Symptoms of hypothyroidism – mental, neurological, skin

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The thyroid gland is a small organ weighing about 30 g. However, it is a very important endocrine gland. It produces hormones that regulate many vital processes. The proper functioning of the thyroid gland corresponds, inter alia, to for metabolism, development of the nervous system and strong bones. When hypothyroidism occurs, it produces too little hormones, and we begin to feel weak and, for example, gain weight. Check what else you should pay attention to.

The work of the thyroid gland

The thyroid gland is a small gland made of two lobes. It is located directly under the larynx at the base of the neck. The thyroid gland is very active and highly vascularized. It produces three hormones, or thyroxine, the so-called FT4, triiodothyronine, the so-called FT3 and calcitonin. FT4 makes up most of the thyroid hormones in the human body.

FT3 and FT4 are hormones responsible for the proper metabolism. They increase oxygen consumption, increase blood glucose levels, are responsible for the production of proteins and stimulate fat burning. Calcitonin, on the other hand, is responsible for the proper level of calcium in the body. The complex regulatory system based on the pituitary hormones, i.e. TSH, the hypothalamus, i.e. TRH, and the thyroid’s own hormones, i.e. the already mentioned FT3 and FT4, are responsible for the proper functioning of the thyroid gland.

Thyroid problems result from inappropriate hormone production. When the thyroid gland produces too little hormones, it means underactive, and too much hormone production is due to overactivity. Various diseases of the thyroid gland are often autoimmune and linked to a malfunction of the immune system, which starts to produce antibodies against the cells of the thyroid gland. Unfortunately, thyroid disorders are much more common in women than in men.

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The causes of hypothyroidism

Hypothyroidism is a disorder of the thyroid gland where the production of thyroid hormones is too low. This gland is responsible for the production of two hormones FT3 and FT4, which regulate the work of most tissues in the human body. They also affect metabolism and thermogenesis, i.e. heat production. It should also be remembered that the work of the thyroid gland is controlled by the TSH hormone produced by the pituitary gland. It is this hormone that stimulates the thyroid gland to produce FT3 and FT4.

The work of the thyroid gland and pituitary gland is closely related. This means that the more thyroid hormones, the lower the production of TSH by the pituitary gland, and the low production of hormones by the thyroid gland is a signal for the pituitary gland to release more TSH.

Hypothyroidism, i.e. too low amount of FT3 and FT4, is most often the result of:

1. Hashimoto’s disease, i.e. chronic autoimmune thyroiditis – the disease is autoimmune and is caused by human antibodies. It is the development of non-painful thyroiditis, which slowly and gradually destroys the thyroid gland and reduces the amount of hormones produced;
2. surgery to remove the thyroid gland – it may be a consequence of various situations, such as nodular goiter, thyroid cancer or Graves’ disease. When the thyroid gland is completely removed, it becomes permanently underactive. The situation is different when only a fragment of the gland is removed. Then the degree of hypothyroidism depends on the scope of the surgery performed;
3. radioiodine treatment – such treatment can be implemented, for example, in the case of Graves’ disease or hyperactive nodular goiter.

Other causes can also develop hypothyroidism, but they are much rarer. This is for example:

1. inflammation of the thyroid gland on a different basis – then the hypothyroidism may be transient, e.g. subacute thyroiditis or postpartum thyroiditis;
2. drug-induced hypothyroidism – as a result of the use of amiodarone or interferon;
3. secondary hypothyroidism appearing during pituitary diseases.

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Hypothyroidism Symptoms – Disturbing Signals

The symptoms of hypothyroidism are related to insufficient stimulation of the body’s cells by the hormones secreted by the thyroid gland. Since symptoms are often very mild and difficult to notice, it delays and makes it difficult to correctly and quickly diagnose hypothyroidism. The symptoms associated with hypothyroidism are often mistaken for the effects of chronic stress. The symptoms of hypothyroidism depend on the cause of its development and the general health of the patient.

The main symptoms of an underactive thyroid gland are:

1. feeling cold unrelated to the ambient temperature;
2. weight gain;
3. slow metabolism, e.g. less frequent bowel movements, constipation, indigestion;
4. slow heart rate, low blood pressure;
5. pain in muscles and joints;
6. hair loss that becomes dry, brittle and very thinning;
7. eyebrow loss;
8. hoarseness as a result of swelling of the vocal cords and tongue;
9. irregular periods and even infertility;
10. greater risk of miscarriage;
11. decreased libido and worse sexual performance;
12. slower breathing;
13. constipation, and even in severe cases, intestinal obstruction and accumulation of fluid in the abdominal cavity, pleura and pericardium;
14. less frequent urination.

