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Hypothyroidism
Last updated October 2004
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What Is Hypothyroidism?

Hypothyroidism is a condition in which there is too little thyroid hormone in the bloodstream. The thyroid gland, which produces the thyroid hormones, is said to be "underactive," because it produces too little thyroid hormone needed for the body to function normally.

Inadequate stimulation of cells and organs in the body due to low levels of thyroid hormone causes the symptoms associated with hypothyroidism, which is generally a "slowing-down" of the body's processes. These symptoms include slowed heart rate, tiredness, inability to tolerate cold, mental fatigue, and constipation.

Hypothyroidism is a common condition, and it can be successfully treated. However, because the symptoms are often subtle, or people believe their symptoms are due to stress, depression, or "getting older," or may frequently mistake for other conditions, it is not unusual for someone with hypothyroidism to go undiagnosed, sometimes for many years. Some experts estimate that as many as 9 million people in the U.S. have undiagnosed hypothyroidism.

The condition affects both men and women, but it is far more common in women.

A different thyroid-related condition involves too much thyroid hormone in the bloodstream, producing symptoms that include rapid heart beat, extreme fatigue, weight loss, and nervousness. This condition is called hyperthyroidism   A condition in which too much thyroid hormone is circulating throughout the body, causing excessive stimulation of metabolic activity in body cells. , and the thyroid gland is said to be "overactive."

For further information about hyperthyroidism, go to Hyperthyroidism.

Nice To Know:

What is the thyroid gland?

The thyroid gland is a small, butterfly-shaped gland that lies just under the Adam's apple   This part of the cartilage that forms the larynx, or voice box, can be felt at the front of the neck. It is more prominent visually and by touch in men than in women. in the neck. There are two lobes to the gland, and they lie just in front and at either side of the windpipe (trachea). The thyroid is part of the body's endocrine system, which consists of glands that secrete hormones into the bloodstream.

The thyroid gland secretes thyroid hormones, which control the speed at which the body's chemical functions proceed (metabolism). To produce thyroid hormones, the thyroid gland needs iodine   A chemical element found naturally in seawater and some other sources that is needed to produce thyroid hormone. Iodized table salt has had iodine added to it., an element contained in many foods. The thyroid gland also produces a hormone   A chemical substance that is produced by an endocrine gland and released into the bloodstream to have its effect on other parts of the body. Also known as a chemical messenger.  For example, thyroid hormone, released by the thyroid gland speeds up or stimulates certain bodily functions.  , called calcitonin, which may be involved in the metabolism   The chemical and physical processes in the body that create the substances and generate the energy needed for cells to function, grow normally, and divide. Metabolism is also known as metabolic activity. of bones.

What Is Thyroid Hormone?

Hormones are chemical messengers released into the bloodstream by specialized glands called endocrine glands. A hormone circulates through the body in the bloodstream, delivering messages to other parts of the body. The "message" causes effects far from the gland that produced the hormone.

Thyroid hormone is produced in the thyroid gland, which is located in the front of the neck. It is released by the thyroid gland into the bloodstream and circulates throughout the body. Almost every cell in the body, from those in the brain to those in the feet, responds to the hormone.

There are two different forms of thyroid hormone present in the bloodstream. The two forms of thyroid hormone differ in the number of iodine units or atoms attached to the hormone. Iodine is a very important component of thyroid hormone.

  • Thyroid hormone with four iodine units is abbreviated as T4   A term used to describe a form of thyroid hormone in the bloodstream.  This form has four iodine units attached to the hormone structure.  Most thyroid hormone in the blood is T4; however, it is not biologically active in the body.  Special cells convert T4 into T3..

  • Thyroid hormone with three iodine units is abbreviated as T3   A term used to describe a form of thyroid hormone in the bloodstream.  It has three units of iodine attached to the hormone structure.  T3 is biologically active..

  • Most thyroid hormone in the blood is T4.

  • T3 is the form that is active in the body, not T4.

  • Certain cells in the body convert T4 to T3.

Nice To Know:

Just about all the iodine we consume in food is used by the body for the production of thyroid hormone.

  • If there is too little iodine in the diet, the body cannot make the thyroid hormone, and hypothyroidism will result.

  • If there is too much iodine, the production of thyroid hormone may be affected and, again, hypothyroidism can result.

In developed countries, iodine is added to regular table salt to ensure that individuals get enough iodine in their diets. Salt boxes are usually labeled "iodized salt."

But in underdeveloped countries, there are nearly 200 million people with goiters (enlarged thyroids) due to insufficient iodine in their diet.

What Does Thyroid Hormone Do?

Cells respond to thyroid hormone with an increase in metabolic activity. Metabolic activity, or metabolism, is a term used to describe the processes in the body that produce energy and the chemical substances necessary for cells to grow, divide to form new cells, and perform other vital functions.

If you think of each cell in the body as a motor car, then thyroid hormone acts as if you were tapping on the accelerator pedal. Its message is "go."

Because thyroid hormone   Chemical substance produced by the thyroid gland and released into the bloodstream. It interacts with almost all body cells, causing them to increase their metabolic activity. Two forms of thyroid hormone, abbreviated as T3 and T4, are found in blood. stimulates cells, it causes major body functions to "go" a bit faster.

  • Heart rate increases.

  • Breathing rate increases.

  • Use of proteins, fats, and carbohydrates rises.

  • Skeletal muscles work more efficiently.

  • Muscle tone in the digestive system, such as those in the walls of the intestines that help to move food through the digestive system increases.

  • Mental alertness and thinking skills are sharpened.

How Are The Blood Levels Of Thyroid Hormone Controlled?

Normally, the body runs like a car on cruise control - functioning at a steady rate. This steady state is known as homeostasis. The body's control system that regulates the cells to function at a steady, appropriate metabolic rate may be explained as follows:

  • Special "detector" cells in the brain monitor the level of thyroid hormone in the blood.

  • When the level of thyroid hormone drops, these cells send signals to a nearby organ in the brain known as the pituitary gland   A relatively small endocrine gland about the size of a pea.  This gland is located underneath the brain and releases a number of essential hormones, including thyroid stimulating hormone (TSH)..

  • These signals stimulate the pituitary gland to release a substance called thyroid-stimulating hormone (TSH) into the bloodstream.

  • TSH signals cells in the thyroid gland to release more thyroid hormone into the bloodstream.

  • When the blood level of thyroid hormone has increased enough, the detector cells in the brain detect the increase in thyroid hormone level.

  • These detector cells send signals to the pituitary gland to stop release of TSH.

Nice To Know:

The medical specialty called endocrinology   The subspecialty within internal medicine devoted to disorders of the endocrine glands. The specialist is called an endocrinologist. is devoted to the study and treatment of disorders of endocrine glands, that is, glands that secrete hormones. Your primary-care physician may refer you to an endocrinologist for a consultation or for ongoing care if you develop hypothyroidism or another endocrine condition.

Facts about hypothyroidism

  • Hypothyroidism can affect people of all ages, including children and infants.

  • Over five million Americans have hypothyroidism.

  • Hypothyroidism affects both sexes, but women are up to eight times more likely to develop it.

  • As many as 10% of women may have some degree of thyroid hormone deficiency.

  • Millions of people have hypothyroidism but do not know it.

  • Hypothyroidism may affect between 4% and 9% of the general population, and between 9% and 16% of people over age 60.

  • One out of every 4,000 infants is born with hypothyroidism.

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