Can you die from thyroid

Complications of Untreated Hypothyroidism

Like many women her age, Susan Stoev, 49, of Rochester, N.Y., felt tired and sluggish, and struggled with occasional aches and pains. A marketing executive and busy mother of two, she chalked up her ailments to middle age. But during a routine physical, Stoev mentioned her recent and inexplicable weight gain to her doctor. Blood tests revealed a common problem: She has hypothyroidism, also called an underactive thyroid.

Stoev is one of more than 9.5 million Americans with hypothyroidism. Hypothyroidism is a condition in which the thyroid gland, found at the base of the front of your neck, doesn’t make enough thyroid hormones. “Thyroid hormones control metabolism — the way the body uses and stores energy — and they affect many organ systems within the body,” says Diana Kao, MD, MS, a women’s health and chronic disease management expert at the University of Washington Neighborhood Factoria Clinic in Bellevue, Wash. Common causes of hypothyroidism include autoimmune disease, removal of the thyroid, radiation treatment, and treatment for an overactive thyroid gland (hyperthyroidism). Being female and over 50 years old are the two biggest risk factors.

Hypothyroidism Symptoms Over Time

An underactive thyroid slows down body processes. Early on, you may not know there’s anything wrong. But over time, in addition to weight gain and fatigue, other common symptoms of hypothyroidism may include:

  • Depression
  • Poor concentration
  • Hoarse voice
  • Increased sensitivity to cold
  • Dry skin and hair
  • Muscle or joint pain
  • Constipation
  • Menstrual problems
  • Elevated cholesterol levels

Stoev experienced many of these symptoms, but “all of those things could be attributed to something else, so it wasn’t until I was tested and diagnosed that I started putting all the pieces together,” she says. “Hypothyroidism then made sense.”

The Complications of Untreated Hypothyroidism

There’s no cure for hypothyroidism, but in most cases it can be controlled successfully with treatment — and doing so is important. Untreated hypothyroidism can contribute to mental decline, heart disease, decreased lung function, and abnormal enlargement of the thyroid gland (also known as goiter). Although rare, severe untreated hypothyroidism can lead to a life-threatening condition called myxedema, a type of coma that occurs when the body’s level of thyroid hormones becomes extremely low. Infection or another illness, certain medications, or exposure to extreme cold can trigger myxedema in someone with an underactive thyroid. Approximately 50 percent of people who develop myxedema die from the condition if it’s diagnosed too late.

Hypothyroidism Treatment: Simple, Effective, and Safe

Treatment for hypothyroidism, also called thyroid hormone replacement therapy, is fairly simple and very effective, so ignoring hypothyroidism symptoms isn’t worth the complication risks. Your doctor will prescribe an initial dose of synthetic thyroid hormone medication and re-test the level of thyroid stimulating hormone (TSH) in your blood in approximately six to eight weeks, Dr. Kao explains. “Depending on the results, the dose of thyroid hormone can be adjusted,” she says. “It’s important to take the medication exactly as prescribed so blood tests results will be most accurate for any dosage adjustment needed.”

It’s also important to take each dose of thyroid hormone medication on an empty stomach, because food can affect how your body absorbs the drug. Talk to your doctor about other medications you’re taking and discuss the best time of day to take your thyroid hormone medication. Doing so at the same time every day works best to keep your thyroid hormone level consistent.

Stoev says she started to feel better after about two months of hypothyroidism treatment, and that now she’s less tired and has more energy — and her weight has become more predictable again, too. Getting diagnosed and starting treatment are key elements of getting this condition under control. Treatment for underactive thyroid is effective and relatively simple, and a number of health problems and potentially serious complications can be avoided.

What Causes Thyroid Problems?

All types of hyperthyroidism are due to an overproduction of thyroid hormones, but the condition can occur in several ways:

  • Graves’ disease: The production of too much thyroid hormone.
  • Toxic adenomas: Nodules develop in the thyroid gland and begin to secrete thyroid hormones, upsetting the body’s chemical balance; some goiters may contain several of these nodules.
  • Subacute thyroiditis: Inflammation of the thyroid that causes the gland to “leak” excess hormones, resulting in temporary hyperthyroidism that generally lasts a few weeks but may persist for months.
  • Pituitary gland malfunctions or cancerous growths in the thyroid gland: Although rare, hyperthyroidism can also develop from these causes.

