Hypothyroidism

What Is Hypothyroidism? Symptoms, Causes, Diagnosis, Treatment, and Prevention

Kristeen Cherney, PhD
经过 Medically Reviewed by
Reviewed:
Medically Reviewed
Hypothyroidism is a condition that occurs when your thyroid gland doesn't produce enoughthyroid hormones。

这re are many glands in the body; the thyroid gland is the small butterfly-shaped organ at the base of your neck that makeshormonesthat regulate yourmetabolism— which affects how the body uses energy — and other processes.

尽管您的身体每天都会经历荷尔蒙变化（您好，情绪波动！），但甲状腺功能减退症期间发生的大量下降会表明危险，因为缺乏甲状腺激素的产生会导致人体的功能减慢。

Not to mention, an underactive oroveractive thyroid(calledhyperthyroidism)可以影响你的腰围。人hypothyroidism experience a slower metabolic rate, which is generally associated with some amount of weight gain, about 5 to 10 pounds, usually due to accumulation of salt and water in the body.

Signs and Symptoms of Hypothyroidism

这甲状腺功能减退症的体征和症状often develop slowly over the years and may be mistaken for the natural changes of aging.

Hypothyroidism Symptoms in Adults

Look out for these potential symptoms of hypothyroidism:

Hypothyroidism Symptoms in Infants

Hypothyroidism is most common in middle-aged and older women. But sometimes infants and children can develop the condition, such as infants who were born without a thyroid gland or who have a thyroid gland that doesn’t function properly.

Congenital hypothyroidism occurs in about 1 in 2,000 to 4,000 newborns.

If undiagnosed, it can lead to increasingly severe symptoms and even physical and mental disabilities.

Hypothyroidism in infants may include these symptoms:

Common Questions & Answers

What happens if hypothyroidism is left untreated?
Left untreated, hypothyroidism can cause reproductive issues, high cholesterol, depression, weight gain, and chronic constipation. There’s no cure for hypothyroidism, so it’s important to remain vigilant about taking your thyroid meds (thyroxine) and getting your levels checked regularly.
什么水平的TSH表示甲状腺功能减退症？
Normal thyroid-stimulating hormone (TSH) levels can vary by lab but generally can range between 0.4 and 4 milliunits per liter. Sometimes a lower TSH is targeted in women trying to get pregnant. A TSH above the normal range should be confirmed with repeat testing but may indicate hypothyroidism.
Can you lose weight if you have hypothyroidism?
这amount of hypothyroid-related weight gain is usually modest, about 5 to 10 pounds at most. As you undergo treatment and get the right amount of thyroid hormones, your basal metabolic rate will increase so that you’ll be able to lose any extra pounds you gained previously.
What are the symptoms of thyroid problems in women?
一个side from common symptoms of hypothyroidism, such as excessive tiredness, hair loss, muscle weakness, and weight gain, women can experience reproductive symptoms, too. These include heavier menstrual periods as well as infertility.
Can you live a long life with hypothyroidism?
Absolutely. When managed, hypothyroidism isn’t life-threatening. Still, it is possible to develop complications from hypothyroidism that is untreated (or even undertreated), which may in turn affect your overall quality of life. Some of these complications include depression, high cholesterol, and heart disease.

Hypothyroidism Symptoms in Children and Teens

Symptoms of hypothyroidism in children and teens are similar to symptoms in adults and can include the following:

  • Poor growth or short stature
  • Delayed puberty
  • Slow reaction time
  • Weight gain
  • Coarse, dry hair or skin
  • 肌肉痉挛
  • Delayed mental development
  • Increased menstrual flow (in girls)

Learn More About the Signs and Symptoms of Hypothyroidism

Causes and Risk Factors of Hypothyroidism

一个nyone can develop hypothyroidism, but you're at higher risk for it if you're a woman older than 60.

  • Having a family history of thyroid disease
  • Having otherautoimmune diseases（如rheumatoid arthritis，，，，type 1 diabetes，，，，orlupus）
  • Taking supplements and medications that affect the thyroid, includingiodineand锂
  • Having undergone thyroid surgery
  • 有暴露于脖子或上胸部的辐射病史
  • Having been pregnant or delivered a baby within the past six months

What You Should Know About Hashimoto’s Thyroiditis

Hashimoto's thyroiditisis a condition in which your immune system attacks your thyroid gland, often causing hypothyroidism.

