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Hypothyroidism (/ˌhaɪpɵˈθaɪərɔɪdɪzəm/), from hypo- (“under” in Greek) and thyroid (the thyroid gland), often called underactive thyroid or low thyroid and sometimes hypothyreosis, is a common endocrine disorder in which the thyroid gland does not produce enough thyroid hormone. It can cause a number of symptoms, such as tiredness, poor ability to tolerate cold, and weight gain. In children, hypothyroidism leads to delays in growth and intellectual development, which is called cretinism in severe cases. The diagnosis of hypothyroidism, when suspected, can be confirmed with blood tests measuring thyroid-stimulating hormone (TSH) and thyroxine levels.
Worldwide, too little iodine in the diet is the most common cause of hypothyroidism. In countries with enough dietary iodine, the most common cause of hypothyroidism is theautoimmune condition Hashimoto’s thyroiditis. Less common causes include the following: previous treatment with radioactive iodine, injury to the hypothalamus or the anterior pituitary gland, certain medications, a lack of a functioning thyroid at birth, or previous thyroid surgery.
Hypothyroidism can be treated with manufactured levothyroxine; the dose is adjusted according to symptoms and normalization of the thyroxine and TSH levels. In Western countries, hypothyroidism occurs in 0.3–0.4% while subclinical hypothyroidism, a milder form of hypothyroidism characterized by normal thyroxine levels and an elevated TSH level, is thought to occur in 4.3–8.5%. Dogs are also known to develop hypothyroidism and in rare circumstances cats and horses can also have the disorder.
Newborn children with hypothyroidism may have normal birth weight and height (although the head may be larger than expected and the posterior fontanelle may be open). Some may have drowsiness, decreased muscle tone, a hoarse-sounding cry, feeding difficulties, constipation, an enlarged tongue, umbilical hernia, dry skin, a decreased body temperature and jaundice. A goiter is rare, although it may develop later in children who have a thyroid gland that does not produce functioning thyroid hormone. A goiter may also develop in children growing up in areas with iodine deficiency. Normal growth and development may be delayed, and not treating infants may lead to an intellectual impairment (IQ 6–15 points lower in severe cases). Other problems include the following: large scale and fine motor skillsand coordination, reduced muscle tone, squinting, decreased attention span and delayed speaking.
In older children and adolescents, the symptoms of hypothyroidism may include fatigue, cold intolerance, sleepiness, muscle weakness, constipation, a delay in growth, overweight for height, pallor, coarse and thick skin,increased body hair, irregular menstrual cycles in girls, and delayed puberty. Signs may include delayed relaxation of the ankle reflex and a slow heart beat. A goiter may be present with a completely enlarged thyroid gland;sometimes only part of the thyroid is enlarged and it can be knobby in character