Complications of Thyroid Issues

Thyroid disorders involve abnormal production of thyroid hormones, goitre (enlarged thyroid) and rarely, thyroid cancer.

 Less thyroid hormones (hypothyroidism) leads to slow down of metabolism which cause a variety of symptoms such as weight gain, easy fatigue, increased sensitivity to cold, constipation, dry skin, muscle weakness, irregular menstrual periods, depression; while excess of thyroid hormones (hyperthyroidism) causes sudden weight loss in spite of normal or increased appetite, increased sensitivity to heat, rapid heart beat, nervousness, hand tremors, excessive sweating.

Complications Related To Hypothyroidism – Less Thyroid Production:

• Goitre: Goitre refers to enlarged thyroid gland and is due to iodine deficiency or underlying autoimmune disease such as hashimoto’s thyroiditis, which is the common cause of hypothyroidism. Large goitre can lead to difficulty in swallowing and breathing. Treatment of hypothyroidism may decrease the size of goitre.
• Heart Problems: Hypothyroidism impairs cholesterol metabolism leading to increase in bad cholesterol (LDL-C) which multiplies the risk of heart disease. Also risk of enlarged heart and heart failure is more, especially in elderly population.
• Pregnancy Issues: Hypothyroidism can interfere with ovulation, which impairs fertility in women. Untreated hypothyroidism leads to increased risk of spontaneous miscarriage and high BP during pregnancy.
• Fetal Development:  Children born to women with untreated hypothyroidism are more prone to serious intellectual and developmental problems. So, timely initiation of Levothyroxine treatment in pregnancy is crucial.
• Mental Health Issues: Depression is common in hypothyroidism and can be severe.
• Myxedema Coma: This is a rare, life-threatening complication of untreated hypothyroidism. Symptoms include a drop in body temperature (hypothermia), decreased lung function, slow heart rate, seizures, stupor and finally coma. It is otherwise uncommon, but may develop in untreated patients subjected to severe stress, such as infection, surgery, or extreme cold.

Complications Related To Hyperthyroidism – Increased Thyroid Production:

• Heart Problems: Rapid and irregular heart rate called Atrial Fibrillation, High BP and congestive heart failure.
• Brittle Bones:Untreated hyperthyroidism can also lead to osteoporosis, i.e. decrease in bone mineral density. Too much thyroid hormone interferes with body’s ability to incorporate calcium into bones.
• Eye Issues:People with Graves’ ophthalmopathy develop eye problems, including bulging, red or swollen eyes, sensitivity to light, and blurring or double vision. Untreated, severe eye problems may lead to vision loss.
• Skin Diseases & Disorders: In rare cases, people with Graves’ disease develop Graves’ dermopathy, which affects the skin, causing redness and swelling, often on the shins and feet.
• Thyrotoxic Crisis: It is an acute, life-threatening state induced by excessive release of thyroid hormones in individuals with thyrotoxicosis. The clinical presentation includes fever, tachycardia, hypertension, and neurological and gastrointenstinal abnormalities. Because thyroid storm is invariably fatal and if left untreated, rapid diagnosis and aggressive treatment are critical.

Timely diagnosis and initiation of treatment can prevent these complications. Oral Levothyroxine replacement therapy remains the mainstay of treatment for hypothyroidism while anti-thyroid drugs or radio-iodine ablation or surgery (thyroidectomy) along with β blockers are the various options available for the treatment of hyperthyroidism.