Hypothyroidism (Underactive Thyroid)

Overview

In Lagos, Nigeria, recent studies estimate that thyroid disorders affect up to 5–10% of the population, with hypothyroidism making up a significant portion. This condition often hides in plain sight fatigue, weight gain, or dry skin may be brushed off as stress or lifestyle-related. Yet untreated hypothyroidism can silently disrupt daily life and long-term health. Understanding its nature, symptoms, and treatment is vital for both patients and healthcare providers across Africa and beyond.

What is hypothyroidism?

Hypothyroidism is a condition in which the thyroid gland does not produce enough thyroid hormones. These hormones regulate essential processes such as metabolism, growth, and energy use. Without adequate hormone levels, the body’s functions slow down, resulting in noticeable physical and mental changes.

Types of hypothyroidism

The most common type is primary hypothyroidism, caused by problems within the thyroid gland itself, often due to autoimmune conditions like Hashimoto’s thyroiditis. Less common is secondary hypothyroidism, where the issue lies in the pituitary gland not signaling the thyroid properly. There is also congenital hypothyroidism, present at birth, which if untreated, can affect brain development.

How common is hypothyroidism?

Globally, hypothyroidism is one of the most widespread endocrine disorders. While prevalence varies, regions with iodine deficiency see higher cases. In Africa, where iodine deficiency remains a challenge in some rural communities, hypothyroidism is a growing public health concern.

Symptoms and Causes

What are the symptoms of hypothyroidism?

The symptoms develop slowly, sometimes over several years, which makes early recognition difficult. Common signs include persistent fatigue, unexplained weight gain, feeling unusually cold, constipation, dry skin, and hair thinning. In more advanced cases, individuals may notice puffy faces, hoarseness, or swelling at the neck (goiter).

What causes hypothyroidism?

Several factors can lead to hypothyroidism. The leading cause in iodine-sufficient regions is autoimmune thyroiditis, where the immune system mistakenly attacks thyroid tissue. In iodine-deficient regions, lack of iodine in the diet plays a major role. Other causes include thyroid surgery, radiation therapy, certain medications, and genetic conditions.

What are the risk factors for hypothyroidism?

Risk increases with age and is more common in women. A family history of thyroid disease, previous neck radiation, or autoimmune conditions like type 1 diabetes also elevate risk. In parts of Africa, dietary iodine deficiency remains an important factor.

What are the complications of hypothyroidism?

If untreated, hypothyroidism can lead to serious complications. These include infertility, heart disease, myxedema (a rare but life-threatening condition), and developmental delays in infants born to mothers with untreated hypothyroidism.

Diagnosis and Tests

How is hypothyroidism diagnosed?

Diagnosis relies on blood tests. The most common is the TSH (thyroid-stimulating hormone) test, which rises when thyroid hormone levels are low. A free T4 test confirms the diagnosis. In congenital hypothyroidism, early screening at birth is critical to prevent developmental problems.

Management and Treatment

How is hypothyroidism treated?

The cornerstone of treatment is levothyroxine, a synthetic thyroid hormone taken daily. The dose is tailored to the patient based on age, weight, and blood test results. Regular monitoring ensures hormone levels stay within the healthy range.

How soon after treatment will I feel better?

Most people begin to feel improvement within a few weeks of treatment. Energy levels rise, mood stabilizes, and metabolism normalizes. However, for some, it may take several months for full recovery as the body adjusts.

Outlook / Prognosis

Can hypothyroidism be cured?

There is no outright cure for most forms of hypothyroidism. However, with lifelong hormone replacement therapy, patients can live full and healthy lives.

How long hypothyroidism lasts

For most, hypothyroidism is a lifelong condition. Exceptions include cases linked to temporary inflammation (thyroiditis) or iodine deficiency, where thyroid function can sometimes be restored.

Outlook for hypothyroidism

When properly managed, the outlook is excellent. Patients who adhere to treatment and undergo regular monitoring typically enjoy normal life expectancy and quality of life.

Prevention

Can hypothyroidism be prevented?

Not all cases can be prevented, but steps such as ensuring adequate iodine intake through iodized salt, monitoring those at risk, and early testing can reduce the burden of disease.

Living With

When should I see my healthcare provider?

Anyone with unexplained fatigue, weight changes, or other suggestive symptoms should seek medical advice. Early diagnosis is key to preventing complications.

When should I go to the ER?

Seek emergency care if experiencing symptoms of severe hypothyroidism, such as confusion, extreme cold intolerance, slow heart rate, or swelling of the face and tongue. These may indicate myxedema, a medical emergency.

Additional Common Questions

Can I get hypothyroidism during pregnancy?

Yes. Hypothyroidism during pregnancy can increase the risk of miscarriage, preterm birth, and impaired brain development in the baby. Screening and treatment are critical for maternal and child health.

What should I know about hypothyroidism in children?

Congenital hypothyroidism must be treated immediately to prevent intellectual and developmental disabilities. In older children, symptoms may include delayed growth, fatigue, and poor school performance.

Is hypothyroidism genetic?

Genetics can play a role, especially in autoimmune thyroid disease. Families with a history of thyroid or autoimmune disorders have higher risk.

Does hypothyroidism cause weight gain?

Yes, slowed metabolism often results in mild to moderate weight gain. However, significant weight gain usually involves additional factors like diet and activity level.

What happens if hypothyroidism isn’t treated?

Left untreated, hypothyroidism can lead to infertility, heart problems, goiter, and in extreme cases, myxedema coma, which can be fatal.

Can hypothyroidism cause anxiety?

While hypothyroidism is more often linked with depression, some individuals experience anxiety, irritability, and mood swings. Hormone replacement typically improves these symptoms.

Published 9th Oct 2025

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