By hypothyroidism, the thyroid gland is producing too less hormones to stimulate the metabolism or the body is not able to utilize the hormones. The lack of thyroid hormones slows down the metabolism and thus all the activities in the body, giving a combination of many symptoms related to slowness of bodily processes.

Hypothyroidism is common, but the frequency of the condition is not well determined. Some authorities estimate that 0.5% of the total American population have the disease to some degree. The frequency is much greater among people over 50 years of age than among young people.

The most common early symptoms are: Mental and physical fatigue, weakness, weight gain or over-weight, and depression.

One or more of these symptoms also use to appear early: Constipation, sensitivity to coldness, cold hands and feet, thick tongue, decreased sweating, dry hair, thin brittle hair, thin brittle nails, muscle and joint pain, pale or yellowish skin.

One or more of these symptoms usually appear later: Poor memory, slow thought process, drowsiness, slow speech, thinning of eyebrows, hoarseness, poor circulation, dry and flaky skin, decreased taste and smell, menstrual irregularities, skin thickening, puffy face, puffy hands and feet, swelling of extremities, overall swelling, muscle spasms, muscle atrophy, joint stiffness.

In children or young persons hypothyroidism may give developmental problems, like disturbed tooth development and short stature.

Hypothyroidism increases the risk of elevated cholesterol levels, heart disease and diabetes (diabetes mellitus). This occurs even by moderately decreased thyroid production.

To understand the hypothyroidism, some knowledge about the thyroid gland and its hormones is essential.

The thyroid gland produces hormones that accelerate and in other wise regulate metabolism. A part of metabolism is the process of breaking down energy containing nutrients, and using the energy to produce molecules that all the processes and activities in the body use as fuel. Another part is the production of molecules that the body use as building materials.

The thyroid makes four hormones: Thyroxin (T4), triiodothyronine (T3), diiodothyronine (T2) and monoiodothyronine (T1). The hormones contain iodine, and the figures tell about the number of iodine atoms in each hormone molecule. T3 is not made directly, but is produced from T4. T3 is a more efficient hormone than T4. Therefore this conversion is important.

The pituitary, a gland under the brain, produces a hormone called thyrotropin or thyroid stimulating hormone (TSH) that enhances the activity of the thyroid gland. If the body has too less thyroid hormone in the blood, the pituitary produces more thyrotropin. This makes the thyroid gland speed up its own production. By a too heavy thyroid hormone concentration, less thyrotropin is produced by the pituitary, and the thyroid gland slows down. This feed-back mechanism regulates the metabolism of the whole body.

By hypothyroidism the body does not get enough thyroid hormone, or the hormones do not work effectively in the body. This causes the metabolism to slow down. When the metabolism decreases, the processes in the body do not get enough fuel and building materials, and all the body activities will therefore slow down. Energy containing nutrient will also be stored as fat, since they are not broken down.

Serious variants of hypothyroidism are called myxedema. This is a rare condition. However, less serious, but painful variants are common. There are several reasons for hypothyroidism, each giving a variant of the disease:

 . An autoimmune reaction against the thyroid tissue can destroy the capability of the thyroid gland to produce hormones (for example Hashimoto's disease).

- Sometimes the production of T3 by conversion from T4 is impaired. The total amount of hormones may be normal in these cases, but the body is still lacking T3, and gets the symptoms of hypothyroidism.

- Iodine deficiency can cause hypothyroidism, since the thyroid hormones contain iodine. In Europe and America the food is seldom short in iodine, but bad nutrition may result in iodine deficiency.

- Surgery or radiation at the thyroid area can destroy enough tissue to cause hypothyroidism.

- Injury or disease in the pituitary or of the part of the brain controlling the pituitary may cause a decrease in secreted thyrotropin, and then the thyroid will respond by producing less of its own hormones with hypothyroidism as a result.

- Some people have symptoms of hypothyroidism even though the amount of thyroid hormone in the blood is normal. One of the symptoms is raised levels of thyrotropin, indicating that the body signals need for more thyroid hormones. This variant may be caused by conditions elsewhere in the body that make it difficult for the hormone to reach their destination in the cells. In many of these cases the immune system produces anti-bodies against the thyroid hormones. This variant is called sub-clinical hypothyroidism, and responds to the same treatment as ordinary hypothyroidism.

For serious hypothyroidism caused by tissue destruction, external supplement of thyroid hormones is necessary.

When the condition is caused by lack of iodine in the diet, dietary changes and iodine supplements will be a part of the treatment.

Less serious, but painful hypothyroidism is sometimes also treated with hormone supplements. In these cases it is difficult to find the right dose, and treatment may result in hormone poisoning.

Changing out mercury dental fillings and avoiding mercury or heavy metal exposure may help to ameliorate the condition.

You may also alleviate the condition by eating food that stimulates the thyroid function according to practical experience: Chia seed, dulse, fish from the ocean, flax seed, pumpkin seed, seaweed, coconut and brewer yeast.

