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Hypothyroidism Diagnosis

Hypothyroidism is the lack of the normal function of the thyorid gland, but this might not only be due to thiroid disease since the strict regulation of patways to hormone production; for thyroid to produce hormones, the hypothalamus must send a message to the pituitary gland to produce another hormone known as “Thyroid Stimulating Hormone”(TSH)that makes the gland work.

The axis works like this: The hipothalamus sends tirotropine liberating factor (TLF) so the pituitary, that then produces thyroid stimulating hormone and it’s effects make the thyroid produce triiodotyronine (T3) and tetraiodotyronine (t4). When the problem is at the hypothalamus, is known as “terciary hypothyroidism” and it’s due to a deficient secretion of tirotropine liberating factor.

“Secondary Hypothyroidism” is due to a problem in the pituitary gland and could be caused by a tumor or a necrosis of the gland postpartum known as Sheehan’s syndrome). “Primary Hypithyroidism” is because a problem in the thyroid gland itself, like goiter, autoimmune diseases, lack of the gland (because of surgery or a birth defect), lack of iodine in your diet (very rare in western countries because salt is added with iodine) and others. And finally, the “tertiary hypothyroidism” is when the peripheral tissues are resistent to the normal production of thyroidal hormones, many of the times, because of antibodies against them.

To make a diagnosis, you should recognize the symptoms; you might not have all of them, but certain clues will help you. You start to increase your weight even you haven’t overeated (even is very true, many people who are obese blame a thyroid malfunction to their overweight), you can’t tolerate hot weather, your skin is very, very dry and becomes thicker (like an orange peel), your voice harshenes without other explication, you get edema (retain water) in your limbs, face, lips, tongue (you can see the marks of your teeth on the border of your tongue)…you are very fatigued with no other explanation.

If you have one or more of these symtomps, you must visit your regular physician. He/she will order a thyroid profile. The most common alterations is a high level of TSH (Thyroid Stimulating Hormone produced by the pituitary) with normal to low thyroid hormones levels. This means the pituitary is doing an extra stimulation to obtain normal to low leveles of thyroid hormones, because the thyroid gland is not working enough. Then your doctor will send you to an endocrinologist who knows a lot more about this condition, to make some workup to check out the causes of this malfunction, but in the majority of the cases of Primary Hipothyroidism the cause still remains unknown.

The endocorinologist will rule out the causes of the lack of hormones, correct the primary cause if it’s possible or start you in a treatment with replacement hormones. BE PATIENT. The dosage is not the same one for each case and your specialist will start with an inicial dose, then increase it or lower it, according to your response… it takes a lot of time to achieve an apporpiate dose for your specific case, so be patient.

If your thyroid profile shows signs of lower levels of TSH and thyroid hormones, then the problem is in the hypothalamus…you will need a different work up, maybe a CT scan of your head to check if everything is OK. CT scan is also recommended to rule out an abnormality in the pituitary gland.
And if your thyroid functions test are normal but you experience symptoms of hypothyroidism, maybe is a tertiary hypothyroidism, your perfierical tissues are not sensible to the thyroyd hormones. You have to get a workup for antiboides to these hormones.

Lastly there is a form of hypothiroidism known as congenital, because you are born without the gland. Babies are jaundiced, very sleepy (it’s hard to wake them up), their body tone is diminished and if it’s not detected in time, they develop mental retardation. Fortunatelyy, when babies are born doctors make a panel of studies to rule out congenital hypothyroidism, among other congenital diseases

Thyroid gland is one of the most important glands in your body because it regulates several functions like heath and cold regulation, exchange of water, cardiac function, among others, and is implicated in many metabolic pathways. The amazing advances of medicine have made for us possible to remediate it’s malfunction by taking simple pills… but you have to take them for the rest of your life.

The hardest part is losing those extra pounds you gained after you where diagnosed. Hormone replacement is going to help, but is not a magic pill to lose weight. In fact, if you take them witouth a prescription for hytpthyroidism in the recommended dosage, you will make a really bad mess in your body that will lead you to the ICU.

Losing weight is hard, but not an impossible task to achieve. Start a diet an excersise, until you reach your normal weight again. Use an extra dry cream until your hormone leveles reach the level in which your sking will be back to normal. The edema will take longer time to disappear, but it will go away.
And don’t miss any of your medical appointments.