Overview
An underactive thyroid (hypothyroidism) occurs when the thyroid gland does not produce enough hormones. Hypothyroidism may not cause symptoms at first but can lead to a number
of health complications including obesity, joint pain, infertility and heart disease. Alternatively, excess production of thyroid hormone causes hyperthyroidism, a condition
characterized by irritability, palpitations, heat intolerance and abnormal bowel habits.
Symptoms and Diagnosis
The symptoms of hypothyroidism in infants include:
- Yellowing of the skin and whites of the eyes (jaundice)
- A large, protruding tongue
- An umbilical hernia
- Hoarse crying
- Difficulty breathing
- Constipation
- Poor muscle tone
- Excessive sleepiness
The symptoms of hypothyroidism in children and adolescents include:
- Puberty abnormalities
- Delayed mental development
- Delayed development of permanent teeth
- Poor growth and short stature
- Constipation
- Cold intolerance
A health care provider will evaluate the symptoms and perform blood tests to determine a diagnosis of hypothyroidism. These tests include:
Investigation Tests
Thyroid function tests including TSH, free T3 and T4 are required to diagnose hypo or hyperthyroidism. Thyroid antibodies are useful in diagnosing some types of hypo or
hyperthyroidism.
Subclinical hypothyroidism
In this condition, the TSH is elevated despite normal thyroid function. It usually presents with no symptoms and is more common in those who are overweight or obesity.
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- Investigations
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Thyroid function tests including TSH (thyroid stimulating hormone), free T3 (triiodothyronine) and T4 (thyroxine) are required to diagnose hypo or hyperthyroidism.
Thyroid antibodies are useful to diagnose some types of hypo or hyperthyroidism
*Subclinical hypothyroidism
It is a condition when the TSH is elevated in the presence of normal thyroid function. It usually presents with no symptoms and is more common in those who are overweight or
obese
Hyperthyroidism
An overactive thyroid (hyperthyroidism) occurs when excessive amounts of the hormone thyroxine are produced by the thyroid gland. Hyperthyroidism can increase the body's
metabolism, resulting in unintentional weight loss and a rapid or irregular heartbeat.
Symptoms and diagnosis
The symptoms of hyperthyroidism in adolescents include:
- Unintended weight loss
- Rapid heartbeat
- An enlarged thyroid gland (goiter)
- Poor heat tolerance and excessive sweating
- Anxiousness and irritability
- Sleep difficulties
- Increased bowel movements
- Difficulty concentrating
- Increased blood pressure
- Fatigue and muscle weakness.
Graves' ophthalmopathy
Graves' ophthalmopathy is an uncommon condition that affects the eyes, resulting in swelling of the tissue and protrusion of the eyeballs. Eye problems often improve without
treatment.
Signs and symptoms of Graves' ophthalmopathy include:
- Dry eyes
- Red or swollen eyes
- Excessive tearing or discomfort in one or both eyes
- Light sensitivity, blurry or double vision
- Inflammation or reduced eye movement
- Protruding eyeballs
The following methods may be used to diagnose hyperthyroidism:
Medical history and physical exam
A doctor may check for tremors in the fingers when they are extended, overactive reflexes, changes in your eyesight and warm, moist skin. As you swallow, a doctor will examine
the thyroid gland for enlargement, bumps, or tenderness and the pulse for irregularity.
Blood tests to examine hormone levels
Thyroxine levels that are high and TSH levels that are low or nonexistent indicate an overactive thyroid.
Treatment
An underactive thyroid requires thyroxin replacement while an overactive gland is treated with hormone suppression. It is necessary to follow up on thyroid function tests
during treatment.