Hypothyroidism , by contrast, stems from an underproduction of thyroid hormones. Since your body’s energy production requires certain amounts of thyroid hormones, a drop in hormone production leads to lower energy levels. Causes of hypothyroidism include:

  • Hashimoto’s thyroiditis : In this autoimmune disorder, the body attacks thyroid tissue. The tissue eventually dies and stops producing hormones.
  • Removal of the thyroid gland: The thyroid may have been surgically removed or chemically destroyed.
  • Exposure to excessive amounts of iodide: Cold and sinus medicines, the heart medicine amiodarone, or certain contrast dyes given before some X-rays may expose you to too much iodine.You may be at greater risk for developing hypothyroidism if you have had thyroid problems in the past.
  • Lithium: This drug has also been implicated as a cause of hypothyroidism.

Untreated for long periods of time, hypothyroidism can bring on a myxedema coma, a rare but potentially fatal condition that requires immediate hormone treatment.

Equally, nobody I saw about my hip problem thought to check. Some years before I had slipped in the street ands hurt myself. This most minor of injuries simply refused to heal. Over the years I had x-rays, I had physio. Nothing could rid me of my limp. Eventually I was told that I had a condition known as avascular necrosis. Something had caused the blood supply to be cut off from my femur and the bone was dying. This is actually yet another symptom of a malfunctioning thyroid gland: the thyroid also produces another hormone known as calcitonin that regulates calcium production.

Likewise the seemingly ever-present colds that made life miserable were linked. My psoriasis, my debilitating joint and back pains, my dry hair and scaly skin, my trombone-like snoring, diarrhoea, bouts of depression and panic attacks, my insomnia, my terrible weight gain. My chronic fatigue. All of these problems came from that little gland in the neck.

Another symptom when one is hypothyroid is that it is impossible to concentrate. This meant that I was unable to write. I became expert at starting things and never finishing. My wife told me I had lost my “mojo” and she was right. I could only go through the motions. By 2012 I was a complete mess. My weight had ballooned, sleep was almost impossible. I limped continually and took powerful painkillers. I was drained of energy and motivation. I really was slowly dying.

People were talking about me. My mother-in-law was urging my wife to get me checked for diabetes. She gave me a long speech about the need to go for a “medical MOT”. Then one day a friend looked at me and casually asked: “Have you had your thyroid checked?” It had never occurred to me to do this because I knew nothing about the thyroid.

I went for blood tests. When the thyroid gland is underactive yet another hormone comes into play. It is called TSH (thyroid stimulating hormone) and is produced by the brain. Its function is to regulate the production of T3 and T4 and its levels in the body indicate how much stimulation a person’s thyroid requires to release the correct amount of these hormones. In a normal person the level of TSH in the body should be approximately 0.5-4.5. Mine was 99. After this reading, I was given some little white pills that I will have to take for the rest of my life. They synthetically replace the missing hormones. Magically, amazingly, things began to change.

Recovering hypothyroidism sufferers speak of the fog lifting, and so it was for me. I felt that I could suddenly think freely for the first time. The pain in my joints and back subsided. I began to sleep. I had energy. I smiled. There was colour in my cheeks. I lost 35lb in weight. I still limp, however.

More importantly, I can work again. I can write. And I have a decade’s worth of catching up to do. I still have my bad days – sometimes the tiredness and the depression return. But I am pretty much the person I was before my problems began. It is just like starting over: I have to begin my career from scratch.

So what is the point of writing all this down? Steve Jobs once said that successful people “ship”. By this, he meant that it is important that we finish what we start and actually deliver. This is me shipping. There will also be people out there who are going through what I experienced. Maybe they will read this and act. They should, because doctors never call you. You always have to call them.


What Happens if Hypothyroidism Is Left Untreated?


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Your thyroid gland, a butterfly-shaped organ that sits in your neck, produces hormones that help regulate how your body uses energy.

When your thyroid gland doesn’t make enough of these hormones — known as hypothyroidism, or underactive thyroid — a wide range of functions in your body can slow down.

This can happen for a number of reasons, but the most common cause of hypothyroidism in the United States is Hashimoto’s thyroiditis, an autoimmune disorder in which your body’s immune system mistakenly attacks the thyroid.