这是美国甲状腺不足的最常见原因。

Hashimoto's thyroiditis通常会影响中年妇女，但任何人都可能发生。它影响大约100人中的5人，在女性中的普遍性比男性高8倍。

About 10 to 12 percent of the population has the antibodies that cause Hashimoto’s thyroiditis, but not all of these individuals will develop thyroid dysfunction.

Currently, the causes of Hashimoto’s thyroiditis are unknown, but experts think they may be due to a combination of genes and an external trigger, like a virus.

Doctors can detect the condition by testing your thyroid function. Treatment usually involves thyroid hormone replacement medication.

碘摄入量

Your thyroid gland must have correct amounts of the mineral iodine to make thyroid hormones.

Consuming too little iodine can lead to hypothyroidism. Too much iodine may also cause or worsen hypothyroidism.

Iodine is found in foods such as seaweed, seafood, and iodized salt.

在世界某些地区，iodine deficiency很常见，但在美国很少见，因为大多数奶油都用矿物加固。因此，在甲状腺功能减退症的评估中未常规测试碘水平。

Thyroidectomy

一个thyroidectomy，，，，surgery to remove all or part of your thyroid gland, can slow or stop the production of thyroid hormones and cause hypothyroidism. The operation is fairly common: In 2011, more than 70,000 patients in the United States received athyroidectomy(the most common cause for surgery was cancer).

People with甲状腺癌，甲虫（一个enlarged thyroid），，，，thyroid nodules，，，，orGraves' disease可能需要执行此过程。

Learn More About the Causes of Hypothyroidism: Common Risk Factors, Genetics and More

如何诊断甲状腺功能减退症？

If you have many of the common symptoms of hypothyroidism, such as dry skin, constipation, fatigue, and a hoarse voice, you can make an appointment with your doctor to check for hypothyroidism.

您的医生可以进行各种筛查：

如果这些测试显示出升高thyroid-stimulating hormone(TSH) and low levels of thyroid hormones — like free T4, total T3, or free T3 — it may be an indication that you have hypothyroidism, saysMayumi Endo, MD，，，，an endocrinologist in Seattle.

How to Prepare for an Upcoming Doctor’s Appointment for Hypothyroidism

一个side from conducting a physical exam, blood test, and possible thyroid-imaging scan, your doctor will ask you extensive questions about your symptoms and how long you’ve been experiencing them. Here's how to prepare for your upcoming doctor’s appointment:

保留详细说明您的症状及其严重性的日记。Bring your notes to your appointment to share with your doctor. This can help the doctor detect patterns in your hypothyroid symptoms and get a better idea which screenings you may need for a proper diagnosis.

列出您目前服用的维生素，草药补充剂，处方或非处方药。这些物品可能会与您的治疗方案相互作用，因此您的医生应该了解它们。

Make a list that details your personal health history, including major surgeries.Include family members and relatives who have had thyroid or autoimmune diseases.

一个sk the office ahead of time if you need to fast for your blood work.这意味着除了水外，预约一天的午夜后不能吃或喝酒。

Make a list of questions you want to ask your doctor.That way, you won’t forget anything during your appointment.

What to Expect Before and After Your Appointment

在预约之前，您可能需要禁食或停止服药，但这只有当您的医生指示您这样做时。

Bring your lists of symptoms, current medications, and family history, and note any updates so your doctor can see. Be prepared to undergo blood work or possible thyroid scans.

一个fter your appointment, follow your doctor’s orders and call the office for any clarifications. You may need to wait for the results of your blood work before making adjustments to your thyroid medication dose (if you're on medication). Schedule all your follow-up appointments and referrals to specialists as necessary.

You may also ask your doctor about websites to follow or thyroid support networks you can check out for additional education and emotional support.

Prognosis of Hypothyroidism

这overall prognosis of hypothyroidism is promising, especially when caught early. This condition is extremely treatable with thyroid hormones. But you will likely need to take medications for the rest of your life to help ensure that you get enough thyroid hormone, according to the American Thyroid Association.

Hypothyroidism can lead to numerous complications if it goes undetected and untreated.

Children with hypothyroidism can still hit normal growth and developmental milestones as long as they take their thyroid medications. Since children are still growing, they may need more frequent blood work than adults with hypothyroidism to help ensure they are getting the correct hormone replacement dosage.

甲状腺功能减退症的持续时间

Hypothyroidism is often a chronic condition. As long as you stick with your treatment plan, though, you can lead a relatively normal life and reduce the risk for related health issues. That said, your medication may need to be adjusted from time to time, so it’s important to keep up with regular blood testing to make sure you’re getting the right amount.

