Stage 3: Subclinical Hypothyroidism The person's thyroid antibodies may be even higher than in stage 2, as increases in TSH can increase the inflammation of the thyroid gland. Some individuals, however, will continue to be antibody negative.
Primary hypothyroidism is the most common type of hypothyroidism. It occurs when the dysfunction is in the thyroid gland itself. Secondary hypothyroidism occurs when there is dysfunction in the pituitary gland. Tertiary hypothyroidism results from hypothalamus disorders.
Myxedema crisis (also called myxedema coma), the most severe form of hypothyroidism, is rare. It occurs when thyroid hormone levels get very, very low.
In tertiary hypothyroidism, the hypothalamus does not release enough thyrotropin-releasing hormone, so the pituitary does not send enough TSH to encourage thyroid hormone (T3 and T4) production. Tertiary hypothyroidism is rare, but it is often due to a mass or tumor near or on the hypothalamus when it does occur.
Stage 3: Subclinical Hypothyroidism
The third stage of Hashimoto's is known as subclinical hypothyroidism. In this stage, TSH levels may be slightly elevated on blood tests (3-10 mU/L), and the levels of free T3 and free T4 are going to be normal.
They're often collectively referred to as “thyroid hormone” because T4 is largely inactive, meaning it doesn't impact your cells, whereas T3 is active. Once your thyroid releases T4, certain organs in your body transform it into T3 so that it can impact your cells and your metabolism.
Hypothyroidism tends to get worse over time and even mild cases should be regularly monitored. Individuals taking small amounts of thyroid hormones may need to have their doses increased with time. People with hypothyroidism usually need to increase their doses during pregnancy.
Because hypothyroidism develops slowly, you may not notice symptoms of the disease for months or even years. Many of these symptoms, especially fatigue and weight gain, are common and do not necessarily mean you have a thyroid problem.
Hypothyroidism is the most common thyroid condition in patients over 60 years of age and steadily increases with age.
If an underactive thyroid isn't treated, it can lead to complications, including heart disease, goitre, pregnancy problems and a life-threatening condition called myxoedema coma (although this is very rare).
You have joint and muscle aches/pains
General joint and muscle pains are common when hypothyroidism is not sufficiently treated, and your dosage of thyroid hormone needs to be increased.
The most common cause of hypothyroidism is an autoimmune disorder. This means your immune system starts to attack itself. It makes antibodies against the thyroid gland. Another cause may be treatment for an overactive thyroid gland.
The most common symptoms in adults are fatigue, lethargy, cold intolerance, weight gain, constipation, change in voice, and dry skin, but clinical presentation can differ with age and sex, among other factors. The standard treatment is thyroid hormone replacement therapy with levothyroxine.
An underactive thyroid is a lifelong condition, so you'll usually need to take levothyroxine for the rest of your life. If you're prescribed levothyroxine because you have an underactive thyroid, you're entitled to a medical exemption certificate.
In most cases, symptoms of hypothyroidism begin to improve within two weeks of starting thyroid replacement therapy. However, people with more severe symptoms, especially muscle pain and weakness, may require several months of treatment before they fully recover.
In its severest form (myxoedema coma), hypothyroidism is potentially fatal and requires urgent medical treatment. Symptoms of hypothyroidism can include: fatigue and low energy levels.
Not enough iodine.
The thyroid gland needs the mineral iodine to make thyroid hormones. Iodine is found mainly in seafood, seaweed, plants grown in iodine-rich soil and iodized salt. Too little iodine can lead to hypothyroidism. Too much iodine can make hypothyroidism worse in people who already have the condition.
Fatty foods – Fats are known to upset your body's ability to absorb thyroid replacement hormones. Fats can also prevent the thyroid's natural ability to produce hormones. Physicians recommend that you cut out all fried foods and limit your intake of fats from butter, mayonnaise and fatty meats.
The T3 hormone not only produces energy and increases metabolism, but it can promote weight loss. If you have low T3, whether caused by low T4 production or a problem converting T4 to T3, the body will slow down your metabolism, which will likely result in weight gain.
Because T4 is converted into another thyroid hormone called T3 (triiodothyronine), free T4 is the more important hormone to measure. Any changes show up in T4 first. T3 and T4 help to control how your body stores and uses energy to do its work (metabolism).
If values are outside the range of 0.4 to 4.5 milliunits per liter (mU/L), measuring T3 and T4 should follow. However, TSH is always the best first test because it is more reliable than plasma T3/T4 levels, which tend to fluctuate.