Symptoms can vary from person to person, but common symptoms of hypothyroidism include:

  • Fatigue
  • Weight gain
  • Constipation
  • Dry skin
  • Dry or thinning hair

Treatment for hypothyroidism is fairly straightforward, and involves taking replacement thyroid hormone. While it may take some trial and error to find the right dose of medication, many symptoms of hypothyroidism may be reversed once you do.

There are a number of reasons people may not treat hypothyroidism, however. They may stop taking medication because they’re experiencing side effects or because they’re not noticing benefits of the medication, for example. Or they may not know they have hypothyroidism. In this case, the condition can gradually become more severe and potentially cause a range of complications.

Because your thyroid affects so many areas of your body, untreated hypothyroidism can cause widespread harm. Here are seven complications to watch out for.

1. Goiter

A goiter is simply an enlarged thyroid gland, and it happens when the organ is trying extra hard to make thyroid hormone.

“Your endocrine system works in feedback loops,” notes Tracy S. Tylee, MD, an endocrinologist at the University of Washington Medical Center in Seattle. Specifically, your brain tells your thyroid how much thyroid hormone to make, and it monitors your thyroid hormone levels to determine this.

To stimulate your thyroid, your brain creates a hormone called the thyroid-stimulating hormone (TSH). If your thyroid hormone level is low, your brain will make more TSH in an attempt to make your thyroid work harder.

A goiter happens when “the brain is hammering the thyroid, trying to get more thyroid hormone out of it,” says Dr. Tylee. “When that happens, the thyroid gets bigger and bigger as it’s trying to make more thyroid hormone.”

A goiter isn’t usually dangerous or uncomfortable, says Tylee, but it’s often an early warning sign of thyroid dysfunction — even before your thyroid hormone levels fall below normal — and it’s a sign that you should get your TSH level checked.

In addition, a large goiter may interfere with your swallowing or breathing, or cause you to be self-conscious about your appearance.

2. Heart disease

There are at least two ways that hypothyroidism can contribute to heart disease, according to Tylee. It tends to make your body retain fluid, which can lead to hypertension (high blood pressure) and congestive heart failure (in which your heart can’t pump blood adequately).

Fluid retention is a major reason people with hypothyroidism often gain weight, and the extra weight looks different than weight gain based on fat tissue. “You tend to get puffy ankles and a puffy face” with fluid retention, says Tylee.

Another way that hypothyroidism can increase your heart risk is by raising your lipid (cholesterol and triglyceride) levels. These substances can contribute to a fatty buildup on the lining of arteries, known as atherosclerosis.

Tylee emphasizes that it’s a good idea to check for thyroid problems in people with elevated lipids. “If you treat their thyroid disease, a lot of times the lipids will get better on their own,” she notes.

Hypothyroidism may also have a separate effect on your risk of coronary artery disease (CAD, or atherosclerosis in the arteries leading to your heart) by contributing to dysfunction in the lining of blood vessels, according to a study published in July 2015 in the Journal of the American Heart Association.

3. Kidney disease

One area of emerging research is the effect of hypothyroidism on kidney function. In a study published in February 2018 in the journal Scientific Reports, researchers looked at data from wide-ranging voluntary health examinations performed on Taiwanese adults.

Using a measure called estimated glomerular filtration rate (eGFR) as well as looking at levels of protein in participants’ urine, the researchers found that people with hypothyroidism had a 2.41 higher risk of chronic kidney disease than people with normal thyroid function.

This number includes participants with both subclinical hypothyroidism — in which TSH is elevated but thyroid hormone levels are normal — who were 2.04 times as likely to have kidney disease, and overt hypothyroidism — in which thyroid hormone levels are low — who were 7.61 times as likely to have kidney disease.

4. Peripheral neuropathy

Uncontrolled hypothyroidism can damage your peripheral nerves, which carry information from your brain and spinal cord to the rest of your body. One reason for this may be fluid retention, which puts excess pressure on the nerves.

Symptoms of peripheral neuropathy often include pain, numbness, or tingling in your arms or legs, and may also include muscle weakness or partial loss of muscle control.

But peripheral neuropathy is most likely to be caused by something other than hypothyroidism.

