Hypothyroidism: Spotting Related Health Concerns
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Hypothyroidism isn’t a problem isolated to your thyroid. Because the gland plays such a vital role in many aspects of your health, hypothyroidism, or an underactive thyroid, can lead to other conditions.
Fortunately, some complications of hypothyroidism can be prevented simply by restoring normal thyroid hormone levels with a daily pill. But other complications require extra vigilance. Reduce your health risks by knowing about the health concerns related to hypothyroidism, and the signs and symptoms of each. Early diagnosis and treatment can make a difference — it may even save your life.
“Thyroid hormone affects the heart by increasing heart rate and causing the muscle cells to grow,” says Joseph Pinzone, MD, an endocrinologist, medical director of AMAI Medicine and Wellness Practice in Santa Monica, Calif., and assistant clinical professor of medicine at the David Geffen School of Medicine at the University of California in Los Angeles. Too little thyroid hormone can cause your heart rate to slow, which can result in heart failure.
The risk of heart disease and death is increased in those who even have a mild form of the condition, called subclinical hypothyroidism, according to study published in 2010 in the journal Clinical Thyroidology for Patients. The risk of heart disease is also elevated because hypothyroidism is associated with high blood pressure and higher levels of low-density lipoprotein (LDL) cholesterol, or “bad” cholesterol. However, the study found that when hypothyroidism is managed with thyroid hormone therapy, the risk of heart disease returns to the same as that of people without hypothyroidism, suggesting that restoring hormone levels to normal should be considered even in mild cases.
Be aware of the signs of heart disease and let your health care provider know right away if you experience any:
- Light-headedness or fainting
- Shortness of breath or trouble breathing
- Chest pains
- Unexplained swelling in your feet, ankles, legs, abdomen, and veins in the neck
- Irregular heartbeat
If symptoms are sudden, call 911.
Caught early enough, heart disease treatment may be as uncomplicated as simple lifestyle changes. A healthy diet and physical activity, in addition to thyroid hormone medication, may be all you need to start feeling like yourself again.
People with hypothyroidism may also be at increased risk for glaucoma, a type of eye disease that results from damage to the optic nerve. In a study published in the British Journal of Ophthalmology in October 2008, researchers found that people who had a thyroid disease like hypothyroidism at some point in their lives were 38 percent more likely to develop glaucoma. Glaucoma can cause blind spots in your field of vision and eventually lead to blindness if not treated. Signs of glaucoma can include seeing spots, unusual difficulty adjusting to dark rooms, unusual sensitivity to light or glare, and double vision. Regular eye exams from an ophthalmologist are the best way to detect glaucoma. Treatments include eye drops, laser procedures, and surgery.
Unmanaged hypothyroidism can interfere with the ability to conceive. In women, untreated hypothyroidism is linked to a greater risk for miscarriages. And hypothyroidism in men can negatively affect erectile function and sperm count, according to a study published in Urology Journal in 2012. The good news is that normal fertility returns once thyroid function is restored through treatment.
For women with hypothyroidism, it’s important to work closely with your doctor to manage the condition when you’re trying to conceive.
Pregnancy Complications and Birth Defects
Once pregnant, it's also important for women to work with their medical team to maintain proper thyroid hormone levels. Hypothyroidism during pregnancy can negatively affect the mom and her developing baby. Pregnant women with poorly managed hypothyroidism may experience muscle pain or weakness, maternal anemia, congestive heart failure, preeclampsia, and postpartum hemorrhage. An unborn child has an increased risk of being born at a low birth weight. Also, if there isn't enough thyroid hormone present as baby's brain develops, there is the risk for severe cognitive, developmental, and neurological abnormalities.
Hypothyroidism symptoms, such as fatigue, weight gain, constipation, and mood changes, can be mistaken for normal pregnancy side effects — even more reason to have your thyroid levels monitored during pregnancy. Fortunately, by working with your doctor during pregnancy, these risks can be well-managed.
“Thyroid hormone helps brain cells to develop and function normally,” says Dr. Pinzone. “Too little thyroid hormone in adults can cause slowed thinking and dullness.” Although rare, some people with hypothyroidism develop ataxia, a group of symptoms (rather than a disease) characterized by uncoordinated and uncontrolled movements. Ataxia could result from thyroid antibodies rather than low levels of thyroid hormone. Signs of ataxia include clumsiness, dizziness, headache, difficulty speaking, and loss of balance, coordination, or eye movements. Thyroid medication often helps the condition, but not in every case, according to a review published in the Journal of Neurology, Neurosurgery and Psychiatry, If you experience any of these, let your doctor know right away.
In the most severe cases of untreated hypothyroidism, a condition called myxedema coma can occur. This happens when thyroid hormone levels get so low that body functions slow to the point of putting your life in danger. Symptoms of myxedema that should be immediately treated include unresponsiveness, decreased breathing, lower than average body temperature, low blood pressure, and uncharacteristic or inappropriate moods. Myxedema coma is a medical emergency that must be treated in the hospital.
People with hypothyroidism have a higher incidence of depression than people without a thyroid condition, according to a 2013 University of Athens study. The study attributes the increased risk of depression to changes in blood flow and blood sugar metabolism in the brain.
Symptoms of depression can vary based the degree of thyroid failure. Classic symptoms of depression include loss of interest in things you normally find pleasurable, changes in appetite, irritability, and feeling sad, empty, or worthless. Speak with your doctor if you are feeling depressed. If you're already being treated for hypothyroidism, this feeling may be a sign that your thyroid medication needs to be modified.
Knowing about the possible complications of hypothyroidism can help you monitor your health and live better with the condition. If you aren’t sure if new symptoms are due to a related condition, don’t hesitate to ask your doctor.
Video: Underactive Thyroid Symptoms
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