Feeling Down Or Depressed
Hypothyroidism is linked to depression. The reasons for this are unclear, but it might be a mental symptom of an overall decrease in energy and health .
64% of women and 57% of men with hypothyroidism report feelings of depression. About the same percentage of men and women also experience anxiety .
In one study, thyroid hormone replacement improved depression in patients with mild hypothyroidism, compared to a placebo .
Another study of young women with mild hypothyroidism showed increased feelings of depression, which were also connected to decreased satisfaction with their sex lives (
Feeling depressed is a good reason to talk to a physician or therapist. They may be able to help you cope, regardless of whether the depression is caused by thyroid problems or something else.
Summary: Hypothyroidism can cause depression and anxiety. These conditions are shown to improve with thyroid hormone replacement.
Causes Of An Overactive Thyroid
There are several reasons why your thyroid can become overactive.
- Graves’ disease a condition where your immune system mistakenly attacks and damages the thyroid
- lumps on the thyroid this extra thyroid tissue can produce thyroid hormones, causing your levels to be too high
- some medicines such as amiodarone, which can be used to treat an irregular heartbeat
Find out more about the causes of an overactive thyroid.
Getting A Diagnosis And Treatment
Together with a physical exam and medical history, diagnostic tests are necessary to determine if you have a thyroid problem.
Your doctor may order blood tests to detect the levels of the hormones TSH, T4 and T3 in your blood, which can indicate hypothyroidism or hyperthyroidism. You may also need to take a thyroid antibody blood test, which can help diagnose underlying autoimmune diseases that can cause hormonal imbalances.
Some people may also need an ultrasound. This scan uses sound waves to take pictures of the thyroid gland and can identify thyroid nodules that may be affecting thyroid function.
If you are diagnosed with a thyroid problem, know that there are treatments available. Many people take medications to balance their hormones, while some may need thyroid surgery or radioiodine therapy. Being proactive is critical to your thyroid health, so share your concerns, ask questions and partner with your care team to find a treatment plan that works for you.
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What Is Thyroid Hormone
Thyroid hormone is made by the thyroid gland, a butterfly-shaped endocrine gland normally located in the lower front of the neck. Thyroid hormone is released into the blood where it is carried to all the tissues in the body. It helps the body use energy, stay warm and keeps the brain, heart, muscles, and other organs working as they should.
Thyroid hormone exists in two main forms: thyroxine and triiodothyronine . T4 is the primary form of thyroid hormone circulating in the blood . To exert its effects, T4 is converted to T3 by the removal of an iodine atom this occurs mainly in the liver and in certain tissues where T3 acts, such as in the brain. T3 normally accounts for about 5% of thyroid hormone circulating in the blood.
Most thyroid hormone in the blood is bound by protein, while only a small fraction is free to enter tissues and have a biologic effect. Thyroid tests may measure total or free hormone levels.
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Can Hyperthyroidism Be Cured
Yes, there is a permanent treatment for hyperthyroidism. Removing your thyroid through surgery will cure hyperthyroidism. However, once the thyroid is removed, you will need to take thyroid hormone replacement medications for the rest of your life. Your body still needs thyroid hormones, just not at such high levels as you have in hyperthyroidism. Though you will need to regularly take the medication and check in with your healthcare provider regularly, this is a manageable form of thyroid disease which allows you to live a normal life.
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At Home Thyroid Blood Test
If you are on too much thyroid medication, your thyroid-stimulating hormone test will likely be on the lower end of the reference range. Your doctor may also check your T4 and T3 levels. If these are on the upper end of the reference range, that may also indicate overmedication.
It is also helpful to track your symptoms to have a log of what you are experiencing and what time of day. This information helps your doctor assess factors that cause dosage or absorption issues that may not show up in your blood work.
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What Are The Dangers Of Low Tsh Levels
Serious complications can result from low TSH levels.These complications can include a variety of heart problems, weak bones, eye and skin problems, and thyrotoxic crisisa serious condition that can cause delirious behavior. Seek medical care if your symptoms increase intensely as this can indicate thyroxic crisis.
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How Thyroid Medication Treats Hypothyroidism
The thyroid gland is responsible for regulating cellular metabolism, growth, and development. When the thyroid does not produce enough hormone, it can slow down all body systems.
Common symptoms of hypothyroidism include:
- Fatigue and malaise
- Dry skin
Thyroid hormone replacement medication can relieve the above symptoms and improve your overall health and quality of life.
Hashimoto’s thyroiditis, an autoimmune condition, is often the cause of hypothyroidism. Chronic inflammation from Hashimoto’s can lead to the thyroid gland’s eventual failure, making it unable to produce enough thyroid hormone. Surgical removal, radiation, thyroiditis, and damage to the pituitary gland can also cause hypothyroidism. No matter the cause, people with hypothyroidism often need thyroid replacement medication.
Dosage Or Drug Quality Issues
Overmedication may occur when there is an error in dosage. For example:
- Your healthcare provider may prescribe a dosage that is too high for you.
- Your pharmacist may give you the wrong dosage or incorrect instructions for use.
