Thyroid hormones are needed to maintain the body's metabolic system; however, too little or too much thyroid hormone could cause severe side-effects. Therefore, proper treatment of hypothyroidism cannot heal the body and can often result in a euthyroid condition.
About 6 million Americans had [hypothyroidism](https://www.withpower.com/clinical-trials/hypothyroidism) in 2005. The numbers of American hypothyroidism cases can be found in the section entitled “hypothyroidism”. Most cases of hypothyroidism in the United States are not discovered until later in life. Thyroid dysfunction is under-recognized in the United States. Hypothyroidism should be considered in patients over 37 years of age who have chronic diarrhea, weight gain, or tiredness, have a family history of either chronic diarrhea or hypothyroidism, or are on thyroid replacement therapy. Thyroid autoimmunity is more common in women than in men, and usually occurs in the fourth decade of life.
Signs and symptoms of [hypothyroidism](https://www.withpower.com/clinical-trials/hypothyroidism) include feeling tired, decreased energy, cold intolerance, weight gain, and feeling agitated. Some of these symptoms can be related to depression, diabetes, or menopause. A history of these symptoms indicates the possibility of hypothyroidism. A screening serum TSH is sometimes done to check for hypothyroidism. A low TSH suggests hypothyroidism. Some other laboratory tests that may be helpful in the diagnosis include a serum ESR; a CBC; thyroid profile; and, a T4 measurement. T4 measurement is a useful diagnostic test for people with symptoms suggestive of hypothyroidism, but it is not sensitive or specific.
This article is based on material from the book "Handbook of Thyroid Diseases: Causes, Diagnosis and Treatment" published by Taylor and Francis, Limited (Taylor & Francis Group, Philadelphia PA) which is in the public domain in the USA"
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The common options include synthetic thiamine, l-thyroxine, folic acid supplementation, and chlormadinone acetate (Medroxyprogesterone acetate). A thyroid uptake study (TUPS) and thyroid function profile (TFP) may be necessary to determine the optimal treatment. If the diagnosis is unlikely to correct, or if the clinical presentation is suggestive of other causes (e.g., Addison's disease), evaluation for Cushing's syndrome by measuring overnight and morning cortisol level and ACTH levels should be conducted. Further testing is available for more specific causes and specific management of hypothyroidism.
The major cause of [hypothyroidism](https://www.withpower.com/clinical-trials/hypothyroidism) is thyroid autoimmunity in which the body has a natural anti-thyroid reaction and it can cause thyroid insufficiency. Autoimmune thyroid disease is usually accompanied with chronic subclinical Hashimoto's thyroiditis or with Hashimoto's thyroiditis, and it is one of the risk factors for occurrence of thyroid cancer.
Clinical trials should be conducted for people who are carefully selected and are of satisfactory nutritional status and who are diagnosed with symptoms of hypothyroidism.
TSH testing has been developed beyond an age when it should have been abandoned. In my view however, there is one new development which could change my life; treatment with thyroid supplementation. If they can control TSH levels well enough, TPO and T3 will be found to have no additional benefit to TSH in the presence of TPO and T3 deficiency. I feel that euthyroid therapy is what’s new, and there is now enough evidence to support it in the treatment of hypothyroidism. There are now so many advantages to thyroid hormone therapy that there is no longer much reason to continue to treat patients with TSH levels above the 99th percentile with TSH testing.
The use of treatment as a sole mode of treatment in hyperthyroidism seems inadequate. Although the effects of treatment in hyperthyroid patients are generally good, further research is needed on the treatment of hyperthyroidism.
Side effects from treatment are very common, the first 3 months being the most common time frame. Mild to moderate side effects can easily be managed with the use of thyroid replacement therapy, for which most patients need less than 2 times as much of the medication as they did at baseline. Severe side effects are more troublesome because they typically come on suddenly and they will only be controlled by more than 2 times the amount of medication that the doctor prescribes\n
In children, subclinical [hypothyroidism](https://www.withpower.com/clinical-trials/hypothyroidism) is a commonly present disorder as it is not an infrequent occurrence. This condition is more common in those who are obese, have autoimmune disease, have a family history of thyroid disease, and in those with chronic infections/inflammation of the thyroid, and those with low circulating TSH concentrations. This implies that hypothyroidism is a condition which is more common among those who have some predisposing factor. In addition to this, it is clear that this condition is more common in individuals that are not taking thyroid hormone, which may not have a significant impact on their health.
Genetic inheritance plays a significant role in the development of thyroid dysfunction. Families with the disease typically have more than one member affected, and a positive index case for familial hypothyroidism can be identified in 11.1% of all cases. The number of brothers and sisters in these family groups is generally lower, suggesting that a dominant mode of inheritance is likely for familial hypothyroidism.