Hypothyroidism and pain
Muscle cramps, tingling in hands, tiredness, slow thinking, intolerance to cold, and weight
gain. These can all be signs that the thyroid gland
is not producing enough hormone, which is called hypothyroidism.
Today, I ll explain why the thyroid stops producing hormones, how you can get diagnosed
and treated for this condition.
So, let s talk about hypothyroidism today
The thyroid is this gland attached to the trachea. It resembles a butterfly.
The thyroid produces 3 hormones: calcitonin, T3 and T4. Today I ll talk about:
Triiodothyronine, also known as T3 Tetraiodothyronine, or T4
T3 and T4 exert their effects on almost every cell of our bodies. These two hormones will
basically go to all cells of your body and tell them how much energy they need to consume.
When the cells are hit by T3 and T4, they work harder, and this causes them to consume
more energy. When there is no T3 and T4, the cells are
underperforming and slow. When the thyroid is overactive, there is too
much T3 and T4, the person will feel super energetic, we call this hyperthyroidism.
There may be serious consequences, for example bulging or protruding eyeballs like this picture.
You can see the eyelids wide opened and the eyes popping out.
The most common thyroid dysfunction is hypothyroidism, when it is NOT producing enough hormones.
There are other diseases of the thyroid, for example tumours: benign tumours and cancers.
But I ll not talk about them today. It is estimated that 12% of the world population
has some type of thyroid problem. We know that thyroid diseases affect more
women than men, and that they become more common with older age.
Today, I ll focus on hypothyroidism, because it is a condition that causes pains, tingling
and also fatigue in many of my patients with chronic pain.
Hypothyroidism is when the thyroid is underactive, and there is low T3 and T4.
So what are the symptoms of hypothyroidism?
The person will feel tired, lack energy, slow thinking, and depression. Muscle cramps, joint
pain, numbness, carpal tunnel syndrome, and tingling in hands and feet. Also, intolerance
to cold, weight gain, hair loss, dry skin and myxedema, which is a kind of peripheral
nonpitting edema. There can also be slowing of heart rate, we
call this bradychardia. In women, we see changes in menstrual cycles,
and reduced libido.
What causes hypothyroidism? The most common causes are:
Hashimoto s thyroiditis, an autoimmune disease that results in inflammation of the thyroid
gland. This condition is more common in women than in men and often runs in families.
Radioactive iodine treatment for hyperthyroidism or toxic multinodular goiter (goy tr)
Congenital hypothyroidism, that is a person is born without a thyroid gland or a poorly
functioning one; Surgical removal of the thyroid gland as a
treatment for thyroid cancer or hyperthyroidism.
How is hypothyroidism diagnosed?
We usually make the diagnosis of hypothyroidism by ordering a blood test that measures TSH.
TSH is a hormone produced by the brain, in the hypophysis or pituitary. This tiny gland
in the brain releases TSH, or thyroid stimulating hormone.
If the thyroid is not producing enough T3 and T4, then the brain will try to increase
the production by releasing more TSH. The TSH is the signal from the brain for the thyroid
to produce more T3 and T4. So, we usually measure the TSH first, and if the TSH is elevated,
we suspect the thyroid is not working properly. The normal levels of TSH in the blood will
depend on the laboratory and type of test used.
Then, we confirm the diagnosis by ordering a blood test to measure the free T4 in the
blood. You may be asking, why don t we just measure
T3 and T4 in the blood instead of measuring the brain hormone called TSH?
That is a very good question. That is because sometimes the levels of T4 are normal, but
the thyroid is deficient and it needs a higher amount of TSH to keep producing a normal amount
of T4 and T3
We call this subclinical hypothyroidism. The thyroid is at risk of failing.
In most cases subclinical hypothyroidism can be monitored without treatment and sometimes
the TSH will return to normal on its own.
How is hypothyroidism treated?
Most patients with hypothyroidism need therapy with thyroid hormone replacement for the rest
of their lives. They will need to keep monitoring to ensure that the dose of thyroid hormone
maintains thyroid function tests in the normal range.
Treatment is in the form of a tablet of thyroid hormones taken once a day. This hormone pill
usually contains T4 hormones and is to be taken on an empty stomach and free from other
medications. This is important so that other medications do not interfere in T4 absorption
from the gut. I would like to thank the Thyroid Foundation
of Canada for reviewing the content of this video. If you are interested, visit their
website at https://thyroid.ca/
Please, don t forget that this video is for educational purpose only.
If you have a condition that needs medical advice, please talk to your doctor.
And if there is an emergency, go to the nearest emergency department.
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