Complications Of Untreated Hypothyroidism
If you have an underactive thyroid gland, sticking to your treatment plan is vitally important. Find out about the serious and even fatal health complications of untreated hypothyroidism.
Like many women her age, Susan Stoev, 49, of Rochester, N.Y., felt tired and sluggish, and struggled with occasional aches and pains. A marketing executive and busy mother of two, she chalked up her ailments to middle age. But during a routine physical, Stoev mentioned her recent and inexplicable weight gain to her doctor. Blood tests revealed a common problem: She has hypothyroidism, also called an underactive thyroid.
Stoev is one of more than 9.5 million Americans with hypothyroidism. Hypothyroidism is a condition in which the thyroid gland, found at the base of the front of your neck, doesnt make enough thyroid hormones. Thyroid hormones control metabolism the way the body uses and stores energy and they affect many organ systems within the body, says Diana Kao, MD, MS, a womens health and chronic disease management expert at the University of Washington Neighborhood Factoria Clinic in Bellevue, Wash. Common causes of hypothyroidism include autoimmune disease, removal of the thyroid, radiation treatment, and treatment for an overactive thyroid gland . Being female and over 50 years old are the two biggest risk factors.
Hypothyroidism Symptoms Over Time
- Elevated cholesterol levels
The Complications of Untreated Hypothyroidism
What Causes Graves’ Disease
Researchers aren’t sure why some people develop autoimmune disorders such as Graves’ disease. These disorders probably develop from a combination of genes and an outside trigger, such as a virus.
With Graves’ disease, the immune system makes an antibody called thyroid-stimulating immunoglobulin that attaches to thyroid cells. TSI acts like a thyroid-stimulating hormone , a hormone made in the pituitary gland that tells the thyroid how much thyroid hormone to make. TSI causes the thyroid to make too much thyroid hormone.
Rarely, people with Graves’ disease develop a reddish thickening of the skin on the shins, a condition called pretibial myxedema or Graves’ dermopathy. This skin problem is usually painless and mild, but it can be painful for some.
How Does Thyroid Cancer Affect Pregnancy
Thyroid cancer is the second most common cancer diagnosed in pregnant women . Approximately 10% of thyroid cancers develop during pregnancy or within the first year after childbirth. Experts believe fluctuating hormone levels during pregnancy may trigger the cancer.
If you receive a thyroid cancer diagnosis during pregnancy, your healthcare provider can discuss treatment options. Depending on the cancer type and severity, your provider may recommend delaying treatment until after you deliver your baby. If treatment cant wait, most women can safely undergo surgery to remove the cancerous gland. You shouldnt have radioactive diagnostic tests or treatments when youre pregnant or breastfeeding.
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What Is Hashimotos Disease
Hashimotos disease affects the thyroid gland. Its also called Hashimotos thyroiditis, chronic lymphocytic thyroiditis or autoimmune thyroiditis. The thyroid gland makes hormones that control virtually all of the bodys metabolic functions and keep it working normally. Hashimotos thyroiditis is a type of autoimmune disease your immune system doesnt recognize your thyroid as your own and attacks it.
Hashimotos disease is common and affects about five people in 100 in the United States.
What Are The Symptoms Of Hashimotos Disease
Some people may not have any symptoms at first. As the disease slowly progresses, the thyroid gland becomes enlarged . A goiter is a common first sign of Hashimotos disease. A goiter is painless, but can create a feeling of fullness in the throat, and can make the front of your neck look swollen.
Other symptoms of Hashimotos disease that develop over time include:
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What Are The Risk Factors For Thyroid Nodules
Risk factors for developing thyroid nodules include:
- Family history. Having parents or siblings who have had thyroid nodules or thyroid or other endocrine cancers increases your chance of developing nodules.
- Age: The chance of developing nodules increases as you get older.
- Gender: Women are more likely than men to develop thyroid nodules.
- Radiation exposure: A history of radiation exposure to the head and neck increases your risk of developing nodules.
Risk factors for developing cancerous thyroid nodules include:
- Family history of thyroid cancer
- A nodule that is hard or is stuck to a nearby structure
- Male gender
How Is Thyroid Disease Treated
Your healthcare providers goal is to return your thyroid hormone levels to normal. This can be done in a variety of ways and each specific treatment will depend on the cause of your thyroid condition.
If you have high levels of thyroid hormones , treatment options can include:
- Anti-thyroid drugs : These are medications that stop your thyroid from making hormones.
- Radioactive iodine: This treatment damages the cells of your thyroid, preventing it from making high levels of thyroid hormones.
- Beta blockers: These medications dont change the amount of hormones in your body, but they help control your symptoms.
- Surgery: A more permanent form of treatment, your healthcare provider may surgically remove your thyroid . This will stop it from creating hormones. However, you will need to take thyroid replacement hormones for the rest of your life.
If you have low levels of thyroid hormones , the main treatment option is:
- Thyroid replacement medication: This drug is a synthetic way to add thyroid hormones back into your body. One drug thats commonly used is called levothyroxine. By using a medication, you can control thyroid disease and live a normal life.
