Subclinical Hypothyroidism Symptoms Diagnosis and Treatment
Posted By Rupa Jaiswal
Posted on Jun 26, 2021
Do you have vague, uncomfortable symptoms with no obvious cause?
Do you feel tired all the time and have trouble in concentrating?
Are your hands and feet always cold?
Is your hair thinning, your voice a little hoarse and your fingernails a little thick ?
Are you depressed and anxious?
Is your sex drive have gone down?
Do you have trouble loosing weight or have you gained weight recently ?
If your answer is yes, for the above mentioned symptoms, then you need to seek a physician immediately, because you may be suffering from a thyroid related problem termed as Subclinical Hypothyroidism (SCH) or Mild thyroid failure.
Many at times we and our consulted physician, misdiagnosed these above mentioned symptoms with the sex hormone imbalance problems, as a wide range of the symptoms are similar or due to the mild condition of the Hypothyroidism the test results may appear in the 'normal' range. So the physician may send you home with nothing more than a advice to 'get more sleep and eat better' or you may be prescribed with some anti-depressant tablets.
But due to the more number of people reporting the same symptom pattern, this condition must not be overlooked.
What is Subclinical hypothyroidism?
Subclinical hypothyroidism is a term used to describe the mild condition of hypothyroidism. In which there is a reduction of the thyroid activity, leading to elevation of serum thyroid stimulating hormone (TSH), while the free thyroxine and free triiodothyronine level is within the normal reference range. It is also called as compensated hypothyroidism. The normal range of the Thyroid Stimulating Hormone (TSH) is within 0.30-5.50 mIU/mL. The raises between 5.50-10 mIU/Lin SCH condition.
The condition is more prevalent than the most people realize it. In which women are affected twice more than the men and the chances increases as the age progresses. The commonest cause of the SCH is the autoimmune thyroiditis or person who are suffering from the type 1 diabetes are at the foremost risk.
Autoimmune thyroiditis, commonly called as Hashimoto's disease is basically the primary reason for the development of the SCH. It is a results of the malfunctioning of the immune system, where the immune system of the individual recognizes normal thyroid cells as foreign tissue, and it produces the antibodies that may destroy the thyroid cells. Many people do not know they might be having this condition and they might be go a long without being diagosed.
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How is SCH is diagnosed?
The diagnosis of the SCH requires a in-depth analysis of the patient's history, close careful examination of the symptoms and the correct interpretation of the test results.
TSH (Thyroid Stimulating Hormone or Thyrotropin) TEST - As the TSH has a log- linear relationship with the circulating thyroid hormones, TSH measurement is the necessary test for the diagnosis of the mild thyroid hormone. Where the level of the TSH is above the upper limit, keeping the level of the free triiodothyronine and free thyroxine within the normal ranges.
But the test report showing slightly elevated TSH and normal thyroid hormone level do not necessarily imply the presence of subclinicalhypothyroidism. Certain medications and conditions bring about fluctuation in the level of TSH, pushing the value to higher side. Drugs like sulfonyl ureas, lithium, amiodarone, ethionamide, phenylbutazone and many more interfere with the mechanism of thyroid hormone production and raises TSH level. Metoclopramide and domperidone the dopamine antagonist exaggerate TSH response by altering the inhibitory effect of dopamine on TSH secretion. Certain conditions like thyroid hormone secreting tumors, adrenal insufficiency, renal failure, hyperprolactinemia and systemic and psychiatric illness also causes elevation.
Antithyroid Antibodies (ATG) TEST - People with SCH shows high level of the anti thyroid antibodies, whose TSH serum level is between 10mIU/L.
Thyroid Scan it produces the image of the thyroid gland, which help to determine the size, shape and position.
Iodine Scan It measure the thyroid function, by determining the quantity of iodine taken up by the thyroid gland. Presently there are no consequences exist to the clinical importance of the adverse effects of the SCH, but as it progresses it can bring about problems related to the health. The following are some of it.
Progression to overt hypothyroidism Person showing the TSH value greater than 10 mIU/L predicts a higher rate of the progression to overt hypothyroidism than the person with the value 6 mIU/L.
Effects on serum lipid profile
The thyroid gland failure shows a reversible elevation in the serum lipid levels. The LDL-bad cholesterol concentration are elevated in the individual with the SCH.
People with subclinical hypothyroidism shows Cardiac Risk Markers Test changes like impairment of the left ventricular diastolic, reduced LV systolic function, prolongation of the pre-ejection time and impaired .myocardial intrinsic contractility. The presence of SCH is the strong indicator risk of atherosclerosis and myocardial infarction.
Somatic and Neuromuscular effects
Subtle clinical manifestation and non specific symptomatology such as dry skin, cold intolerance, constipation and easy fatigability is seen in people with SCH.
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Treatment The treatment of the Subclinical Hypothyroidism is relatively easy and is recommended, though being the mild form in order to avoid the adverse consequences. Subclinical Hypothyroidism is the condition of under performance of the thyroid gland, so replacement of the hormones that the thyroid is not producing in form of orally ingested thyroid supplements can be done.
This can be done on the daily basis and it have to be continued for life. The other treatment is the hormone replacement supplement called levothyroxine. The treatment is innocuous and non allergenic in nature. Like any medication, there is the possibility that the recommended treatment may interact with other medications and food supplements, so one needs to follow the instructions by the physician.
Though subclinical hypothyroidism is not life threatening, but it will make you feel 'out of whack'. So when it comes to the health condition, a single ignorance can be scourge for you in later stages.