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Hypothyroidism : Causes, Risk Factors, Signs & Symptoms, Treatment, Lifestyle Management, Diet, Exercise

What Is Hypothyroidism?

Hypothyroidism, also known as underactive thyroid is a condition in which the thyroid gland is not able to produce enough of thyroid hormone and the body remains deficient of those important hormones. This condition is more common in women and is generally found in persons over 50 years of age.


The main function of the thyroid hormones is to regulate metabolism or control the ability of the body cells to appropriately use energy. Any disturbance in the thyroid hormone affects the way body utilizes energy and causes disturbed metabolism. This can result in an imbalance of bodily chemical reactions.

Causes Of Hypothyroidism

The major cause for hypothyroidism includes inflammation and swelling of the thyroid gland, which could result from

  • Hashimoto’s Thyroiditis– defects in immune system, where the person’s own immune system attacks the thyroid gland causing thyroid inflammation leading to thyroid gland failure.
  • Respiratory infections and other viral infections like common cold.
  • Pregnancy related thyroiditis

Some Of The Other Causes Of Hypothyroidism Include:

  • Congenital birth defects
  • Some medical treatments like lithium, amiodarone, radiation therapy, radioactive iodine for treating hyperthyroidism, partial surgery of thyroid gland, etc.
  • Sometimes, medical conditions or surgeries affecting pituitary gland leading to less production of thyroid stimulating hormone (TSH) can cause hypothyroidism, even when the thyroid gland is normal.
  • Iodine deficiency can also lead to this condition, as iodine salt is important for producing thyroid hormones.

Risk Factors Of Hypothyroidism

While hypothyroidism can occur in anyone, persons with an increased risk include

  • Elderly women
  • Those with an autoimmune disorder
  • Those with a family history of autoimmune disorder
  • Those who have undergone radiation therapy for neck or chest, had treatment or surgery for overactive thyroid.

Signs And Symptoms Of Hypothyroidism

Clinical manifestations of hypothyroidism greatly vary based on the severity of the hormone deficiency. The symptoms may develop gradually within some years.

Symptoms Of Hypothyroidism In Adults- Some of the symptoms generally observed in adults include

  • Constipation
  • Weight gain
  • Weakness and fatigue
  • Increased sensitivity to cold
  • Irregular or abnormal menstrual cycle
  • Dry skin and hair, brittle hair or fingernails
  • Puffiness of face and hands
  • Hoarseness of voice
  • Muscle weakness, cramps, muscle aches and stiffness
  • Painful, stiff or swollen joints
  • Increased blood cholesterol levels
  • Feeling depressed or sad, irritability
  • Impaired memory

The symptoms may gradually become more severe if the condition is left untreated. In advanced cases, known as myxedema, there can be decreased breathing, lowered body temperature and blood pressure and may lead to a potential fatal condition; hence it is advisable to identify the condition at the earliest and follow medical advice.

Symptoms Of Hypothyroidism In Infants- In hypothyroidism resulting from congenital conditions, the babies may be born without a thyroid gland or possess a gland that does not function effectively. Symptoms observed in such cases may include

  • Puffy face
  • Frequent choking
  • Protruding tongue
  • Yellowish discoloration of skin and sclera occurring due to improper metabolism of enzymes in the liver.

In progressive stages, it may affect the baby’s normal growth and development. Symptoms like constipation, sleepiness or decreased muscle tone may be seen.

Symptoms Of Hypothyroidism In Children And Teens– As children and teens are in the growing phase, hypothyroidism may affect their natural growth. In addition to the symptoms seen in adults, they may also have problems like delayed development, poor mental growth, delayed secondary dentition and delayed puberty.

Diagnosis Of Hypothyroidism

In order to make a diagnosis of hypothyroidism, the physician will perform clinical examination to determine the enlargement of thyroid gland. Other signs and symptoms related to skin, hair, nails, swelling can also be detected.

Further laboratory tests to determine other parameters of Hypothyroidism include

  • Thyroid profile – To determine levels of thyroid hormones, T3, T4 and TSH
  • Complete blood count (CBC)
  • Lipid profile – To determine cholesterol levels
  • Others like sodium prolactin and levels

Treatment Of Hypothyroidism

Treatment of hypothyroidism mainly aims at making up for the thyroid hormone deficiency by replacement. The most commonly preferred drug is levothyroxine. The doses vary depending on the person and the hormone requirements. Regular monitoring of thyroid hormone levels should be done as advised.

It is essential to follow medical advice and continue medicines as prescribed. Certain foods and medicines may interact with this drug and it is advisable to seek medical opinion about food and any other on-going treatment. Some of the warning signs like palpitations, tremors, excessive weight loss and sweating should be immediately reported to the physician for re-evaluation.

Lifestyle Management For Hypothyroidism

Lifestyle management can be of great value when living with hypothyroidism is considered. Although there is no specific diet for hypothyroidism, it is essential to maintain a healthy diet and exercise routine in order to manage issues related to metabolism and weight gain.

Hypothyroidism Diet

While satisfactory evidences are being researched, some foods are suspected to be interacting with the natural thyroid hormone producing mechanism or may be interfering in the action of the thyroid medication.

Some foods that can help include nuts and fish (fatty fish like salmon, tuna, mackerel) which are rich in omega-3-fatty acids. Adding whole grains in place of refined flour is the best option for breads, cereals, rice and pastas. For weight management, it is essential to include plenty of fresh fruits and vegetables in daily diet. Some foods specifically known to have high content of iodine are seaweed, iodized salt and other fortified products; seek medical advice on adding them in daily diet.

Some may advice to avoid foods like soy, cruciferous vegetables and follow a gluten free diet like avoiding processed wheat. Considering increased chances of weight gain, it is advisable to avoid fried or fatty foods, sweets and bakery products, highly processed and junk foods. High fiber foods are better when used in moderation. Avoiding alcohol, coffee, soft drinks and other stimulants can also help.

Exercises For Hypothyroidism

An exercise regimen is very good to maintain weight and can also help in regulation of metabolism. The precise duration and type of exercise can depend on individual person’s condition. In general, taking up activities like walking, jogging, swimming, cycling for 20 to 30 minutes daily can be beneficial. Activities and exercise that help in burning excess calories can aid in metabolism.

In yoga, ‘Suryanamaskar‘ or ‘Sun Salutations‘, which is an exercise for the whole body, can be performed. Additionally, breathing techniques or ‘Pranayama can be practiced.


  1. Mayo Clinic – Hypothyroidism: https://www.mayoclinic.org/diseases-conditions/hypothyroidism/symptoms-causes/syc-20350284
  2. American Thyroid Association – Hypothyroidism: https://www.thyroid.org/hypothyroidism/
  3. National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) – Hypothyroidism: https://www.niddk.nih.gov/health-information/endocrine-diseases/hypothyroidism
  4. Cleveland Clinic – Hypothyroidism: https://my.clevelandclinic.org/health/diseases/8541-hypothyroidism
  5. Endocrine Society – Hypothyroidism: https://www.hormone.org/diseases-and-conditions/thyroid/hypothyroidism

Also Read:

Pramod Kerkar, M.D., FFARCSI, DA
Pramod Kerkar, M.D., FFARCSI, DA
Written, Edited or Reviewed By: Pramod Kerkar, M.D., FFARCSI, DA Pain Assist Inc. This article does not provide medical advice. See disclaimer
Last Modified On:July 27, 2023

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