It is also possible that the quality of your medication may change from one refill of your prescription to another. This is sometimes the case when your medication is produced by several different manufacturers.
If you are taking generic levothyroxine, you may receive a batch of medication that is more or less potent than your previous refill. Even a slight change of potency from one refill to the next can lead to hypothyroidism.
Switching formulations of levothyroxinefor example, from tablet to gel-caps or liquidcan also cause overmedication. That’s because your body absorbs certain formulations of levothyroxine better than others.
In particular, both Tirosint liquid gel-caps and Tirosint-SOL liquid levothyroxine absorb better than levothyroxine in tablet form. You may be prescribed gel-cap or liquid levothyroxine if you are allergic to dyes or fillers, but the switch may result in overmedication.
This is why close monitoring is important. You should get your TSH level checked within six weeks after beginning thyroid hormone replacement, or after changing the brand or dose of your medication.
Pay particular attention to symptoms that develop after a recent pharmacy refill. They may be due to a medication error or change in the formulation.
How Is Hashimotos Disease Treated
Hashimotos disease is treated with a daily dose of . This is the same hormone that your thyroid gland makes. You will probably need to take thyroid hormone pills for the rest of your life. Talk to your doctor or nurse about any questions or concerns.
You may have to see your doctor or nurse a few times to test the level of thyroid stimulating hormone in your body. Thyroid hormone acts very slowly in the body, so it can take several months after the start of treatment for symptoms to go away. Once your TSH level is normal, your doctor or nurse will need to see you less often.
The same treatment dose usually works for many years. But your TSH levels may change sometimes, especially during pregnancy, if you have , or if you take . Your doctor or nurse may need to adjust your dose.
Signs And Symptoms Of Overmedication
Signs and symptoms of thyroid hormone overmedication can vary, but some common ones include:
- Elevated pulse and blood pressure
- Anxiety, nervous energy, tremors
- Feeling like your heart is skipping a beat or racing
- Weight loss with no change in your diet/exercise routine
- Increase in food intake with no weight gain
In some cases, symptoms of overmedication can be similar to those of hypothyroidism. You may feel more exhausted than usual, or achy and as if you have the flu you may put on weight, or feel jittery and anxious.
In fact, it’s not unheard of for a person to visit their healthcare provider to get tested, certain that they need an increased dosage, only to discover that their symptoms are actually due to overmedication.
Thyroid Disease Healthcare Provider Discussion Guide
Get our printable guide for your next healthcare provider’s appointment to help you ask the right questions.
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What Are The Symptoms Of Hypothyroidism In Men
Although many symptoms of hypothyroidism can be the same in men and women, there are some that are specific and of special concern to men.
Sexual dysfunction refers to any problem that affects your desire for or enjoyment of sex. In men, low thyroid levels can cause several different types of sexual dysfunction.
Some studies report that about 60% of men with hypothyroidism have low libido , erectile dysfunction, or delayed ejaculation. Premature ejaculation is much less common, affecting about 7% of men. Hypothyroidism has also been shown to affect semen quality and is associated with lower sperm count, form, and movement. These factors could potentially lower fertility.
While these symptoms may be alarming, they are often reversible with treatment.
Up to 50% of people with hypothyroidism can experience some type of hair loss, ranging from partial to very extensive.
Individual hair follicles have a specific growth cycle of growth and rest stages. Hypothyroidism negatively affects this cycle, which can result in hair loss. Other hair changes can also be seen in hypothyroidism, including dry, brittle, and coarse hair that may take longer to grow.
Fortunately, with proper treatment, these changes can be reversed, too.
Testosterone is a sex hormone with many important roles in mens health, including bone and muscle growth, sex drive, and normal reproduction.
Muscle weakness and cramps
Other common symptoms
What You Can Do To Improve Symptoms
Eating a proper diet, with a focus on calcium and sodium, is important, especially in preventing hyperthyroidism. Work with your doctor to create healthy guidelines for your diet, nutritional supplements, and exercise.
Hyperthyroidism can also cause your bones to become weak and thin, which can lead to osteoporosis. Taking vitamin D and calcium supplements during and after treatment can help strengthen your bones. Your doctor can tell you how much vitamin D and calcium to take each day. Learn more about the health benefits of vitamin D.
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Are There Risk Factors That Increase Your Chances Of Having Thyroid Problems
Females are more likely to have a thyroid-related disease than males but other factors may increase the risk of thyroid problems. These include a family history of thyroid disease, having an autoimmune condition such as lupus or rheumatoid arthritis, ingesting excessive iodine , age older than 60, and having had a thyroid issue or thyroid cancer in the past.
Diagnosing High Tsh Levels
When you see your doctor, the most common test for a high TSH level is a blood test. They will not only check your TSH level, but they also are looking at your triiodothyronine and thyroxine levels.
Imaging tests such as an ultrasound or a thyroid scan with a special camera and slightly radioactive iodine are used to look at your thyroid. It looks for inflammation or shrinkage, which can both occur with hypothyroidism. Another test, called a radioactive iodine uptake test, is done to see if your thyroid is taking up enough iodine to make the hormones it produces.
