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Thyroid Regulation

Consequences of Hypothyroidism

Gastrointestinal problems. Hypothyroidism is a common cause of constipation. Constipation in hypothyroidism may result from diminished motility of the intestines. In some cases, this can lead to intestinal obstruction or abnormal enlargement of the colon.36 Hypothyroidism is also associated with decreased motility in the esophagus, which causes difficulty swallowing, heartburn, indigestion, nausea, or vomiting. Abdominal discomfort, flatulence, and bloating occur in those with small intestinal bacterial growth secondary to poor digestion.31

Depression and psychiatric disorders. Panic disorders, depression, and changes in cognition are frequently associated with thyroid disorders.37 Hypothyroidism is often misdiagnosed as depression.38 A study published in 2002 suggests that that thyroid function is especially important for bipolar patients: “Our results suggest that nearly three-quarters of patients with bipolar disorder have a thyroid profile that may be suboptimal for antidepressant response.”39

Cognitive decline. Patients with low thyroid function can suffer from slowed thinking, delayed processing of information, difficulty recalling names, etc.40 Patients with subclinical hypothyroidism show signs of decreased working memory,41 and decreased speed of sensory and cognitive processing. 42 An evaluation of thyroid hormones along with TSH may help avoid misdiagnosis as being depressed.43

Cardiovascular Disease. Hypothyroidism and subclinical hypothyroidism are associated with increased levels of blood cholesterol, increased blood pressure, and increased risk of cardiovascular disease.44 Even those with subclinical hypothyroidism were almost 3.4 times as likely to develop cardiovascular disease than those with healthy thyroid function.45

  • High blood pressure. Hypertension is relatively common among patients with hypothyroidism. In a 1983 study, 14.8% of patients with hypothyroidism had high blood pressure, compared with 5.5% of patients with normal thyroid function.46 “Hypothyroidism has been recognized as a cause of secondary hypertension. Previous studies … have demonstrated elevated blood pressure values. Increased peripheral vascular resistance and low cardiac output has been suggested to be the possible link between hypothyroidism and diastolic hypertension.”47
  • High cholesterol and atherosclerosis. “Overt hypothyroidism is characterized by hypercholesterolemia and a marked increase in low-density lipoproteins (LDL) and apolipoprotein B.”48 These changes accelerate atherosclerosis, which causes coronary artery disease.43 The risk of heart disease increases proportionally with increasing TSH, even in subclinical hypothyroidism.49 Hypothyroidism that is caused by autoimmune reactions is associated with stiffening of the blood vessels.50 Thyroid hormone replacement may slow the progression of coronary heart disease by inhibiting the progression of plaques.51,52
  • Homocysteine. Treating hypothyroid patients with thyroid hormone replacement might attenuate homocysteine levels, an independent risk factor for cardiovascular disease: “A strong inverse relationship between homocysteine and free thyroid hormones confirms the effect of thyroid hormones on homocysteine metabolism.”53
  • Elevated C-reactive protein. Overt and subclinical hypothyroidism are both associated with increased levels of low-grade inflammation, as indicated by elevated C-reactive protein (CRP). A 2003 clinic study observed that CRP values increased with progressive thyroid failure and suggested it may count as an additional risk factor for the development of coronary heart disease in hypothyroid patients.54

Metabolic Syndrome. In a study of more than 1500 subjects, researchers found that those with metabolic syndrome had statistically significantly higher TSH levels (meaning lower thyroid hormone output) than healthy control subjects. Subclinical hypothyroidism was also correlated with elevated triglyceride levels and increased blood pressure. Slight increases in TSH may put people at higher risk for metabolic syndrome.55

Reproductive system problems. In women, hypothyroidism is associated with menstrual irregularities and infertility.56 Proper treatment can restore a normal menstrual cycle and improve fertility.57

Fatigue and weakness. The well-known and common symptoms of hypothyroidism, such as chilliness, weight gain, paresthesia (tingling or crawling sensation in the skin) and cramps are often absent in elderly patients compared with younger patients, fatigue and weakness are common in hypothyroid patients.58