Treatment and Medication Options for Hypothyroidism

这re are a number of treatments for hypothyroidism, usually involving medication. Some people also use alternative medicines to help them manage their disease, too.

Common Medication for Hypothyroidism Treatment

Treatment for hypothyroidism generally involves taking the oral medicinelevothyroxine，，，，sold under the brand names Levothroid, Synthroid, and others.

Levothyroxineis a man-made thyroid hormone that works by replacing thyroxine, the hormone your body can no longer make in adequate amounts. It's typically taken daily to reverse symptoms of hypothyroidism.

Endo博士解释说：“研究后的研究表明，左甲状腺素是选择的最佳治疗方法。”她指出，有些人对左甲状腺素的通用形式过敏，主要是由于染料。在这种情况下，您可以使用左甲状腺素50微克药（其中没有染料）或品牌Tirosint，尽管这更昂贵。

Levothyroxine may lower yourcholesterol levelsand help you return to a normal weight. The medicine causes very few side effects and is relatively inexpensive, with an average retail price of around $15.

该药物的通用形式被大多数覆盖bob sports app and insurance plans.

Treatment with levothyroxineis usually continued for the rest of your life, but your doctor may adjust your dose over time.

Why Figuring Out the Right Dosage of TSH May Take Some Time

TSH is just one marker that can indicate how your thyroid gland is functioning. Thyroid medications increase T4 hormones, which in turn reduce TSH.

这process can take time to work, which is why doctors usually retest within six to eight weeks of a new thyroid medication prescription.

一旦您的TSH水平与甲状腺药物一致，您的医生可能需要每年检查一次或两次血液。

Factors That Can Affect the Proper Absorption of Levothyroxine

这absorption of levothyroxine, the most common prescription used to treat hypothyroidism, can be influenced by many foods and medications. It’s important to take levothyroxine in the morning with water, at least 30 minutes before eating.

You should avoid certain supplements and foods for several hours after taking levothyroxine. These supplements and foods include:

一个Quick Warning About Subclinical Hypothyroidism and Ineffective Treatment

Subclinical hypothyroidismoccurs when your TSH levels are elevated but the circulating thyroid hormone levels are normal. It is important for your doctor to determine how your TSH fluctuates before you begin your treatment regimen, as various health conditions can temporarily affect your thyroid levels. In most cases of subclinical hypothyroidism, you should have a discussion regarding the risks and benefits of treatment with levothyroxine with your doctor. That’s particularly true if your TSH is less than 10, which means your doctor should assess carefully whether to treat you for hypothyroidism.

一个lternative and Complementary Therapies

Some people with hypothyroidism choose to supplement their treatment with alternative medicines, often to help with symptoms like fatigue, weight gain, stress, and mental fog.

Treatments can include yoga, meditation, hypnosis, supplements, or special diets.

Research that includes one small study of 20 women with hypothyroidism found that yoga helped patients manage their symptoms.

While people with thyroid disease are often careful to eat a diet low in iodine (which can worsen hypothyroidism once a patient has it) or to takevitamin Dor calcium supplements, no diet or nutrient can cure thyroid disease.

Above all, keep in mind that any natural remedies for hypothyroidism are not regulated. In fact, some alternative treatments may be dangerous.

Hypothyroidism Treatments That Don’t Work

One treatment that medical doctors do not recommend? Natural dessicated thyroid products (either porcine or bovine products). The most common is the pig thyroid extract called Armour. Because the components of the pig’s thyroid hormone are very different from those of a human being, medical professionals recommend against using this agent, Endo says. These are most often prescribed by naturopathic doctors.

Learn More About Treatment for Hypothyroidism: Medication, Alternative and Complementary Therapies, and More

Hypothyroidism Diet

这re's no medical evidence that any particular diet will improve the functioning of your thyroid gland, despite anecdotal claims seen online and elsewhere.

如果您要替代甲状腺功能减退症的甲状腺激素，则可能需要避免在服用甲状腺药物后的几个小时内食用某些食物。Endo说，某些食物（例如钙，铁和多种维生素）可能会阻止甲状腺激素的吸收，因此应从左甲状腺素分开四个小时。

甲状腺功能减退症的食物：

  • Soybean flour and cottonseed meal
  • Iron and calcium supplements
  • 一个ntacidscontaining aluminum or magnesium
  • Someulceror cholesterol-lowering drugs
  • Walnuts

Overall, it is most important for people with hypothyroidism to eat a well-balanced diet, rather than consuming any particular food group, Endo says.