In a study of previously unexplained neuropathy published in November 2015 in the journal Muscle & Nerve, researchers found that only 0.7 percent of cases were due to hypothyroidism — compared with 25.3 percent of cases caused by diabetes or prediabetes.

5. Cognitive issues

Mental and emotional difficulties are common in hypothyroidism. “The thing that people most describe is just difficulty focusing,” says Tylee. “They feel like they’re in a cloud.”

Hypothyroidism can also contribute to depression. In these cases, treatment with thyroid hormone can help reverse depressive symptoms.

In a study published in March 2015 in the journal Endocrine Research, people with subclinical hypothyroidism were given a depression assessment and then randomly assigned to take either thyroid hormone or a placebo (inactive pill). After 12 weeks, depression scores improved significantly in the thyroid hormone group, but not in the placebo group.

Even if you’re not aware that hypothyroidism is affecting your mental or emotional status, this effect may become clear once you begin treatment. “They feel so much better that it becomes apparent in retrospect,” says Tylee about many of her patients.

6. Fertility issues

In many women with hypothyroidism, menstrual periods become irregular and unpredictable. This can have a negative impact on fertility, as can the autoimmune problems that often cause hypothyroidism.

In a study published in January 2015 in the Endocrine Journal, 69 infertile women with subclinical hypothyroidism were given thyroid hormone treatment. After this, 84.1 percent successfully conceived within an average time of less than a year, although 29.3 percent later miscarried.

7. Myxedema (coma)

Myxedema is a rare but life-threatening complication of severe hypothyroidism that involves extreme fatigue and impaired cognition, followed by loss of consciousness.

In someone with untreated hypothyroidism, a myxedema coma can be triggered by stress on the body, an infection, or taking sedatives, according to the Mayo Clinic.

Tylee stresses that myxedema is a medical emergency, and that although it’s rare, some people are at increased risk — such as elderly people and those who live alone. Often, she says, “they get sick with something else, like a heart attack or pneumonia,” and that can lead to myxedema.

Both myxedema and certain other cases of severe hypothyroidism require intravenous (IV) delivery of thyroid hormone, since fluid in the gut lining may prevent absorption of oral drugs.

But Tylee emphasizes that doctors should check for hypothyroidism well before severe symptoms develop.

“It’s important that if someone comes in complaining of feeling tired and having trouble focusing, you don’t just attribute that to stress and depression,” she says. “You check their thyroid levels, because that’s something you can fix.”


What is hypothyroidism?

Hypothyroidism is a common disorder that occurs when the thyroid gland is underactive and does not produce enough thyroid hormone. The thyroid gland is located in the front part of the neck, and it releases hormones that regulate your metabolism and how you use energy.

7 Ways to Boost Your Energy with Hypothyroidism

If you find yourself lacking energy with hypothyroidism, try these tips to get you going.

The lack of thyroid hormone due to hypothyroidism slows the body’s chemical processes and metabolism. This leads to symptoms such as fatigue and weight gain. Hypothyroidism, also called myxedema, hypothyroid, or underactive thyroid, is more common in women than in men. It is also more common in people older than 50 years of age.

Hypothyroidism is not curable, but it is treatable. Left untreated, hypothyroidism may lead to serious, potentially life-threatening complications, such as heart disease and rarely, myxedema coma. Seek prompt medical care if you have symptoms of hypothyroidism, such as cold hands and feet, fatigue, and weight gain. Timely diagnosis and treatment of hypothyroidism reduces the risk of serious complications.

What are the symptoms of hypothyroidism?

The types and severity of symptoms of hypothyroidism vary, and many are associated with other conditions. At the onset of the disease, the symptoms can be vague and develop or progress slowly. Symptoms may include:

  • Brittle nails
  • Cold hands and feet
  • Constipation
  • Dry skin
  • Fatigue
  • Joint pain
  • Menstrual irregularity
  • Muscle aches
  • Sensitivity to cold (cold intolerance)
  • Thinning, brittle hair
  • Weakness (loss of strength)
  • Weight gain

Later symptoms of undiagnosed or untreated hypothyroidism can include:

  • Bradycardia (slow heartbeat)
  • Depression
  • Enlargement of the tongue
  • Slowing of speech
  • Swelling of the arms or legs
  • Swelling of the hands, feet or face
  • Thickening skin
  • Thinning eyebrows

