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July 08, 2023 11 min read

So, you may find yourself wondering, "What could possibly happen if hypothyroidism goes untreated?" If you've just recently been diagnosed, or if it's been suggested you may have hypothyroidism, these questions might be racing through your mind. Let's clear up those doubts today.

What is hypothyroidism?

Firstly, a quick refresher for some context. Let's begin with a basic understanding of hypothyroidism, also called underactive thyroid. This thyroid disease occurs when the thyroid gland, a small butterfly-shaped gland located in the neck, can't produce enough thyroid hormones to meet the body's needs. These hormones, (triiodothyronine) T3 and (thyroxine) T4, are important players in our body's metabolism—they're responsible for controlling how our bodies use energy. So, everything, including heart rate, body temperature, and digestion, can be affected by these hormones. When thyroid hormone levels begin to drop, we start to feel the effects on these bodily functions, and that's when symptoms of hypothyroidism kick in.

Early signs of an underactive thyroid, or hypothyroidism, often include fatigue, weight gain, feeling cold, constipation, dry skin, thinning hair, slowed heart rate, and depression. It's important to keep in mind that these symptoms of hypothyroidism can be subtle and easily mistaken for regular wear and tear or stress. If you're experiencing these symptoms, it might be a good time to consult with a healthcare professional. They'll likely order blood tests to see if you have enough thyroid hormone and properly diagnose hypothyroidism.

The causes of hypothyroidism are as varied as the people it affects. One of the most common culprits is Hashimoto's Thyroiditis, an autoimmune disease where the body's immune system attacks the thyroid gland, limiting its ability to produce hormones. It's like your own body playing a trick on you, getting confused, and attacking its own member! In some cases, hypothyroidism can also be caused by birth defects, thyroid surgery, and treatments for overactive thyroid (when your body has too much thyroid hormone).

What are the risks of untreated hypothyroidism?

Should hypothyroidism be left untreated, the consequences could be far-reaching and serious. Given the thyroid gland's vast influence across various bodily functions, its underperformance can trigger widespread negative effects. Below are the potential complications to keep on your radar.

Kidney disease

There's recent research that explains how an underactive thyroid can impact your kidneys. In this study, researchers performed health check-ups on adults in Taiwan. They wanted to understand the effects of hypothyroidism on the kidneys, so they measured two things – estimated glomerular filtration rate (eGFR) and protein levels in the urine.

eGFR is a type of blood test that checks how well the kidneys are working. The research showed that people with hypothyroidism had a higher chance of getting chronic kidney disease, a condition where your kidneys don't work as well as they should.

They also looked at two types of hypothyroidism: subclinical and overt. Subclinical is when you have slight hypothyroidism with normal hormone levels, and overt is when you have low hormone levels due to hypothyroidism. They found that people with subclinical hypothyroidism were just over two times more likely to have kidney disease. In those with overt hypothyroidism, the risk was nearly eight times higher.

In another research study, it was found that for many adults with hypothyroidism, their kidneys' ability to filter and clean the blood drops by around 40 percent. Following this, there is an increase in a substance known as creatinine, a waste product from muscle breakdown, in the blood. Additionally, there's a higher likelihood of developing muscle-related diseases.

This means that hypothyroidism could make your kidneys less efficient in their job of cleaning and filtering your blood. Additionally, having an underactive thyroid could lead to a greater chance of diseases affecting the muscle tissues. But here's some good news: these changes caused by hypothyroidism can be reversed with the right treatment!

Heart disease

When left untreated, hypothyroidism contributes to an increased risk of heart disease in a variety of ways. It can directly interfere with the function of the heart, causing it to beat less efficiently and affecting blood circulation. An underactive thyroid also negatively impacts the coronary arteries, impeding optimal blood flow. These changes can potentially lead to the development of coronary artery disease and congestive heart failure.

Further consequences of hypothyroidism include a decrease in cardiac output, the volume of blood the heart pumps, and the elasticity of arteries. Together, these factors can lead to atherosclerosis, a condition characterized by stiffening and narrowing of arteries due to plaque build-up. Moreover, a 2013 study has linked hypothyroidism to a higher mortality risk in heart failure patients compared to individuals with normal thyroid function.

Hypothyroidism also tends to trigger fluid retention in the body, often manifesting as weight gain and increased swelling, specifically in areas like ankles and face. The accumulation of fluid can contribute to high blood pressure and increase the severity of congestive heart failure.

One of the less obvious ways hypothyroidism can exacerbate heart risk is by increasing lipid levels. Unusually high levels of lipids, such as cholesterol and triglycerides, can contribute to fatty buildups on artery linings, leading to atherosclerosis. Additionally, a study published in the Journal of the American Heart Association in July 2015 found hypothyroidism to be a contributor to dysfunction in the lining of blood vessels, adding another dimension to its role in causing heart disease.

Goiter

A goiter refers to an abnormal enlargement of the thyroid gland. While several factors, such as iodine deficiency or pregnancy, can contribute to developing a goiter, a common cause is hypothyroidism.