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Stage : Overt Hypothyroidism
At this stage, the person has started to have thyroid gland failure. Their thyroid gland will be destroyed to the point where they will no longer be able to make their own thyroid hormone.
The person will have an elevated TSH, with low levels of free T3 and free T4. Thyroid antibodies may be even higher than in previous stages. This is the most common stage when a person is diagnosed, as the person usually has a significant amount of thyroid symptoms at this point.
This is also the stage where a person will require thyroid medications to prevent serious health consequences. Even the staunchest conventional physicians almost always recommend thyroid medication at this point.
Lifestyle changes and the root cause approach are critical at this stage, as you will likely be very symptomatic. Since you will have likely had an inflammatory process in your body for almost a decade at this point, you will need to take on the most aggressive treatment.
I often recommend LDN at this point to prevent progression of autoimmunity.
At stage 4, natural tissue regeneration is going to be much more challenging, but luckily, there are new options that exist that can accelerate thyroid tissue repair .
Stage : Subclinical Hypothyroidism
The third stage of Hashimotos is known as subclinical hypothyroidism.
In this stage, TSH levels may be slightly elevated on blood tests , and the levels of free T3 and free T4 are going to be normal. The persons thyroid antibodies may be even higher than in Stage 2, as increases in TSH can increase the inflammation of the thyroid gland. Some individuals, however, will continue to be antibody negative.
In the world of conventional medicine, this stage is controversial in terms of treatment. Doctors may take a wait and watch approach, but if nothing is done, this is the stage where one would begin to experience more symptoms that will eventually progress to overt hypothyroidism.
Some individuals have been able to reverse their condition at this stage without using medications, but I would not linger in this stage for too long, as an elevated TSH contributes to thyroid gland inflammation. Studies have shown that adding a small dose of thyroid medication to lower the TSH at this stage, results in a reduction of thyroid antibodies and can also make a big difference in your symptoms.
Thus, I, along with most progressive, integrative, and functional medicine physicians, will often recommend thyroid hormone treatment at this stage .
To learn more about optimizing thyroid medications, download my free eBook below!
In some cases, once the autoimmune attack is balanced, the person may be able to wean off thyroid medications naturally, under their doctors supervision.
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Can You Die From Thyroid Disease
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How Does Eating Diet And Nutrition Affect Hyperthyroidism
Your thyroid uses iodine to make thyroid hormones. If you have Graves disease or another autoimmune thyroid disorder, you may be sensitive to harmful side effects from iodine. Eating foods that have large amounts of iodinesuch as kelp, dulse, or other kinds of seaweedmay cause or worsen hyperthyroidism. Taking iodine supplements can have the same effect. Talk with members of your health care team about
- what foods to limit or avoid
- any iodine supplements you take
- any cough syrups or multivitamins you take because they may contain iodine
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When To Get Medical Advice
See a GP if you have symptoms of thyroid cancer. The symptoms may be caused by less serious conditions, such as an enlarged thyroid , so its important to get them checked.
A GP will examine your neck and can organise a blood test to check how well your thyroid is working.
If they think you could have cancer or theyre not sure whats causing your symptoms, youll be referred to a hospital specialist for more tests.
If you are having thyroid surgery, known as a thyroidectomy, itâs important to know what to expect as you recover. Side effects of surgery are common and include neck pain, a sore throat, difficulty swallowing, hoarseness, and temporary hypoparathyroidism. Complications are much less common and can include bleeding , permanent hypoparathyroidism , and damage to nerves that can lead to long-term hoarseness and vocal changes.
Taking time to learn about post-thyroidectomy recovery can prepare you to cope with any symptoms and to be alert to any problems.
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Who Gets Graves’ Disease Is It Common
Graves’ disease is the most common cause of hyperthyroidism in the United States. The disease affects about 1 in 200 people.
Graves’ disease usually affects people between ages 30 and 50, but can occur at any age. The disease is seven to eight times more common in women than men.3 A persons chance of developing Graves disease increases if other family members have the disease.
People with other autoimmune disorders are more likely to develop Graves’ disease than people without these disorders. Conditions linked with Graves’ disease include
- rheumatoid arthritis, a disorder that affects the joints and sometimes other body systems
- pernicious anemia, a condition caused by a vitamin B12 deficiency
- lupus, a chronic, long-term disorder that can affect many parts of your body
- Addison’s disease, a hormonal disorder
- signs of Graves’ eye disease, present in about one out of three people with Graves’ disease
- a history of other family members with thyroid or autoimmune problems
If the diagnosis is uncertain, your doctor may order further blood or imaging tests to confirm Graves’ disease as the cause.
A blood test can detect TSI. However, in mild cases of Graves’ disease, TSI may not show up in your blood. The next step may be one of two imaging tests that use small, safe doses of radioactive iodine. Your thyroid collects iodine from your bloodstream and uses it to make thyroid hormones it will collect radioactive iodine in the same way.