You can find nutritional supplements to help for hypothyroidism. The compositions of these products vary:

*They may contain building materials that the thyroid uses to make its hormones, for example: iodine, acetyl-L-tyrosine or L-phenylalanine.

*They may also contain vitamins and minerals that stimulate the mechanism of hormone production by being a part of necessary enzymes, or by helping the absorption of the ingredients that hormones are made from, like: Magnesium, zinc, selenium, copper and vitamin E.

*They may furthermore contain constituents that stimulate tissue regeneration by being part of tissue building enzymes, and thus helping to restore a degraded thyroid, for example: Folic acid or folate, vitamin B2 (riboflavin), B3 (niacin), B5 (pantothenic acid or pantothenate), B6 (pyridoxine), B12 (cyanocobalamin) and molybdenum.

As mentined above, autoimmmune reactions against tissues or contents in the thyroid gland can cause hypothyroid disease. Ons such condition is Hashimoto's thyroiditis. By this condition, the immune system attacks the proteins thyroid peroxidase and thyroglobulins and destroy those proteins.

When thyroid hormones are produced, the raw material thyrosine, intermediate products and the ready thyroid hormones are held in place and stored in proteins called thyreoglobulines. The enzyme thyroperoxidase coverts the inactive form of iodine I- (negative iodine ion) to an axtive form, iodine atoms or I+ (positive iodine ions) by taking electrons out of the negative iodine ions and transfering the electrons to peroxide molecules that are thereby converted to OH-. Then the activated iodine can be attached to thyrosine. This is a step in the production of the thyroid hormones.

The thyroid globulins, the thoroperoxidase, the precursors, intermediate products and ready thyroid hormons are contained in cystic structures called thyroid follickles. The attacks of the immune system on these proteins destroy the follicles and the mechaisms inside these that produce thyroid hormones.

The proteins are destroyed by antobodies that attach to the proteins and there is also an invation into the thyroid tissue of T-lymphosytes that participate in destroying the tissue.

Hashimoto's disease seems to be partly inhertitable. Several people in the same families often develop the disease. Sufferers form Hashimoto's diseae often have the histocompatibility antigens HLA-DR5 and HTLA-4 and the genes for these in their genomes.

By Knut Holt

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More information about the thyroid gland and its hormones

The thyroid gland or (glandula thyroidea) is situated in the neck before the airpipe just below the Adam's apple. It consists of two lobes at each side with a thin bridge between the lobes. Inside the thyroid gland, there are four other small glands imbedded, the parathyroid glands.

 

The role of the thyroid gland

The thyroid produces the four hormones Thyroxin (T4), triiodothyronine (T3), diiodothyronine (T2) and monoiodothyronine (T1).

The thyroid hormones are chemically a sort of amino acids, the same elements that build up proteins, but they contain iodine in the molecules, and the figures tell about the number of iodine atoms in each hormone molecule. T3 is not made directly, but is produced from T4. T3 is a more efficient hormone than T4. Therefore this conversion is important. The conversion occur both in the gland itself and in the body.

The parathyroid glands produce it own hormones, parathoroid hormone (PTH), and the thyroid glald produces also the hormone calcitonine that work together with the parathyroid hormones.

The thyroid is full of spherical objects, called follicles, that are small bladder of cells with a colloidal matrix at the inside. The matrix contains the protein thyroglobulin and iodine that serve as raw materials for making the hormones. The thyroid gland selectively absorb iodine (as iodide ions, I-) from the blood for production of thyroid hormones. Twenty-five percent of all the body's iodide ions are in the thyroid gland.

By the production of the hormones, thyrogluboline is broken apart, making the amino acid thyrosine. Then first one iodine atom is connected to the thyrosine molecules, making triiodothyronine. Then another atom is connected to monoiodothyronine, making diiodothyronine.

The iodine is also linked to the thyrosine elements allready when they are bound in the protein thyroglobuline, so that elements ready linked to iodine are also released when this proteine is broken apart.

The next step is connecting two molecules of diiodothyronine together, and at the same time stripping away some parts of themoleules, making throxine. At last one iodine atom is released from the thyroxine, producing triiodothyronine.

 

The effect of the thyroid hormones

The thyroid hormones stimulate the syntesis of proteins, they stimulate the breakdown of fat and sugar to yield energy, and they stimulate the response of the body to other hormones.

Because of the role in regulation of protein syntesis, thyroid hormones are important for growth and development of the fetus during pregnancey and growth and development in childhood.

Cells of the brain are a major target for the thyroid hormones T3 and T4. Thyroid hormones play a particularly crucial role in brain development during pregnancy.

 

The role of the parathyroid hormone and calcitonine

The parathyroide hormone stimulate the release of calcium from bones into the blood.

Parafollicular cells in he thyroid gland  produce calcitonin in response to hypercalcemia, that is high calcium level in the blood. Calcitonin stimulates movement of calcium into bone, and thus opposes the effects of parathyroid hormone.