Learn More About What to Eat and Avoid if You Have Hypothyroidism

Prevention of Hypothyroidism

您无法预防甲状腺功能减退症。虽然某些危险因素可能有助于这种甲状腺疾病的发展（包括垂体疾病，碘deficiencies，，，，congenital disease, and pregnancy), hypothyroidism is most often caused by factors out of your control.

Instead, it’s more important to be aware of the signs of hypothyroidism and to see your doctor if you suspect any of your symptoms could be related.

Complications of Hypothyroidism

Endo says some of the major risks of living with hypothyroidism include hypothermia, cognitive impairment,coronary artery disease，和高脂血症（血液中的高浓度脂肪或脂质）。此外，她说高脂血症和coronary artery diseaseshould be especially aware of their hypothyroidism risk.

Other potential long-term complications include:

  • Decreased lung function

  • Depression due to slower mental functioning

  • 一个n abnormal enlargement of the thyroid gland (goiter)

  • Heart issues, includinghigh cholesterolandheart disease

  • Infertility in women, due to the inability to ovulate from lack of thyroid hormones

  • Inability to lose weight

  • Nerve damagein the arms, legs, and feet (peripheral neuropathy）

  • Delayed physical and intellectual development in babies born to mothers who are hypothyroid

  • Delayed development in children with untreated hypothyroidism

  • Myxedema coma (in rare cases), when the body’s level of thyroid hormone becomes extremely low

What Is Myxedema, or Advanced Hypothyroidism?

Myxedema is advanced hypothyroidism and occurs in patients who have had untreated and severe hypothyroidism for a long time.

这condition is rare — one estimate notes the number of cases in medical literature is only around 300 total — but it can be life-threatening. Myxedema is more common among older patients, particularly women, and research estimates that the mortality rate for this condition is between 20 and 50 percent.

Symptoms of myxedema include:

Research and Statistics: How Many People Have Hypothyroidism?

一个ccording to the National Institute of Diabetes and Digestive and Kidney Diseases, in the United States, hypothyroidism affects around 4.6 percent of people age 12 and older (about 5 out of every 100 people).

While anyone can develop hypothyroidism, this condition is most common in women and people over 60.

一个lso, an estimated 1 in 8 women will develop some form of thyroid disease, which can include hypothyroidism, hyperthyroidism, goiter, and甲状腺癌，，，，among others.

Related Conditions and Causes of Hypothyroidism

Underactive thyroid may also be due to these causes:

Medication许多类型的药物会影响甲状腺。锂is a common drug that can cause hypothyroidism.

Radioactive iodine, which is used totreat hyperthyroidism(overactive thyroid), may also impair your thyroid function.

In addition, many other drugs can affect your thyroid gland, such asamiodarone，，，，any chemotherapy category with tyrosine kinase inhibitor and checkpoint inhibitors, steroids, interferon alpha, and more, Endo says. Check with your doctor if you are concerned about any medication you are taking.

Radiation Therapy头颈癌的辐射会导致甲状腺功能减退症。

先天性问题Sometimes babies are born without a thyroid gland or with a deformed gland, which results in reduced thyroid function.

Rare DisordersDiseases that deposit abnormal substances in the thyroid can affect its ability to function. These diseases may include淀粉样变性(a rare disease in which amyloid proteins build up in organs like the heart and kidneys),sarcoidosis(a disease that involves the growth of inflammatory cells in the body), orhemochromatosis(the buildup of too much iron in the body).

PregnancyAbout 15 percent of pregnant women may experience an increase in the size of their thyroid during pregnancy; it returns to normal after birth. This can be a normal process to increase thyroid hormone production needed to support the pregnancy.

这same antibodies that cause Hashimoto’s thyroiditis can be present in women who become pregnant. In the year following the pregnancy, women with these antibodies can have thyroid dysfunction, eitherhyperthyroidism or hypothyroidism。

Pituitary DisorderWhen the pituitary gland fails to produce enough TSH, hypothyroidism can occur.

Usually this is caused by a tumor in the pituitary.

Such tumors typically occur in older adults, and about 10,000 pituitary tumors are diagnosed each year in the United States.

一个ging Well With Hypothyroidism

年龄超过60岁的病人甲状腺功能减退very common and increases with age. In fact, up to 1 in 4 patients in nursing homes may haveundiagnosed hypothyroidism，，，，according to the American Thyroid Association.