Serious symptoms that might indicate a life-threatening condition

Any of the following symptoms can indicate worsening of hypothyroidism and a serious or possibly life-threatening situation. Seek immediate medical care (call 911) if you, or someone you are with, have any of these symptoms:

  • Change in level of consciousness or alertness, such as passing out or unresponsiveness
  • Change in mental status or sudden behavior change, such as confusion, delirium, lethargy, hallucinations and delusions
  • Dizziness
  • Low blood pressure
  • Respiratory or breathing problems, such as shortness of breath, difficulty breathing, labored breathing, wheezing, not breathing, or choking

What causes hypothyroidism?

Hypothyroidism can be caused by a variety of diseases and conditions. Most commonly, hypothyroidism is the result of inflammation of the thyroid gland, which can be due to:

Hashimoto’s thyroiditis, an autoimmune disease in which the body’s immune system mistakes healthy thyroid tissue as potentially dangerous to the body and attacks it. This results in inflammation of the tissue that eventually can destroy the function of the thyroid gland.

Viral infection of the thyroid gland (viral thyroiditis)

Hypothyroidism can also be caused by:

  • Birth defects, such as being born without a thyroid gland or with an abnormal thyroid gland

  • Disorders of the pituitary gland or the hypothalamus, which are glands that control the function of the thyroid gland

  • Radiation treatments of the neck

  • Treatments for hyperthyroidism

What are the risk factors for hypothyroidism?

It is generally not possible to prevent hypothyroidism, and a number of factors can put you at risk for developing it. Not all people who are at risk for hypothyroidism will develop the disease. Risk factors include:

  • Addison’s disease (chronic endocrine disorder affecting the adrenal glands)

  • Autoimmune diseases

  • Eating disorders

  • Family history of hypothyroidism

  • Female gender, especially women over 50 years old

  • Gout

  • Increasing age

How is hypothyroidism treated?

There is no cure for hypothyroidism. However, with recognition and treatment, low levels of thyroid hormone can be replaced to reach normal levels in the body. To accomplish this, most people with hypothyroidism have to take the oral thyroid hormone replacement medication called levothyroxine for the rest of their lives.

Medication therapy is monitored closely with blood tests for several months after beginning treatment to ensure you are taking the right amount of the drug. Ideal doses vary among individuals. If the dose of thyroid hormone replacement medication is too small for an individual, it will not adequately replace thyroid hormone in the body. If the dose is too high, it may result in side effects and a potentially serious condition called hyperthyroidism.

Once a safe and effective dose of thyroid hormone replacement medication has been established, it is then generally monitored yearly, or more frequently if symptoms reappear or side effects develop. It is very important not to skip or change doses of your medication without consulting with your licensed health care provider.

Treatment of the life-threatening complication of myxedema coma may require intravenous thyroid hormone replacement medication and steroids and intensive monitoring in a critical care unit.

What are the possible complications of a hypothyroidism?

Complications of untreated hypothyroidism can be serious and even life-threatening in some cases. You can minimize the risk of serious complications of a hypothyroidism by following the treatment plan you and your health care professional design specifically for you.

Complications of untreated hypothyroidism include:

  • Birth defects
  • Heart disease
  • Heart failure
  • Infertility
  • Miscarriage
  • Myxedema coma
  • Osteoporosis

Hyperthyroidism (Graves’ Disease) – Neonatal

Hyperthyroidism means overactivity of the thyroid gland, resulting in too much thyroid hormone in the bloodstream.

Thyroid Gland – Click to Enlarge

The oversecretion of thyroid hormones leads to overactivity of the body’s metabolism. In newborns, the most common cause of an overactive thyroid is called neonatal Graves’ disease, which can be life threatening. However, hyperthyroidism occurs more often in children and adolescents than in newborns.

Newborn hyperthyroidism results when the mother has or has had Graves’ disease herself. Graves’ disease in adults is an autoimmune disorder characterized by the production of antibodies that stimulate the thyroid gland. When a pregnant woman has these antibodies, they can cross the placenta and affect the fetus’ thyroid gland. Graves’ disease in pregnant woman can result in stillbirth, miscarriage, or premature birth.

