Dr. Jorge Velez Garza questions a 33-year-old mother about symptoms that would indicate her common, but often undetected condition, needs additional treatment.
He asks, are you extremely tired, have brain fog, constipation or dry skin? What about uncontrollable weight gain, thinning hair or feeling cold a lot of the time?
She says no to having those symptoms. He checks the results of her blood tests and concludes the medication she takes daily is working.
Dr. Velez is an endocrinologist who specializes in treating hormone-related diseases.
His patient has hypothyroidism, the most common among thyroid conditions, which affect an estimated 12% of the U.S. population, according to the American Thyroid Association.
What Is Hypothyroidism?
Hypothyroidism occurs when the thyroid — a small butterfly-shaped gland just above the Adam’s Apple — is not producing enough of the hormones needed to control a patient’s metabolism and regulate vital body functions including heart rate, body temperature and cholesterol levels.
It’s the flip side of hyperthyroidism, where the thyroid produces too much of the hormones, often creating a rapid heartbeat, excessive weight loss and anxiety.
Not long ago, Dr. Velez’s patient had her diseased thyroid gland removed because it was hyper, or overly active. Now, without it her body doesn’t produce the needed hormones, so she automatically has hypothyroidism.
What Causes Hypothyroidism?
The most common cause of hypothyroidism is an autoimmune disorder known as Hashimoto's thyroiditis, in which the immune system attacks itself.
Other causes include radioactive iodine therapy; a condition triggered by pregnancy; and iodine deficiency.
Congenital hypothyroidism is rare in newborns but can damage a baby’s brain and nervous system. That’s why Texas and many other states require a simple blood test shortly after birth to ensure it is identified and treated.
Why Is Hypothyroidism often Undetected?
Dr. Velez says hypothyroidism, most common in women over 60, sneaks up on many patients who believe exhaustion and faulty memory are just part of getting older.
Patients start paying attention, though, when they have to trade in their size 8 pants for size 16.
Dr. Velez says the so-called “fat thyroid” condition can be detected by testing hormone levels, especially TSH, thyroid stimulating hormone. If it’s elevated, it’s a pretty good bet the patient has hypothyroidism.
“Once you are treated, you should be able to lose weight like a normal person,” he said.
Hypothyroidism can also lead to anemia, elevated cholesterol, heart disease, and in the most severe cases, myxedema coma, a life-threatening condition.
Can Hypothyroidism Be Treated Naturally? And Cured?
While diet and exercise can make a patient feel better, most experts say that won’t reverse hypothyroidism. A patient’s health can usually be restored, however, with a synthetic hormone, levothyroxine, which they will probably take for the rest of their lives.
