HealthCare

What is hypothyroidism? How do you treat it?

Understanding Hypothyroidism: Causes, Treatment, and Key Takeaways

Hi, Anna Goldman here answering the question, what is hypothyroidism and how do you treat it? The thyroid gland is this little butterfly-shaped gland that sits right on your neck. The pituitary gland, which is this gland in your brain that makes a hormone called TSH or thyroid-stimulating hormone. TSH binds to receptors on the thyroid gland itself and tells the thyroid gland to make thyroid hormone. Then thyroid hormone feeds back negatively in a feedback loop to tell the pituitary gland all is good, and thus regulating its own production. Generally, if one has primary hypothyroidism, the most common cause of this is what we call Hashimoto's thyroiditis where there's autoimmune inflammation of the thyroid gland so it's less able to make thyroid hormone over time. There's a drop in the thyroid hormone levels themselves, a loss of negative feedback to the brain, and so the pituitary, which is like the thermostat for the body says, we need more thyroid hormones. TSH starts to rise to try and stimulate a failing gland. In order to treat hypothyroidism, it's pretty easy. We just give thyroid hormone back. For most people, we just give levothyroxine, which is T4. Most of what your thyroid gland makes is T4, a little bit is T3, which is actually the active hormone. We don't really need to give back T3 because we think that the body has what are called diodinases or enzymes that will convert T4 into T3. It's a bit controversial whether or not we also have to give back T3 as a separate medication called Cytomel. You can also give patients desiccated pig or cow thyroid hormone. That's generally not recommended because the ratio of T3 to T4 is not considered physiologic for humans and that's putting people at higher risk for things like arrhythmias or osteoporosis. So generally you just have to give back T4. Thanks.

Hypothyroidism occurs when the thyroid gland is no longer able to produce enough thyroid hormone, and is usually caused by Hashimoto's thyroiditis. Treatment is typically done with levothyroxine (T4) medication.

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Hi there, I'm Anna Goldman, and I'm here to answer the question: What is hypothyroidism and how do you treat it? Hypothyroidism refers to an underactive thyroid gland, which is a small butterfly-shaped gland located in your neck. The pituitary gland, found in the brain, produces a hormone called TSH (thyroid-stimulating hormone). TSH binds to receptors on the thyroid gland and instructs it to produce thyroid hormone. In turn, the thyroid hormone provides negative feedback to the pituitary gland, indicating that everything is functioning properly.

The most common cause of primary hypothyroidism is Hashimoto's thyroiditis, an autoimmune condition that causes inflammation of the thyroid gland. This inflammation reduces the gland's ability to produce sufficient thyroid hormone over time. As a result, there is a decrease in thyroid hormone levels, leading to a lack of negative feedback to the brain. In response, the pituitary gland increases production of TSH in an attempt to stimulate the underactive thyroid.

Treating hypothyroidism is relatively straightforward. We simply replace the missing thyroid hormone. Most commonly, levothyroxine (T4) is prescribed since this is what the thyroid gland primarily produces. Only a small amount of T3 (the active hormone) is required as we believe that enzymes in the body can convert T4 into T3. There is some controversy surrounding whether additional T3 medication (Cytomel) should be given separately. It's important to note that using desiccated pig or cow thyroid hormone is generally not recommended due to the unnatural ratio of T3 to T4 for humans, which can increase the risk of complications like arrhythmias or osteoporosis.

In summary, treating hypothyroidism involves replenishing the missing thyroid hormone with levothyroxine (T4). Thank you!

What causes hyperthyroidism? How is it treated?

Hyperthyroidism: Causes, Symptoms & Treatment Options

What's hyperthyroidism? Hyperthyroidism is a condition where the levels of the thyroid hormone are just too high in the blood. This could be because somebody has a diagnosis of hypothyroidism and they're just taking too much thyroid hormone. One could have an autoimmune condition called Graves' disease where the pituitary gland makes a hormone called TSH or thyroid stimulating hormone that binds to receptors for TSH on the thyroid gland itself. The body can make antibodies that bind to and stimulate the TSH receptor which essentially causes the thyroid gland to just produce way too much thyroid hormone. It also often is associated with the diffuse enlargement of the thyroid gland which is called a goiter. Another condition could be that somebody could have one or more nodules that are just autonomously secreting too much thyroid hormone. Or the last possibility is that somebody has a condition called thyroiditis where the gland gets inflamed and then spits out all of this preformed thyroid hormone. So thyroiditis is a self-limited condition. There's not much you can do for it aside try a medication like beta blockers to block the effects of the high thyroid level. Hyperthyroidism can often lead to things like palpitations, anxiety, having a tremor. Generally, once that preformed thyroid hormone is absorbed by the body, then you can actually have a hypothyroid phase while the damaged thyroid gland is healing. With Graves' disease or a hot nodule, we can use antithyroid drugs that decrease the amount of thyroid hormone that the thyroid gland can make. Or we can use radioactive iodine that effectively radiates and cures the hyperthyroidism. Or sometimes we actually have to send patients for a thyroidectomy to remove the thyroid gland and then give them thyroid hormone back. Thanks for the question.

Hypothyroidism is a condition where the levels of thyroid hormone are too high in the blood. This can be caused by Graves disease, autonomous nodules, and thyroiditis. Treatment for hyperthyroidism includes anti-thyroid drugs, radioactive iodine, and thyroidectomy.

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Hyperthyroidism occurs when the levels of thyroid hormone in the blood are excessively high. There are several causes for this condition. One cause is taking an excessive amount of thyroid hormone, which can happen in individuals with a diagnosis of hypothyroidism. Another cause is an autoimmune condition called Graves' disease, where antibodies stimulate the thyroid gland to produce an excessive amount of thyroid hormone. This condition is often associated with an enlarged thyroid gland, known as a goiter. Hyperthyroidism can also be caused by nodules in the thyroid gland that autonomously secrete too much thyroid hormone. Lastly, thyroiditis, which is inflammation of the thyroid gland, can lead to a temporary release of excess preformed thyroid hormone.

Treatment for hyperthyroidism depends on the underlying cause. In the case of thyroiditis, it is a self-limited condition, and medications like beta blockers may be used to manage symptoms. For Graves' disease or a hot nodule, antithyroid drugs can be prescribed to reduce the production of thyroid hormone. Another treatment option is radioactive iodine, which effectively treats and resolves hyperthyroidism. In some cases, a thyroidectomy, the surgical removal of the thyroid gland, may be necessary, followed by the administration of thyroid hormone replacement.

Hyperthyroidism can lead to symptoms such as palpitations, anxiety, and tremors. It's important to consult with a healthcare professional for an accurate diagnosis and appropriate treatment.

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Dr. Anna Goldman, MD answers your HealthCare questions. See all the advice Dr. Anna Goldman, MD has and get answers to your own HealthCare questions.

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Dr. Anna L. Goldman is an endocrinologist in Foxboro, Massachusetts, and is affiliated with Brigham and Women's Hospital. She received her medical degree from the Perelman School of Medicine at the University of Pennsylvania.