimoto's thyroiditis and their genetic family members will never experience any other autoimmune condition, they do have a statistically increased risk of developing the following disorders:
  • Type 1 Diabetes Mellitus (insulin-requiring)
  • Graves' disease (goiter and hyperthyroidism or overactive thyroid)
  • Rheumatoid arthritis
  • Pernicious anemia (inability to absorb vitamin B12, potentially causing anemia and neurological problems)
  • Addison's disease (adrenal failure; the adrenal gland provides cortisone to handle stress and illness)
  • Premature ovarian failure (early menopause)
  • Vitiligo (patchy loss of skin pigmentation)
  • Thrombocytopenic purpura (bleeding disorder due to inadequate platelets in the blood)
  • Lupus erythematosus (autoimmune disease that involves skin, lymph glands, heart, lungs, kidneys)
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