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People with hypothyroidism often have no or only mild symptoms. Numerous symptoms and signs are associated with hypothyroidism and can be related to the underlying cause, or a direct effect of having not enough thyroid hormones. [14] [15] Hashimoto's thyroiditis may present with the mass effect of a goitre (enlarged thyroid gland). [14]
Certain medications can have the unintended side effect of affecting thyroid function. While some medications can lead to significant hypothyroidism or hyperthyroidism and those at risk will need to be carefully monitored, some medications may affect thyroid hormone lab tests without causing any symptoms or clinical changes, and may not require treatment.
However, deprescribing may be considered if a patient experiences side effects like rapid heart rate, anxiety, or bone loss, or if their thyroid function tests normalize.”
Side effects of thyroid replacement therapy are associated with iatrogenic hyperthyroidism. [5] Symptoms to watch out for include, but are not limited to, anxiety, tremor, weight loss, heat sensitivity, diarrhea, and shortness of breath. More worrisome symptoms include atrial fibrillation and bone density loss. [5]
Hypothyroidism is common in pregnancy with an estimated prevalence of 2-3% and 0.3-0.5% for subclinical and overt hypothyroidism respectively. [8] Endemic iodine deficiency accounts for most hypothyroidism in pregnant women worldwide while chronic autoimmune thyroiditis is the most common cause of hypothyroidism in iodine sufficient parts of the world.
Congenital hypothyroidism can also occur due to genetic defects of thyroxine or triiodothyronine synthesis within a structurally normal gland. Among specific defects are thyrotropin ( TSH ) resistance, iodine trapping defect, organification defect, thyroglobulin , and iodotyrosine deiodinase deficiency.
Other side effects may include allergic reactions. [1] Use in pregnancy and breastfeeding is generally safe. [2] Regular blood tests are recommended to verify the appropriateness of the dose. [1] They contain a mixture of thyroxine (T4) and triiodothyronine (T3). [1] Desiccated thyroid has been used since the late 1800s. [3]
A low amount of thyroxine (one of the two thyroid hormones) in the blood, due to lack of dietary iodine to make it, gives rise to high levels of thyroid stimulating hormone (TSH), which stimulates the thyroid gland to increase many biochemical processes; the cellular growth and proliferation can result in the characteristic swelling or hyperplasia of the thyroid gland, or goiter.
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