Laboratory tests also show elevated cholesterol and anemia. The symptoms of an underactive thyroid can vary in severity depending on the severity of the disease. In people with mild hypothyroidism you may not observe any of the above-mentioned symptoms. However, this does not mean that the disease does not develop. Untreated hypothyroidism it can lead to heart disease, infertility and even coma.

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Symptoms of hypothyroidism – mental symptoms

Various psychological symptoms can be observed in people with hypothyroidism. Hypothyroidism caused by Hashimoto’s disease can manifest itself in depressive states and mood swings. These people are lethargic, lack energy, are constantly tired and sleepy, and have a hard time concentrating on everyday activities. As hormone levels balance out, gradually the psychological symptoms of hypothyroidism usually subside. However, if there is no improvement in the patient’s well-being, it may be suspected that he or she has affective disorders at the same time.

Symptoms of hypothyroidism – neurological symptoms

The neurological symptoms of hypothyroidism are common in people with congenital hypothyroidism. Thyroid hormones are very important in the formation of synapses and nerve connections, which is why their correct level in the first two years of life is so important for proper psychomotor development. Undiagnosed congenital hypothyroidism can have serious consequences in the future, such as low intellectual levels and a lowered IQ.

In addition, the emerging motor disorders resulting from hypothyroidism affect joint changes. Then there is a decrease in bone age, development of hip dysplasia and underdevelopment of the lumbar vertebrae. In people with advanced congenital hypothyroidism, it may even happen that the patient will have a body the size of a child, i.e. he will have features of dwarfism, a stocky torso, a large head and short limbs. His posture will also be very characteristic, i.e. he will have a prominent abdomen and buttocks, slightly bent knees and a flat back as a consequence of the disappearance of the natural curves of the spine. The gait is therefore duck-like, the steps are very small, the knees are lopsided and the pelvis is tilted forward.

On the other hand, in people with acquired hypothyroidism, symptoms may be observed from the side of the muscles, i.e. stiffness, pain and muscle weakness. This is especially true of the muscles located proximally. It appears in sick people muscle pseudohypertrophyand in advanced cases, even creatine kinase may appear, which normalizes after administration of hormonal drugs.

In addition, in advanced cases, there is also a bilateral carpal tunnel syndrome. A neurological examination also shows a weakening of the tendon reflexes. In extreme cases of hypothyroidism, when the disease is severe or is diagnosed late, it may appear hypometabolic comawhich is life-threatening and requires treatment in an intensive care unit.

In turn, patients with autoimmune hypothyroidism as a result of Hashimoto’s disease also produce other antibodies that may be directed against muscle antigens, such as ubulin or myoglobin. Antinuclear antibodies develop much more often than in healthy people. In practice, this means greater tiredness and muscle pain. The symptom of hypothyroidism is also the development of the rare Hashimoto’s encephalopathy, which manifests itself with impaired consciousness, hallucinations and epileptic seizures.

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Symptoms of hypothyroidism – skin symptoms

Hypothyroidism also leaves a mark on our skin, as the disease is often accompanied by dry skin. But that’s not all. People with hypothyroidism often have pale, cold skin due to a slower metabolism. In addition, cracks appear on the skin, it is much easier to scratch and even wounds that are difficult to heal.

Hashimoto’s disease, which can result in an underactive thyroid gland, can lead to skin discoloration. Most often they appear on the upper eyelids, but most often they are visible in places exposed to sunlight. In turn, rough calluses appear on the elbows and knees. Due to the swelling caused by the accumulated water, the skin may appear thickened on both the eyelids and the hands.

Symptoms of hypothyroidism – diagnosis

When we notice the above symptoms, it is best to first visit your family doctor who will collect your medical history and order the necessary tests. They will also decide if you need a TSH test. This test is periodically performed on people who have a family history of Hashimoto’s disease. Diagnose hypothyroidism is very important for women trying to conceive as the disease can have a bad effect on both the mother and the baby. That is why many specialists recommend TSH level determination in every woman planning pregnancy.

The family doctor orders tests to assess the functioning of the thyroid gland, e.g. the level of TSH. If the result is alarming, i.e. above the norm, it is necessary to perform the FT4 test, on the basis of which primary hypothyroidism is diagnosed (low FT4 and increased TSH level). When tests confirm hypothyroidism, your doctor will usually look for the cause of the condition. Usually, he or she orders an ultrasound of the thyroid gland to determine if the thyroid gland is reduced and has a lower than normal echogenicity, indicating Hashimoto’s disease.

You may also be referred for anti-TPO (anti-thyreoperoxidase antibodies) and anti-TG (anti-thyroglobulin antibodies) tests.