The following are the most common symptoms of hyperthyroidism in a newborn. However, each baby may experience symptoms differently. Symptoms may include:

  • Low birth weight

  • Small or abnormally shaped head

  • Poor weight gain despite adequate caloric intake

  • Enlarged liver and spleen

  • Goiter

  • Fast heartbeat (which can lead to heart failure)

  • High blood pressure

  • Nervousness

  • Irritability

  • Difficulty sleeping

  • Bulging eyes

  • Vomiting

  • Diarrhea

  • Difficulty breathing due to enlarged thyroid gland (goiter) pressing on the windpipe

Prolonged exposure to high levels of thyroid-stimulating hormone (characteristic of hyperthyroidism) can pose serious health problems to a child, including the following:

  • Premature closing of bones in the skull (fontanelles)

  • Intellectual disability

  • Hyperactivity

  • Slowed growth

The symptoms of hyperthyroidism may resemble other conditions or medical problems. Always consult your child’s doctor for a diagnosis.

How is hyperthyroidism diagnosed?

If not diagnosed shortly after birth, hyperthyroidism in the newborn can be fatal. In addition to a complete medical history and physical examination, diagnostic procedures for hyperthyroidism may include measurement of thyroid hormone in the bloodstream.

How is hyperthyroidism treated?

With prompt treatment, babies usually recover completely within a few weeks. However, hyperthyroidism may recur during the first 6 months to 1 year of life. The goal of treatment is to restore the thyroid gland to normal function, producing normal levels of thyroid hormone. Specific treatment for hyperthyroidism will be determined by your child’s doctor in consultation with you.

Treatment may include:

  • Medication that blocks the production of thyroid hormones and treats rapid heart rate

  • Treatment for heart failure

Complications of Hypothyroidism

If left untreated, hypothyroidism can progress and cause a multitude of complications. Understanding the symptoms of hypothyroidism and getting regular screenings to ensure an early diagnosis will prevent the onset of the complications listed below.

Birth Defects
If you are pregnant and have an untreated thyroid disorder, your child may have a higher risk of having birth defects than babies born to healthy mothers. Babies born to women with untreated thyroid disorders may have significant mental and physical development issues because thyroid hormones are vital for brain development. Fortunately, if these problems are addressed shortly after the birth, the child may experience healthy development. An abbreviated thyroid function test is part of the newborn screen. This usually includes a panel of blood tests performed on a newborn to exclude diseases.

When your thyroid over exerts itself in an effort to produce an adequate amount of hormones, the excessive stimulation may cause the thyroid gland to enlarge to the point where you have a bulge in your neck. This is known as a goiter.

Heart Problems
Hypothyroidism—even in its mildest forms—can affect the health of your heart. An underactive thyroid can increase your risk of developing heart disease because it increases levels of “bad” cholesterol. Too much bad cholesterol can lead to atherosclerosis, hardening of the arteries, which can increase your risk of heart attacks and strokes. Hypothyroidism can also result in the buildup of fluid around the heart, a pericardial effusion, which may make it harder for the heart to pump blood.

If thyroid hormone levels are too low, it can affect ovulation and decrease a woman’s chances of conceiving. Even with proper treatment for hypothyroidism—thyroid hormone replacement therapy—there is no guarantee that the woman will be fully fertile.

Mental Health Issues
The symptoms of hypothyroidism can take a mental toll if left untreated. Mild hypothyroidism can cause mild forms of depression. But without treatment, the symptoms of hypothyroidism will increase. This can directly affect your mental state, and your depression may intensify as a result.

Moreover, untreated hypothyroidism has been associated with a gradual decrease in mental functioning.

Myxedema is the medical term for extreme hypothyroidism—when the disorder has progressed for a long time with no treatment. Myxedema is very rare because it’s highly unlikely that you wouldn’t recognize the symptoms and seek treatment.

This form of hypothyroidism is life threatening. Myxedema can eventually slow metabolism to the point where you would fall into a coma. If you experience symptoms of myxedema, such as extreme fatigue or cold intolerance, seek medical treatment immediately.

The key to preventing the complications of hypothyroidism is to understand the disorder’s symptoms and seek proper medical care. Hypothyroidism is manageable with the right treatment—it doesn’t have to interfere with your everyday life.

Updated on: 03/29/19 Continue Reading Preventing Hypothyroidism View Sources

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