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There are several distinct causes for chronic hypothyroidism. Historically and, still, in many developing countries iodine deficiency is the most common cause of hypothyroidism worldwide. In present day developed countries, however, hypothyroidism is mostly caused by Hashimoto's thyroiditis, or by a lack of the thyroid gland or a deficiency of hormones from either the hypothalamus or the pituitary.
Hypothyroidism can result from postpartum thyroiditis, a condition that affects about 5% of all women within a year after giving birth. The first phase is typically hyperthyroidism. Then, the thyroid either returns to normal or a woman develops hypothyroidism. Of those women who experience hypothyroidism associated with postpartum thyroiditis, one in five will develop permanent hypothyroidism requiring life-long treatment.
Hypothyroidism can also result from sporadic inheritance, sometimes autosomal recessive. It is a relatively common disease in purebred domestic dogs as well, and can have a hereditary basis in dogs.
Temporary hypothyroidism can be due to the Wolff-Chaikoff effect.
General psychological associations
In addition, patients with hypothyroidism and psychiatric symptoms may be diagnosed with:
The ability of Hypothyroidism to mimic a number of medical conditions originates in the vast functions of the thyroid hormones, which are reduced or absent in this case. The functions of thyroid hormones include modulation of carbohydrate, protein and fat metabolism, vitamin utilization, mitochondrial function, digestive process, muscle and nerve activity, blood flow, oxygen utilization, hormone secretion and sexual and reproductive health to mention a few. Thus, when the thyroid hormone content gets out of balance, systems covering the whole body are affected. This is why hypothyroidism can look like other diseases. Conversely, sometimes other conditions can be mistaken for hypothyroidism.
In adults, hypothyroidism is associated with the following symptoms:
Hypothyroidism in pediatric patients can cause the following additional symptoms:
The severity of hypothyroidism varies widely. Some have few overt symptoms, others with moderate symptoms can be mistaken for having other diseases and states. Advanced hypothyroidism may cause severe complications including cardiovasular and psychiatric myxedema.
To diagnose primary hypothyroidism, many doctors simply measure the amount of Thyroid-stimulating hormone (TSH) being produced. High levels of TSH indicate that the thyroid is not producing sufficient levels of Thyroid hormone (mainly as thyroxine (T4) and smaller amounts of triiodothyronine (fT3)). However, measuring just TSH fails to diagnose secondary and tertiary forms of hypothyroidism, thus leading to the following suggested blood testing if the TSH is normal and hypothyroidism is still suspected:
Additionally, the following measurements may be needed:
Both synthetic and animal-derived thyroid tablets are available and can be prescribed for patients in need of additional thyroid hormone. Thyroid hormone is taken daily, and doctors can monitor blood levels to help assure proper dosaging. The American Association of Clinical Endocrinologists recommends the use of levothyroxine (T4) as thyroid replacement. In general, desiccated thyroid hormone, combinations of thyroid hormone, or triiodothyronine should not be used for replacement therapy.
The American Thyroid Association cautions against taking herbal remedies, and warns that taking too much iodine can actually worsen hypothyroidism.
|This article is licensed under the GNU Free Documentation License. It uses material from the Wikipedia article "Hypothyroidism". A list of authors is available in Wikipedia.|