Understanding the relationship between hypothyroidism and goiter begins in the feedback loops of our endocrine system, which regulates hormone production. The brain signals the thyroid, indicating the required amount of thyroid hormone to produce, using thyroid stimulating hormone (TSH), a hormone produced by the pituitary gland. In a scenario where the thyroid hormone level is low due to hypothyroidism, the brain compensates by producing more TSH, urging the thyroid to work harder.

This process can be likened to an individual peddling harder on a sluggish bicycle to gain speed. As the brain sends repeated signals to the thyroid to produce more hormones, the gland progressively enlarges, forming a goiter. In a sense, the development of goiter can be seen as the thyroid being coaxed to produce more thyroid hormone under the unrelenting signal of TSH.

While goiters often pose no immediate threat or discomfort, they're an early warning sign of thyroid dysfunction, potentially even before a noticeable drop in thyroid hormone levels. This serves as a significant reason to monitor TSH levels. However, it is essential to note that large goiters might interfere with one's breathing or swallowing, resulting in physical discomfort. These larger sizes may also cause self-consciousness about appearances.

Goiters appear as lumps at the front of the neck and are usually painless. They can lead to symptoms such as coughing or hoarseness and can potentially affect breathing and swallowing. Small goiters that do not bring about any physical or cosmetic issues might not require treatment. However, sizable goiters causing noticeable symptoms usually necessitate intervention, typically through medication or surgical procedures.

Infertility

Hypothyroidism can cause a series of problems that interfere with the ability to conceive. These issues can include menstrual irregularities, hyperprolactinemia, and imbalances in sex hormones.

A distinct issue for many women with hypothyroidism is the irregularity and unpredictability of menstrual periods. This lack of regularity can pose challenges to fertility. Furthermore, the autoimmune issues often associated with hypothyroidism can also contribute to difficulties in conceiving.

In fact, research has illuminated a substantial correlation between infertility and hypothyroidism. In one noteworthy study published in the Endocrine Journal in January 2015, thyroid hormone treatment was administered to 69 infertile women with subclinical hypothyroidism, a mild form of hypothyroidism. The results were heartening, with over 84 percent of the participants successfully conceiving within a year, although nearly 30 percent did suffer miscarriages.

During pregnancy, an inadequacy of thyroid hormone can spell risks for both mother and baby. Mothers may face higher risks of complications like high blood pressure, anemia, bleeding, and placental abruption. Moreover, the requirement for thyroid hormones escalates due to the demands of pregnancy. In the absence of appropriate treatment, hypothyroidism can also hinder the baby's development and increase the risk of complications such as preterm birth, low birth weight, respiratory distress, and stillbirth.

Additionally, children born to mothers with hypothyroidism have been found to have lower IQ scores compared to those born to mothers with normal thyroid hormone levels.

Nerve damage

Nerve damage is viewed as a striking consequence of untreated hypothyroidism, one that manifests specifically in your peripheral nerves. The peripheral nerves form a vast network that connects your brain and spinal cord to the rest of your body. Unregulated hypothyroidism has the potential to harm these nerves, and fluid retention, which triggers excessive pressure on the nerves, is thought to be a contributing factor.

Should peripheral nerve damage occur, you'd most likely experience symptoms that include pain, numbness, and a tingling sensation in your arms or legs. Other signs to look out for would be muscle weakness or even partial loss of muscle control. Hypothyroidism isn't alone in causing such nerve damage, though. There are other potential causes of peripheral neuropathy, some more prevalent than hypothyroidism. For instance, a study in the Muscle & Nerve journal in November 2015 found hypothyroidism to be the cause of previously unexplained neuropathy in only 0.7 percent of the studied cases, while diabetes or prediabetes was responsible in a notable 25.3 percent of the cases.

Moreover, chronic or long-term hypothyroidism can trigger other different types of nerve damage. Symptoms may present as pain or as numbness and tingling, particularly felt in the hands. An associated condition known as carpal tunnel syndrome can arise due to hypothyroidism causing inflammatory changes within the narrow tunnel in the wrist that houses hand nerves. This inflammation has the potential to adversely affect the nerves housed within. Furthermore, untreated hypothyroidism and the nerve damage it causes can even result in hearing loss.

Mental health changes

Untreated hypothyroidism affects not only your body but also your mind and emotional health. This condition can make it hard for you to concentrate and can give you a feeling like you're in a fog.

One of the main effects of hypothyroidism is depression. But here's something hopeful - when people with hypothyroidism get the right treatment for their thyroid, it can help their depression too. This was shown in a study where people with a mild form of hypothyroidism got treatment for their thyroid condition, and their depression improved a lot more than another group who got a placebo or a 'dummy' pill.

It's interesting to note that often, people don't realize that hypothyroidism has been making them feel bad until they start getting treatment. After starting treatment, they feel so much better that they can then see how badly they had been feeling before.

Hypothyroidism can also cause your thoughts to slow down, make you forget things, and even lead to dementia - although this is reversible, so treating the thyroid condition can improve memory and thinking.

Emotional health also takes a hit with hypothyroidism. People may have more mood swings and can feel irritable. Hypothyroidism can also make people more likely to experience worry or depression. If someone already has depression, hypothyroidism can make it harder to treat.

