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Symptoms of Extreme Hypothyroidism

The thyroid gland, which sits in the front, bottom part of the neck, produces two hormones that play essential roles in regulating food metabolism. When the thyroid gland fails to produce adequate amounts of thyroxine and triiodothyronine, the patient suffers hypothyroidism. This condition can result from birth defects, drug therapy, radiation therapy, injury or surgical removal of part or all of the thyroid gland. People with extreme, untreated hypothyroidism can experience symptoms ranging from lack of energy and pain to depression, brittle fingernails and coma. The symptoms increase in severity as the production of thyroid hormones decreases, or if the condition lasts for an extended period.

  1. Diagnosis

    • The concentration of thyroid stimulating hormone (TSH) in the bloodstream provides the principal marker of thyroid function. Healthy individuals have serum TSH concentrations between 0.4mIU/L and 5.0mIU/L. More specific measures of thyroxine and triiodothyronine can be taken from blood samples, as well. Normal concentrations of thyroxine range between 4.5mcg/dL and 11.2mcg/dL, while normal concentrations of triiodothyronine range from 100ng/dL to 200ng/dL. Doctors can also administer radioactive iodine or technetium to patients in order to get a clear image of the thyroid glands on a medical scanner. Hormone concentrations that fall below the lowest normal number or irregularities in thyroid shape signify hypothyroidism.

    Whole-Body Symptoms

    • Fatigue, sluggishness and weakness are the foremost symptom of hypothyroidism. People with the condition can also become cold more easily than usual and begin speaking more slowly, thickly or with a hoarse voice. Babies born with a congenital form of hypothyroidism often have thick, protruding tongues and below-normal stature (i.e. length), widely spaced skull plates and flat, fat hands and fingers.

    Gastrointestinal Symptoms

    • Because hypothyroidism slows down a patient's metabolism, people with the condition often gain weight. They can also become constipated, develop high cholesterol and experience decreases in their senses of taste and smell. Younger women with hypothyroidism can also have heavy or irregular menstrual periods and may have difficulty becoming pregnant. Newborns with hypothyroidism will often eat very little.

    Pain and Muscle Synptoms

    • Extreme hypothyroidism often causes pain in patients' muscles and joints. The muscles of people with hypothyroidism can also become stiff and tender. Babies suffering from hypothyroidism appear "floppy" due to poor muscle tone.

    Skin, Hair and Nail Symptoms

    • Patients with hypothyroidism can develop brittle nails and hair. Their faces can swell and become puffy, and their skin overall can take on a pallor. Patients' skin may also dry out and thicken.

    Coma

    • When thyroid hormone concentrations drop to near zero, patients experience a severe form of hypothyroidism called myxedema. If thyroid hormones are not raised rapidly, a patient with myxedema can slip into a coma.

    Treatments

    • Patients with hypothyroidism need to take a synthetic thyroid hormone known as levothyroxine. The dosage will depend on the patient's age, weight and degree of hypothyroidism. Older people require less levothyroxine, and heavier people and those with extreme hypothyroidism require more. The goal of levothyroxine treatment is to raise a patient's serum TSH to between 0.5mIU/L and 3.0mIU/L. Brand-name versions of levothyroxine include Levothroid from Forest Pharmaceuticals, Levoxyl from King Pharmaceuticals, Synthroid from Abbott Laboratories and Unithroid from Jerome Stevens Pharmaceuticals. Patients with myxedema require intravenous levothyroxine and may also require supplemental oxygen and IV fluids.

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