Extremely Low Thyroxine And Its Complications!

What is Thyroxine?
Thyroxine, also known as T4, is the main hormone which is secreted by the thyroid gland into the bloodstream. Although it is an inactive form, most of it is converted to an active form called triiodothyronine by organs such as the liver and kidneys. The hypothalamus in the brain along with the pituitary and thyroid glands modulate the production and release of thyroid hormones.

What Happens If You Have Too Little Thyroxine?
If the level of thyroxine in the blood is low, then the pituitary gland releases more thyroid-stimulating hormone (TSH) to try and stimulate the thyroid gland to make more thyroxine. Therefore, a raised level of TSH means the thyroid gland is underactive and is not making enough thyroxine. When the thyroid gland produces very little quantity of thyroxine, then the condition is known as hypothyroidism.

As thyroid hormones are essential for physical and mental development, so hypothyroidism during development or before birth and during childhood causes mental impairment and reduced physical growth.

Symptoms usually show a slow and gradual progression before they become worse over months or years as the level of thyroxine in the body gradually falls.

In adults it causes a decrease in metabolic rate resulting in symptoms that include:

• Fatigue
• Intolerance of cold temperature
• Low heart rate
• Weight gain
• Reduced appetite
• Poor memory
• Depression
• Stiffness of the muscles
• Constipation
• Infertility
• Slow movements and thoughts
• Muscle aches, cramps, and weakness
• Dry skin

Less Common Symptoms include:

• Hoarse voice
• Irregular or heavy menstrual periods in women
• Infertility
• Loss of sex drive
• Carpal tunnel syndrome (which causes pains and numbness in the hand)
• Memory loss or confusion in the elderly

Etiology

1. Autoimmune diseases: The immune system makes antibodies against your body cells
2. Poor iodine intake 
3. Use of certain drugs like amiodarone and lithium
4. Surgical removal or injury to thyroid gland
5. Underactive thyroid gland (congenital hypothyroidism)

Complications

1. Low thyroxine level causes the blood fats (lipids) - cholesterol etc., to rise
2. Pregnant females have an increased risk of developing some pregnancy complications like:
3. Pre-eclampsia (high blood pressure and protein in urine)
4. Anemia
5. Premature labor
6. Low birth weight
7. Stillbirth
8. Serious bleeding after the birth
9. Hypothyroid coma (myxedema coma) is a very rare complication
10. Myxedema coma is a rare but life-threatening state of extreme hypothyroidism

Diagnosis and Investigations:

It involves a blood test which screens the levels of TSH and free T4 and T3. Usually, the reports show high TSH and T3 and T4 levels.

Treatment:

Treatment usually involves taking a daily tablet of thyroid hormone levothyroxine to replace the missing thyroxine. Treatment works very well for most people with hypothyroidism but is required for life. In case you have a concern or query you can always consult an expert & get answers to your questions!