Understanding Hypothyroidism: Causes, Symptoms and Treatment Options

Hypothyroidism is a condition that affects millions of people worldwide—many of whom don’t even know they have it. It’s often dismissed as just “getting older” or “feeling run down,” but in reality, it’s a medical condition that needs attention.

Let’s break it down into simple, easy-to-understand sections so you can take control of your thyroid health.

The History of Hypothyroidism

Hypothyroidism has likely existed for thousands of years, but it wasn’t always well understood.

• The first documented descriptions of goiters (enlarged thyroid glands) date back to Ancient China and India.

• Hippocrates (460–370 BC), the “Father of Medicine,” noted that swelling in the neck could indicate a health issue.

• In 1500s Europe, goiters were common in areas where people had iodine-deficient diets, particularly in the Alps.

The First Scientific Discoveries

• In 1811, French chemist Bernard Courtois discovered iodine, leading to its connection with goiter prevention.

• In 1873, British physician Sir William Gull officially described "myxedema"—a severe form of hypothyroidism causing swelling, fatigue, and mental slowing.

• In 1891, Dr. George Murray successfully treated hypothyroidism with injected sheep thyroid extract, proving that thyroid hormone replacement therapy worked!

The Evolution of Treatment

• Early treatments included dried animal thyroid extracts.

• In 1926, Dr. Edward Kendall isolated thyroxine (T4), paving the way for modern thyroid hormone therapy.

• Levothyroxine (Synthroid) was first introduced in the 1950s and remains the most common treatment today.

What Is Hypothyroidism?

Hypothyroidism occurs when your thyroid gland doesn’t produce enough thyroid hormones—specifically T3 (triiodothyronine) and T4 (thyroxine). Since these hormones control your metabolism, low levels can slow down nearly every system in your body.

• The thyroid is a butterfly-shaped gland located at the base of your neck.

• It plays a crucial role in energy production, brain function, digestion, and body temperature regulation.

• When the thyroid isn’t producing enough hormones, your body slows down—making you feel tired, sluggish, and foggy.

How Common Is It?

• Hypothyroidism affects around 5% of the population, but another 5% may have it without knowing (Garmendia Madariaga et al., 2014).

• It is five to eight times more common in women than men.

• The risk increases with age—by 60, around 1 in 10 women may have it (Hollowell et al., 2002).

What Causes Hypothyroidism?

There’s no single cause of hypothyroidism—several factors can contribute, including:

Autoimmune Disease (Hashimoto’s Thyroiditis)

• The #1 cause of hypothyroidism in developed countries.

• Your immune system mistakenly attacks your thyroid, leading to inflammation and reduced hormone production.

• Often linked to other autoimmune conditions like celiac disease and type 1 diabetes (McLeod & Cooper, 2012).

Iodine Deficiency

• The leading cause of hypothyroidism worldwide.

• Your thyroid needs iodine to produce hormones—without enough, it can’t function properly.

• Common in regions where iodized salt isn’t used or diets are low in seafood, eggs, and dairy (Zimmermann et al., 2008).

Nutrient Deficiencies

• Selenium and zinc are crucial for thyroid hormone conversion.

• Iron deficiency can also impair thyroid function.

• Many people with hypothyroidism have low vitamin D levels, which may contribute to autoimmunity (Choi & Kim, 2017).

Chronic Stress & Adrenal Fatigue

• Long-term stress raises cortisol levels, which can suppress thyroid hormone production.

• Stress also affects gut health, which is important for thyroid function.

Toxins & Endocrine Disruptors

• Chemicals like BPA (found in plastics) and fluoride (in water and toothpaste) can interfere with thyroid hormone production.

• Heavy metals like mercury and lead can damage thyroid cells.

Postpartum Thyroiditis

• Some women develop thyroid issues after pregnancy due to immune system fluctuations.

• Often resolves within a year but can lead to long-term hypothyroidism (Lazarus et al., 2014).

Medications & Medical Treatments

• Radioactive iodine treatment for hyperthyroidism can cause permanent hypothyroidism.

• Certain medications (like lithium, amiodarone, and some antidepressants) can suppress thyroid function.

Symptoms of Hypothyroidism

Hypothyroidism symptoms can creep up slowly, making them easy to overlook. Many people go undiagnosed for years because their symptoms are mistaken for aging, stress, or depression.

Most Common Symptoms:

• Extreme fatigue (no matter how much sleep you get)

• Weight gain (especially if diet and exercise haven’t changed)

• Brain fog (trouble focusing, forgetfulness, slow thinking)

• Cold intolerance (always feeling chilly, even in warm weather)

• Depression, anxiety, or mood swings

Physical Signs:

• Dry, flaky skin and brittle nails

• Hair thinning or hair loss (especially outer eyebrows)

• Puffy face or swollen hands/feet

• Hoarseness or a deeper voice

• Slow heart rate

How Is Hypothyroidism Diagnosed?

If you suspect you have hypothyroidism, don’t rely on symptoms alone—you need lab tests to confirm.

Full Thyroid Panel (Recommended Tests)

• TSH

• Free T3 & Free T4

• Reverse T3 (RT3)

• Thyroid Antibodies (TPO & TGAb)

Treatment Options

Conventional Treatment (Thyroid Medication)

• The most common treatment is levothyroxine (Synthroid, Eltroxin, Oroxine, etc.)

• Some people may need T4/T3 combination therapy (like Armour Thyroid or compounded thyroid).

Natural Approaches & Lifestyle Changes

• Optimize Nutrients: Iodine, selenium, zinc, iron, and vitamin D.

• Reduce Stress: Chronic stress suppresses thyroid function—try meditation or yoga.

• Improve Gut Health: Since 20% of thyroid hormone is converted in the gut, a healthy gut is essential.

Diet for Hypothyroidism

• Prioritize protein & healthy fats

• Limit gluten & dairy (especially for Hashimoto’s)

Final Thoughts

If you’re struggling with fatigue, brain fog, weight gain, or other symptoms, don’t ignore them—your thyroid might be the culprit!

The good news? Hypothyroidism is manageable, and with the right knowledge, you can feel like yourself again.

Disclaimer: The information provided in this article is for educational purposes only and is not intended to diagnose, treat, or cure any medical condition. Always consult with a qualified healthcare professional before making any changes to your diet, lifestyle, or treatment plan. Individual needs may vary, and what works for one person may not be suitable for another.