Hypothyroidism is an endocrinological condition wherein the thyroid gland fails to produce optimal quantity of thyroid hormone. As a result, there is a very low level of the hormone circulating in the body. Hypothyroidism is distinguished by a wider clinical spectrum ranging from an undisguised state of myxoedema, end-organ effects and multisystem failure to an asymptomatic or subclinical condition with normal levels of thyroxine and triiodothyronine and mildly elevated levels of serum thyrotropin. Hypothyroidism can lead to serious health complications if untreated. Inadequate thyroid hormone in the body results in slowing down of body functions such as metabolism. General symptoms of hypothyroidism include weight gain, dry skin, constipation, memory loss, fatigue, weakness, sadness and heavy menstrual periods (in rare cases). Elevated levels of Thyroid Stimulating Hormone (TSH) and reduced levels of free T3/T4 hormones in blood can indicate hypothyroidism. However, a final diagnosis can be done only by a physician. A milder form of hypothyroidism is subclinical hypothyroidism, manifested by elevated TSH and normal T3/T4 hormones.
How Common Is It?
Hypothyroidism is one of the most regularly prevailing disorders in Indian population. Elderly and overweight women are highly prone to it than anyone else. Autoimmune mechanisms are thought to play an etiological role in a majority of the patients. Intake of iodine in urban areas ceases to be the lone etiological contender for thyroid disorders.
Prevalence of hypothyroidism in India is more in inland areas than those in the coastal areas. Research studies have reported that older population (>35 years) are at increased risk of hypothyroidism than the youth. Among the genders, women are nearly three-times more predictably affected than men, predominantly midlife population (46-54 years). Also, nearly one-third of the population is not aware of the disease state until they were approached at the time of study screening.
Clinical Features – Signs and Symptoms:
Common complaints embody fatigue and lethargy, cold sensitivity, dry skin and lifeless hair, impaired concentration and memory, multiplied weight with poor appetency and constipation. Patients may also fairly often experience a hoarse voice, tingling of the hands (carpal tunnel syndrome), and heavy and, later, absent periods, deafness and joint aches.
In childhood, there is also delayed development and within the adolescent precocious time of life. The aged might develop memory disturbance, associate impaired condition or depression, and in rare cases coma will occur, leading to death if left untreated.
Signs include slow movements, ‘myxoedema facies’ in which the face looks puffy due to the accumulation of subcutaneous fluid, cool dry skin, slow pulse rate, thinning of the hair, including the eyebrows, slow tendon reflex relaxation time, slow pulse rate and hoarse voice.
The thyroid may be enlarged (causing a goitre) in some patients due to accumulation of lymphocytes (Hashimoto’s thyroiditis), but in others the thyroid is destroyed by the time of diagnosis and there is no goitre. Nowadays patients often are diagnosed at an early stage of disease, due to increased awareness and improved biochemical testing. Therefore many patients have relatively few of the classical signs or symptoms just listed. In addition, none of the symptoms or signs is sufficiently sensitive or specific for the diagnosis of hypothyroidism, even when combined together.
Risk Factors and Complications:
Even though anyone can have hypothyroidism, you have a high risk of hypothyroidism if
- Being a woman
- Family history of thyroid disease
- Family history of autoimmune disease
- Having an autoimmune disease
- Older than 60 years of age
- Exposure to radiation of neck
- Treated with radioactive iodine or anti-thyroid medications
- Have been pregnant or delivered a baby within the past six months
Hypothyroidism if untreated, may lead to the following health issues.
- Heart diseases
- Mental health and psychological issues
- Myxoedema (chronic hypothyroidism)
- Birth defects and infertility
Do Genes Have Anything To Do With It?
Genetic risk of hypothyroidism is influenced by the variants in the following genes.
- SH2B3 gene (also linked with increased risk for autoimmune disease such as type 1 diabetes and rheumatoid arthritis)
- PTPN22 gene (modulator of T-cell signalling and helps regulate apoptosis of autoreactive T cells)
- HLA region
- PDE8B gene (associated with TSH levels and thyroid disease)
Managing Hypothyroidism: Risk- Diet and Lifestyle:
- Treatment to hypotension should include drugs for curing disease, diabetes and any possible infection.
- Water has to be consumed aplenty due to dehydration in the cases of vomiting or diarrhoea.
- Staying hydrated also means, you can prevent the symptoms of neutrally mediated hypotension. Emotional stress must be taken care of, and should be aimed at decreasing it.
- Ensure adequate intake of iodine, selenium and zinc in your diet. Rich sources include iodized salt, seaweed, seafood (cod, tuna, sardines, oysters), eggs, milk, lean meat (chicken, beef, lamb), Brazil nuts, fresh vegetables, etc.
- Stick to moderate consumption of goitrogen-containing foods such as soy (tofu), edamame, cabbage, broccoli, cauliflower, etc.
- Regular exercise to boost metabolism.
- Keep tabs on weight, energy fluctuations and sudden/unexplained weight gain, if any.
How Mapmygenome Can Help you:
At Mapmygenome, our focus is mainly on predictive risk assessment, maintaining a proper diet, adapting to a healthier lifestyle. A comprehensive wellness assessment like Genomepatri will give an insight into the weaknesses of your immunity, genetic predisposition to specific health conditions, drug efficiency and helps in pre-empting most of these risks. Genetic counselling is therefore recommended to obtain authenticated reviewing and recommending testing/screening options, diet/lifestyle interventions and as educational and emotional support.
Tapping into your genes will assist you to know the real ‘YOU’. Genomepatri helps you find the best-suited route for yourself, and reiterates the importance of not following the crowd but forging a unique way of leading quality life. It is personalized, predictive, participatory, preventive, and POWERFUL!!!
- Unnikrishnan, Ambika Gopalakrishnan et al., “Prevalence of hypothyroidism in adults: An epidemiological study in eight cities of India.” Indian journal of endocrinology and metabolism vol. 17,4 (2013): 647-52. doi:10.4103/2230-8210.113755.
- Unnikrishnan, Ambika Gopalakrishnan, and Usha V Menon. “Thyroid disorders in India: An epidemiological perspective.” Indian journal of endocrinology and metabolism vol. 15,Suppl 2 (2011): S78-81. doi:10.4103/2230-8210.83329.