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What Happens If I Have Hypothyroidism During Pregnancy
For pregnant women, there is a different thyroid stimulating hormone goal. If your TSH level is not at goal, your provider will likely offer you treatment with synthetic thyroid hormone to protect the safety of your pregnancy and your baby.
Untreated hypothyroidism during pregnancy can increase the risk of miscarriage, premature birth and stillbirth. Or it may cause a dangerous rise in blood pressure in late pregnancy . Untreated hypothyroidism can also affect your babys growth and brain development. Your providers will work with you to make sure your hypothyroidism is under control during your pregnancy.
Hypothyroidism during pregnancy is not common. But sometimes symptoms of hypothyroidism can be overlooked during pregnancy, with its fatigue and weight gain. Let your providers know right away if you notice any hypothyroidism symptoms, or feel like youre developing a goiter.
A note from Cleveland Clinic
In most cases, hypothyroidism can remain well controlled as long as you take your daily medication and get blood tests to adjust the dosage as instructed by your healthcare provider. Eating healthy and getting enough exercise can help you live a long, healthy life with the condition. Your healthcare providers can tell you what steps to take to feel better along the way.
Last reviewed by a Cleveland Clinic medical professional on 06/11/2020.
Left Untreated Low Thyroid Can Be Life
Many seniors attribute symptoms such as fatigue, forgetfulness, weight gain and moving more slowly to normal aging.
But these health problems can point to a much bigger, often overlooked problem–hypothyroidism, which means the body is not making enough thyroid hormone. The thyroid is a butterfly-shaped endocrine gland in the neck, just above the collarbone. It makes hormones that regulate metabolism and tells other body parts and organs what to do.
If not treated, long-term uncontrolled hypothyroidism can cause:
- Heart problems. Hypothyroidism raises cholesterol levels and can lead to heart attack or stroke.
- Peripheral neuropathy. This condition can damage nerves that run from the brain and spinal cord to the rest of the body, such as arms and legs, causing pain, numbness, tingling, and muscle weakness.
- Myxedema. Symptoms of this rare, life-threatening condition include intense cold intolerance and drowsiness followed by profound lethargy, unconsciousness and myxedema coma. Myxedema requires emergency medical treatment.
- Mental health issues. Depression may occur early in hypothyroidism and may become more severe over time. Hypothyroidism can also cause slowed mental functioning.
John E. Morley, M.D, a geriatric doctor and endocrinologist and director of the Geriatric Medicine Division at Saint Louis University School of Medicine told AgingCare.com that low thyroid can be quickly diagnosed and easily treated.
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How Is Thyroid Disease Diagnosed
Sometimes, thyroid disease can be difficult to diagnose because the symptoms are easily confused with those of other conditions. You may experience similar symptoms when you are pregnant or aging and you would when developing a thyroid disease. Fortunately, there are tests that can help determine if your symptoms are being caused by a thyroid issue. These tests include:
- Blood tests.
- Physical exams.
One of the most definitive ways to diagnose a thyroid problem is through blood tests. Thyroid blood tests are used to tell if your thyroid gland is functioning properly by measuring the amount of thyroid hormones in your blood. These tests are done by taking blood from a vein in your arm. Thyroid blood tests are used to see if you have:
The specific blood tests that will be done to test your thyroid can include:
These tests alone arent meant to diagnose any illness but may prompt your healthcare provider to do additional testing to evaluate for a possible thyroid disorder.
Additional blood tests might include:
Talk to your healthcare provider about the ranges for these thyroid blood tests. Your ranges might not be the same as someone elses. Thats often alright. If you have any concerns or worries about your blood test results, talk to your provider.
An ultrasound typically takes about 20 to 30 minutes.
Is There A Higher Risk Of Developing Thyroid Disease If I Have Diabetes
If you have diabetes, youre at a higher risk of developing a thyroid disease than people without diabetes. Type 1 diabetes is an autoimmune disorder. If you already have one autoimmune disorder, you are more likely to develop another one.
For people with type 2 diabetes, the risk is lower, but still there. If you have type 2 diabetes, youre more likely to develop a thyroid disease later in life.
Regular testing is recommended to check for thyroid issues. Those with type 1 diabetes may be tested more often immediately after diagnosis and then every year or so than people with type 2 diabetes. There isnt a regular schedule for testing if you have type 2 diabetes, however your healthcare provider may suggest a schedule for testing over time.
If you have diabetes and get a positive thyroid test, there are a few things to you can do to help feel the best possible. These tips include:
- Getting enough sleep.
- Taking all of your medications as directed.
- Getting tested regularly as directed by your healthcare provider.
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What Are Clinical Trials For Hyperthyroidism
Clinical trialsand other types of clinical studiesare part of medical research and involve people like you. When you volunteer to take part in a clinical study, you help doctors and researchers learn more about disease and improve health care for people in the future.
Researchers are studying many aspects of hyperthyroidism, such as its natural history, clinical presentation, and genetics.