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Hypothyroidism

Definition

Hypothyroidism is a condition in which the thyroid gland does not make enough thyroid hormone.

See also:

Alternative Names

Myxedema; Adult hypothyroidism

Causes, incidence, and risk factors

The thyroid gland is located in the front of the neck just below the voice box (larynx). It releases hormones that control metabolism.

The most common cause of hypothyroidism is inflammation of the thyroid gland, which damages the gland's cells. Autoimmune or Hashimoto's thyroiditis, in which the immune system attacks the thyroid gland, is the most common example of this. Some women develop hypothyroidism after pregancy (often referred to as "postpartum throiditis").

Other common causes of hypothyroidism include:

  • Congenital (birth) defects
  • Radiation treatments to the neck to treat different cancers, which may also damage the thyroid gland
  • Radioactive iodine used to treat an overactive thyroid (hyperthyroidism)
  • Surgical removal of part or all of the thyroid gland, done to treat other thyroid problems
  • Viral thyroiditis, which may case hyperthyroidism and is often followed by temporary or permanent hypothyroidism

Certain drugs can cause hyperthyroidism, including:

Risk factors include:

  • Age over 50 years
  • Being female

Symptoms

Early symptoms:

  • Being more sensitive to cold
  • Constipation
  • Depression
  • Fatigue or feeling slowed down
  • Heavier menstrual periods
  • Joint or muscle pain
  • Paleness or dry skin
  • Thin, brittle hair or fingernails
  • Weakness
  • Weight gain (unintentional)

Late symptoms, if left untreated:

  • Decreased taste and smell
  • Hoarseness
  • Puffy face, hands, and feet
  • Slow speech
  • Thickening of the skin
  • Thinning of eyebrows

Signs and tests

A physical examination may reveal a smaller-than-normal thyroid gland, although sometimes the gland is normal size or even enlarged (goiter). The examination may also reveal:

  • Brittle nails
  • Coarse facial features
  • Pale or dry skin, which may be cool to the touch
  • Swelling of the arms and legs
  • Thin and brittle hair

A chest x-ray may show an enlarged heart.

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Neonatal hypothyroidism (Doctor-Reviewed information)
Neonatal hypothyroidism is decreased thyroid hormone production in a newborn. In very rare cases, no thyroid hormone is produced.If the baby was born with the condition, it is called congenital hypothyroidism. Reviewer: Alan Greene, MD, FAAP, Department of Pediatrics, Stanford University School of Medicine, Lucile Packard Children's Hospital; Chief Medical Officer, A.D.A.M., Inc. Previously reviewed by Robert Hurd, MD, Professor of Endocrinology, Department of Biology, Xavier University, Cincinnati, OH, and physician in the Primary Care Clinic, Cincinnati Veterans Administration Medical Center, Cincinnati, Ohio. Review provided by VeriMed Healthcare Network. (7/17/2007)Date: 08/15/2007

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