Myxedema coma

Myxedema coma, a life-threatening complication, is a potential outcome of severely untreated hypothyroidism. Characterized by extreme fatigue, impaired cognition, and, ultimately, loss of consciousness, the severity of this condition is not to be underestimated.

Myxedema typically advances when hypothyroidism progresses without intervention over a prolonged period. Despite its rarity, largely due to the unlikelihood of severe symptoms going unnoticed, certain individuals, such as the elderly and those living alone, show increased susceptibility.

For those with untreated hypothyroidism, this precarious state can be triggered by various factors that place stress on the body. An existing infection, the use of sedatives, or even stress caused by other illnesses, such as a heart attack or pneumonia, can lead to myxedema coma. It is, therefore, crucial to monitor any potential stressors in individuals already identified with hypothyroidism.

This pressing condition requires prompt attention and immediate treatment. In cases of myxedema and certain instances of severe hypothyroidism, the intravenous (IV) delivery of thyroid hormone is necessary. This method bypasses the gut lining, which might hinder the absorption of orally administered drugs, ensuring swift and effective treatment.

Consequently, early detection of hypothyroidism is vital, and medical professionals should remain vigilant to its signs well before severe symptoms surface. Often, symptoms like exhaustion and difficulty focusing might be inaccurately dismissed as stress or depression. However, it's crucial to verify these symptoms by checking thyroid levels, particularly because hypothyroidism is an ailment that can be effectively managed.

How is hypothyroidism treated?

When it comes to treating hypothyroidism, doctors usually prescribe thyroid hormone replacement therapy. There are several types of thyroid replacement therapy. These include:

1. Levothyroxine

Firstly, there's Levothyroxine. This thyroid hormone medicine is a synthetic form of T4, one of the key thyroid hormones underproduced in hypothyroidism. Starting a levothyroxine regimen can help replenish the body's T4 levels, easing hypothyroidism symptoms. However, being synthetic, it might not provide the full spectrum of thyroid hormones that some patients need.

2. Liothyronine

Then we have Liothyronine, which is a synthetic form of T3, another vital thyroid hormone. This thyroid medication aims to increase the body's T3 levels when they are lacking. While it's another useful treatment option, similar to levothyroxine, it doesn't offer the complete range of thyroid hormones.

3. Natural Desiccated Thyroid (NDT)

Contrastingly, Natural Desiccated Thyroid (NDT) therapy is a more comprehensive treatment option. NDT is derived from the dried thyroid glands of pigs and provides a mix of thyroid hormones, both T3 and T4. Many patients find NDT to be a superior option, as it mimics more closely the body's natural hormone balance. This therapy permits patients to regain a sense of normalcy effectively, which other treatments might fail to provide fully. This is why NDT is becoming increasingly popular and is regarded as the better option for many patients dealing with hypothyroidism.

If you're considering exploring natural alternatives, VitaliThy, a natural desiccated thyroid you can buy online, is a worthwhile option. This natural desiccated thyroid supplement is conveniently available online for purchase. Produced in Vietnam, VitaliThy is classified as a supplement rather than a medication due to the differing regulations between the US and Vietnam. Still, you can confidently rely on its quality, as it complies with the strict standards set forth by the Good Manufacturing Practices from the Vietnamese Ministry of Agriculture, an entity recognized for its stringent guidelines.

Is it possible for hypothyroidism to go away on its own?

While discussing hypothyroidism, a frequently asked question is, "Can it resolve on its own?" The answer considerably depends on the specific cause of hypothyroidism.

For most individuals with hypothyroidism, especially those with thyroid hormone replacement medication, lifelong treatment is typically necessary. This is especially relevant for those with conditions causing irreversible damage to the thyroid gland.

However, certain forms of hypothyroidism are associated with temporary changes in the body and can indeed improve over time. For instance, it's not uncommon for hypothyroidism to occur during or after pregnancy. This form, known as maternal hypothyroidism, may only require temporary treatment. After childbirth, the woman's thyroid hormone levels often return to normal, allowing for the cessation of treatment.

Medications taken for other conditions can sometimes affect the thyroid, leading to transient hypothyroidism that resolves once the treatment is ceased. Similarly, exposure to excessive iodine might cause temporary hypothyroidism due to its effect on thyroid hormone production.

Autoimmune thyroiditis, or inflammation of the thyroid gland due to an immune response, can also induce a temporary state of hypothyroidism, improving once the inflammation settles.

Also worth noting is the condition known as subclinical hypothyroidism. This is an early, mild form of hypothyroidism where thyroid-stimulating hormone (TSH) levels are only slightly elevated. In these instances, doctors may hold off on immediate treatment, opting to monitor the hormone levels closely.

Can hypothyroidism be cured?

While hypothyroidism doesn't have a permanent cure, it's important to note that with proper treatment and care, mainly in the form of thyroid replacement therapy, people with this condition can lead normal, healthy lives. So, while we may not be able to completely 'cure' hypothyroidism, we can manage it effectively for lifelong well-being.

Wojciech Majda
Wojciech Majda


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