Treating gentle hypothyroidism: Advantages nonetheless unsure – . Well being Weblog

Your thyroid, a tiny, butterfly-shaped gland located in front of your windpipe (windpipe) and under your voice box (larynx), can have a profound effect on your health and wellbeing. Throughout your life, your thyroid gland is constantly producing hormones that affect your metabolism. These hormones affect your mood, energy, body temperature, weight, heart, and more.

A brief overview of hypothyroidism

Your thyroid produces two types of thyroid hormones: T4 or thyroxine and T3 or triiodothyronine. These hormones affect every cell, tissue, and organ in your body, from your muscles, bones, and skin to your digestive tract, brain, and heart, by controlling how quickly and efficiently cells convert nutrients into energy – a chemical activity that known as metabolism.

The thyroid gland is under the influence of the pituitary gland. The pituitary gland is no bigger than a pea and is located at the base of the brain. It controls the thyroid hormone production by your thyroid gland by releasing thyroid stimulating hormone (TSH).

The levels of TSH in your bloodstream go up or down depending on whether there is enough thyroid hormone to meet your body's needs. Higher TSH levels cause the thyroid to produce more thyroid hormone, while lower levels signal the thyroid to produce less.

Hypothyroidism occurs when the thyroid gland doesn't produce enough thyroid hormone to meet the body's needs, which slows down the metabolism. In someone with overt hypothyroidism, thyroid hormone levels are below normal and TSH levels are well above normal.

What is mild hypothyroidism?

Subclinical or mild hypothyroidism does not meet the standard definition of hypothyroidism. If you have mild hypothyroidism, you may or may not have symptoms and your T4 and T3 levels are normal, but your TSH levels are slightly elevated. Mild hypothyroidism is diagnosed by a blood test.

More than 10 million adults in the United States have hypothyroidism, the vast majority of which is subclinical.

What are the risks if mild hypothyroidism is left untreated?

Whether or not mild hypothyroidism should be treated has been studied and debated for years. What worries doctors most about mild hypothyroidism is the possible link between untreated mild hypothyroidism and coronary artery disease. Research into whether subclinical thyroid disease causes heart problems is contradicting itself. The condition has been linked to heart and blood vessel abnormalities, and studies show that treating mild hypothyroidism can improve various markers of heart structure and function.

However, a study recently published in the Journal of the American Medical Association may give doctors a break. The researchers looked at people with mild hypothyroidism who also had a heart attack. They treated one group of these patients for mild hypothyroidism and left the condition untreated in the other group. The study showed that those treated for mild hypothyroidism did not have better heart function than those who were not treated.

What are the disadvantages of treating mild hypothyroidism?

When treating mild hypothyroidism, levothyroxine (T4) is the treatment of choice.

A 2017 study published in the New England Journal of Medicine found that treating people 65 and over for mild hypothyroidism didn't have much benefit. The authors found no real differences in symptoms between participants who received levothyroxine and those who received a placebo. The authors say that many older adults will return to normal thyroid function on their own without treatment. A follow-up study recently published in the Annals of Internal Medicine analyzed data from patients enrolled in the 2017 NEJM study and found that even those with the greatest number of symptoms had no benefit.

In addition to the possibility that the treatment may not be of benefit, there are other reasons to be careful. Over-treatment – prescribing thyroid medication to people with subclinical conditions who may not need treatment, or giving excessive thyroid medication – carries serious risks, particularly thyrotoxicosis, the presence of too much thyroid hormone in the body. This is common; It is estimated that 20% or more of patients treated with thyroid hormone suffer from thyrotoxicosis. Long-term complications of even mild thyrotoxicosis can include heart problems and bone loss.

Consider the risks and benefits of treatment

As you weigh the pros and cons of treatment for hypothyroidism, discuss the following questions with your doctor:

• How could I benefit from treatment? Could it treat my symptoms? Prevent heart disease? Help me understand
• What are the risks of treatment?
• How do we know if the treatment is working and how long will it take to find out?
• How long do I have to continue treatment?