These hormones thus play an important role in holding the calcium concentration in the blood at a right level and they influence the strength of bones.

 

How thyroid production is transported and then act inside the cells

The thyroxine is mostly bound to special transport proteins when transported in the blood, transthyretin and albumin.

A transport protein (OATP1C1) seems to transport the hormone across the blood brain barrier, and still another transport protein (MCT8) transports T3 across brain cell membranes.

The hormone is freed from the transport proteins before they take action. Inside cells they bind to receptors (α1, α2, β1 and β2), which act alone, in pairs or together with the retinoid X-receptor upon the DNA to modulate DNA transcription. DNA transcription is a step in syntetizing proteins in the cells.

 

How the thyroid production is regulated

The thyroid-stimulating hormone (TSH, thyreotropine) produced by the anterior pituitary stimulates the production of thyroxine and triiodothyronine.

The thyroid and thyreotropine production form a negative feedback loop: TSH production is suppressed when the T4 levels are high, and vice versa. The TSH production itself is stimulated by thyrotropin-releasing hormone (TRH) that is produced by the brain part hypothalamus and transported down to the pituitary.

When there is need for more heat or other use of energy in the body, the brain produces more TRH. Then there is produced more TSH and then more thyroid hormones.

The levels of other hormones in the body, also influence the production of thyroid hormones. TSH production is blunted by somatostatin (SRIH), rising levels of glucocorticoids and sex hormones (estrogen and testosterone), and excessively high blood iodide concentration.

A bout goiter ( goitre )

Goiter is an enlargement of the thyroid gland. This enlargement is seen as a clearly visible swelling or lump at the front part of the neck. Sometimes this swelling is so pronounced that the shape of the neck is totally disturbed. The causes of goiter are of many types, so goiter is not any specific diseasse.

 

The shape of the goiter

Goiter can afffect the whole thyroid glands (disseminated goiter), or it can affect only one or two lobes.

 

Toxic goiter

By toxic goiter the thyroid gland is too active, and produces too mch thyroid hormone, a condition called hyperthyroidism, and the body suffers from too much thryroid hormones. By toxic goiter, the hormone producing cells proliferate and the increased glandular mass produces thyroid hormones. There are many kinds of toxic goiter:

- The thyroid cells can proliferate because of inflammation or autoimmune disease in the thyroid glands.

- There may be cell proliferation caused by disturbances in the pituitary so that an excessive amount of thyreotropine is produced. A very great amount of thyreotropine stimulate the thyroid cells to proliferate.

-There may be changes in the thyropd cells themselves. These can be benign or malign.

The symptoms by toxic goiter apart from the swelling in the neck, are those caused by hyperthyroidism. These are: Major clinical weight loss, sometimes a ravenous appetite, intolerance to heat, fatigue, weakness, hyperactivity, irritability, apathy, depression, polyuria, sweating, tremor, chorea, myopathy, and periodic paralysis.

Additionally, patients may present with a variety of symptoms such as palpitations and arrhythmias (notably atrial fibrillation), shortness of breath (dyspnea), loss of libido, nausea, vomiting, and diarrhea. In the elderly, these classical symptoms may not be present and they may present only with fatigue and weight loss leading to apathetic hyperthyroidism.

 

Goiter by hypothyroidism caused by lack of iodine

By lack of iodine there will be hypothyroidism, that is lack of thyroid hormones because the thyroid gland does not have enough iodine as raw material. By lack of thyroid hormone, the pituitary can be stimulated to produce a great excess of thyreotropine. This stimulates the thyroid cells to proliferate.

 

Goiter by hypothyroidism of other causes

All kind of hypothyroidism that does not directly destroy all of the hormone-producing cells can cause goitre. The lack of throid hormone by hypothyroidism can sometimes stimulate the pituitary to produce very great amount of thyreotropine. This excessive amount of thyreotropine stimulates the thyroid cells to proliferate.

 

Goiter by normal levels of thyroid hormones

Sometimes the leves of thyroid hormones are normal by presence of goiter.

 

Treatment of goiter

When goiter is caused by a too small production of thyroid hormone, the  treatmentwill firstly have the aim to increase this production, or by furnishing thyrpid hormone as a drug. This will often cause the goiter to go back.

By lack of iodine, this is simply done by restoring enough iodine in the diet or by supplements of iodine.

By toxic goiter, the treatment is usual surgery, or sometimes radiation treatment to take away thyroid mass. When the goitre only affects parts of the thyroid gland only these parts are removed.

Sometimes the whole thyroid gland is removed, and after that a supply of thyroid hormone must be furnished as a drug.

These statements have not been evaluated by the Food and Drug Administration. These products are not intended to diagnose, treat, cure, or prevent any disease. This information is nutritional in nature and should not be construed as medical advice. This notice is required by the Federal Food, Drug and Cosmetic Act.