Symptoms may include:

  • Memory loss
  • Weight gain
  • Fatigue
  • 皮肤干燥
  • Constipation
Since symptoms may mimic normal aging, it’s important for a doctor to make an assessment and decide on a possible course of treatment, such as thyroid hormone replacement.

Doses ofhormone treatmentmust be increased slowly, to prevent too much stress on other body systems, like the heart and central nervous system.

Surprisingly, some studies have found that slightly elevated TSH levels could contribute to an extended life span.

具有正常T4水平的TSH稍高，称为亚临床甲状腺功能减退症。应治疗65岁以上患有甲状腺功能减退症的人，但还应讨论TSH治疗目标（更高的正常TSH目标可能更好）。尽管如此，还应治疗老年人的甲状腺功能减退症，主要是为了缓解症状并预防粘液性水肿。

Resources We Love

最喜欢的甲状腺疾病信息的组织

一个merican Thyroid Association

Founded nearly a century ago, the American Thyroid Association is one of the most trusted and well-known thyroid organizations; it provides the latest information on diseases that affect the thyroid gland. On its website, you will find a variety ofthyroid-related brochures，，，，updated treatment guidelines，，，，and more. If you’re looking for the latest information on hypothyroidism research and treatment, be sure tosign up for the Friends of the ATA newsletter，通过电子邮件交付。

激素健康网络

这是另一个我们最喜欢的patient-center之一ed websites for hypothyroidism, thanks to its vast library of in-depth information pertaining to the causes and symptoms of this condition. Because hypothyroidism is a hormone-related condition, you can also learn more about other aspects of endocrinology that could affect your thyroid. Be sure to check out the pages onpregnancy，，，，goiter，，，，stress，，，，and more.

国家糖尿病与消化和肾脏疾病研究所(NIDDK)

一个branch of the National Institutes of Health, the NIDDK is a leader in research pertaining to all kinds of endocrine diseases, including hypothyroidism. Be sure to review and bookmark theNIDDK’s webpage on hypothyroidismas you prepare for your first appointment with your endocrinologist. Check out the list of risk factors and causes to have on hand as you discuss diagnosis and treatment options with your doctor.

一个merican Association of Clinical Endocrinologists

This website isn’t for doctors only. Enter the Public Community Portal’sthyroid pagefor professional knowledge related tohypothyroidism treatment guidelinesand other related conditions, such as thyroid nodules, to better prepare yourself for your appointment with an endocrinologist. While you’re there, you can also learn how to check your own thyroid gland在本分步指南中。

Favorite Alternative Medicine Resource

National Center for Complementary and Integrative Health (NCCIH)

Depression, stress, and fatigue are some of the many symptoms you might experience with hypothyroidism. Alongside any medical treatment, you may be tempted to research yoga and other complementary practices for support. Before you do, talk to your doctor and come armed with information from this resource. We like the NCCIH because it provides straightforward and up-to-date research on alternative medicine.

Favorite Online Support Network

Thyroid Federation International

寻找一个本地或在线支持组?我们李ke Thyroid Federation International because of its ability to help patients connect with one another across global borders. Wherever you’re located, finding a support group near you is simple viathis list of member organizations。

Favorite Resources for Diet Advice

Thyroid Dietitian

虽然没有具体的饮食可以治愈甲状腺功能减退,eating well can help you feel your best. Still, it can be difficult knowing which foods to eat and avoid, as well as how to cook thyroid-healthy meals. If you need help getting started, check out some of the resources offered by registered dietitianNicole Morgan，，，，including herYouTube channelfeaturing free cooking and exercise tips, as well as建议用于甲状腺饮食书籍，杂货店购物必备品和美容产品。在开始之前，请务必与您的医生讨论这些饮食和运动技巧。

最喜欢的应用程序

增强甲状腺

If you want an easier way to track your symptoms and lab results, look no further than the BOOST Thyroid app for Apple devices. It helps you track more than 20 symptoms each day to help you discover patterns you can discuss with your endocrinologist. We also like how the app lets you look at your blood work and past treatments for a better understanding of your thyroid hormone changes.

这增强甲状腺app is free to download on Apple products, but you will need a membership to access all of the benefits.In the Apple store，，，，you can try out a monthly membership for $3.49 or an annual membership for $14.99. Currently, BOOST Thyroid is under production for Android devices, andyou can sign up here确保您收到最新的更新。

一个dditional reporting by Stephanie Bucklin and Lynn Marks.

Editorial Sources and Fact-Checking

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