Thyroid antibody tests can be used to diagnose autoimmune thyroid disorders, like Hashimotos disease.
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Whats Special About University Of Michigans Treatment Of Graves Disease
UM is one of the few places in the country that has a multidisciplinary group dedicated to the treatment of patients with Graves disease. UMs multidisciplinary group consists of endocrinologists, endocrine surgeons, ophthalmologists, nuclear medicine physicians, rheumatologists and psychiatric professionals. Our group sees Graves disease patients from around the country and is involved with one of the most well-known national organizations concentrating on helping patients and families coping with Graves disease and Graves eye disease. Our group routinely publishes papers with new research results on Graves disease.
The ophthalmologists in our group specialize in the treatment of Graves eye disease which can require complex management. Most ophthalmologists have little experience treating patients with Graves disease and Graves eye disease. For those patients with Graves eye disease, it is the severity of the eye disease which drives the selection of the type of treatment for hyperthyroidism if these two problems occur together.
While those patients with no Graves eye disease or only mild eye disease may be candidates for any of the three types of treatments for hyperthyroidism, those who have moderate to severe eye disease are often referred for surgical thyroidectomy as RAI has a higher chance of worsening the eye disease than surgery does.
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Weakness And Aches In Muscles And Joints
Low thyroid hormone flips the metabolic switch toward catabolism, which is when the body breaks down body tissues like muscle for energy .
During catabolism, muscle strength decreases, potentially leading to feelings of weakness. The process of breaking down muscle tissue can also lead to aching .
Everyone feels weak once in a while. However, people with hypothyroidism are twice as likely to feel more weak than usual, compared to healthy people (
One study in 35 individuals with hypothyroidism showed that replacing low levels of thyroid hormone with a synthetic thyroid hormone called levothyroxine improved muscle strength and decreased aches and pains, compared to no treatment .
Another study showed a 25% improvement in the sense of physical well-being among patients receiving thyroid replacement .
Weakness and aches are normal following strenuous activity. However, new, and especially increasing, weakness or aching is a good reason to make an appointment with your physician.
Summary: Low levels of thyroid hormone slow down your metabolism and can cause painful muscle breakdown.
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What Are The Symptoms Of Hyperthyroidism
High amounts of T4, T3, or both can cause an excessively high metabolic rate. This is called a hypermetabolic state. When in a hypermetabolic state, you may experience a rapid heart rate, elevated blood pressure, and hand tremors. You may also sweat a lot and develop a low tolerance for heat. Hyperthyroidism can cause more frequent bowel movements, weight loss, and, in women, irregular menstrual cycles.
Visibly, the thyroid gland itself can swell into a goiter, which can be either symmetrical or one-sided. Your eyes may also appear quite prominent, which is a sign of exophthalmos, a condition thats related to Graves disease.
Other symptoms of hyperthyroidism include:
Other tests may be performed to further evaluate your diagnosis. These include:
The Symptoms Of High Tsh
While experiencing symptoms of high TSH and hypothyroidism is common, many patientsand even cliniciansoften fail to attribute those symptoms to a thyroid disorder. This is largely because they are typically also symptoms of other medical conditions as well as non-pathological physical or emotional states. As the American Thyroid Association Task Force on Thyroid Hormone Replacement noted in 2014, The symptoms often have an insidious onset and overlap significantly between patients with thyroid disease and those without. Many signs and symptoms of thyroid dysfunction are neither sensitive nor specific. In other words, you can have hypothyroidism and have the exact same symptoms of someone without it. Thats why it is important to look at the cumulative symptoms.
The most common symptoms of high TSH andhypothyroidism include:
- Feeling tired/worn out
- Hair loss
Unfortunately, as previously noted, thesesymptoms are often difficult to identify as thyroid-related. To use the wordsof the task force, they are not always sensitive nor specific. Thereare, however, a number of symptoms that may more urgently point tohypothyroidism, including:
- Slowed heart rate
- Puffiness in ankles
- Delayed ankle reflexes
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What Are The Effects Of High Thyroxine Levels
Having high thyroxine levels, or an elevation in T4, principally induces a state of hyperthyroidism. This may cause a variety of symptoms, including weight loss, hair loss, insomnia, and trembling. It is also associated with fatigue, poor tolerance of higher temperatures, and perspiration. People with hyperthyroidism may notice other symptoms like anxiety, palpitations, and a growth at the base of the neck called a goiter. Generally, the presence of hyperthyroidism can be explained by Graves disease, taking too much T4 to treat low thyroid levels, growths on the thyroid gland or some temporary conditions like a virus, and these causes help to indicate treatment.
The purpose of the thyroxine is to regulate the bodys metabolic system, use calories, and stimulate, as needed, certain neurotransmitters like norepinephrine. Essentially, in the presence of high levels of thyroxine, thyroid hormones signal these systems to overwork and to produce more than is needed. The body begins to consume calories too quickly and produces an excessive amount of neurotransmitters. Thus, the principal symptoms of too much thyroxine are agitation, weight loss, shakiness, and poor sleep.