| In hypothyroidism, as the name indicates, there is a | | | | normal limits. |
| decline in the functioning of the thyroid gland. The gland | | | | What is TSH? |
| is either damaged as a result of an autoimmune | | | | It is a hormone secreted by the pituitary gland, lying in |
| disease of the thyroid gland, or in the case of an | | | | the brain, which controls the activity of the thyroid |
| overactive thyroid gland, when more than the required | | | | gland. This hormone has got a highly stimulating action |
| amount of antithyroid drug has been administered. | | | | on thyroid activity, so that as soon as the activity of |
| Similarly, hypothyroidism may occur following | | | | the thyroid gland decreases (hypothyroidism), and the |
| radio-iodine treatment or surgery, in cases of an | | | | quantity of the thyroid hormone, the major being T4, or |
| overactive thyroid gland. | | | | even when it touches the lower limit of its normal |
| Subclinical hypothyroidism. | | | | range, there will be an increase in the secretion of TSH |
| The most characteristic feature of an underactive | | | | from the pituitary gland. |
| thyroid gland is that it remains asymptomatic for a long | | | | Hence there is a close relationship between the |
| period, and there are only vague symptoms in the | | | | pituitary and thyroid glands so that a normal level of |
| beginning. Sometimes the diagnosis is made when a | | | | thyroid hormones may be maintained in the blood as |
| person is undergoing routine tests for a general | | | | far as possible. (However, it may be said in passing, |
| medical check-up. | | | | that if hypothyroidism occurs as a result of the |
| The hidden nature of the disease is clear enough. Such | | | | involvement/ disease of the pituitary gland, the levels |
| early cases of hypothyroidism are suspected, | | | | of TSH will not be elevated, although T4 may be on |
| diagnosed/investigated and labelled under the head | | | | the lower side). |
| 'Subclinical Hypothyroidism'. They may, however, still be | | | | Since the raised levels of TSH the blood is the most |
| in the infancy stage and have only minimal symptoms. | | | | sensitive/ earliest index for the decreased function of |
| This truly highlights the need for early diagnosis and | | | | the thyroid gland, this test, along with T4 must be |
| treatment of all cases of hypothyroidism. | | | | carried out whenever there is the slightest suspicion |
| When to suspect subclinical hypothyroidism? | | | | regarding the underactivity of the thyroid gland. |
| The disease may be suspected when the patient | | | | Does subclinical hypothyroidism require treatment? |
| feels lethargic, especially in the case of a patient | | | | Difficulty does arise in such cases. However, it may be |
| suffering from hyperthyroidism who is undergoing | | | | said that in the absence of significant, rather |
| antithyroid drug treatment, or radio-iodine therapy, or | | | | troublesome symptoms, the physician will have to |
| has undergone surgery of the thyroid gland. Or, the | | | | make his own judgement for the initiation of therapy. If |
| condition may occur in cases which have a positive | | | | no therapy is considered necessary for the time being, |
| family history of hypothyroidism. | | | | the patient must be monitored at least 3-6 monthly, so |
| How to diagnose subclinical hypothyroidism? | | | | that the disease does not progress unnoticed. |
| Once suspected, estimation of the thyroid-stimulating | | | | As regards the size of the thyroid gland, in cases of |
| hormone (TSH) in the blood should be carried out. The | | | | hypothyroidism, it may be noted that the gland may be |
| levels of this test will be elevated significantly, although | | | | either enlarged or atrophied, or may remain normal in |
| the levels of T4 may be just on the lower side of the | | | | size. Hence the size of the thyroid does not indicate |
| normal, or just below the normal level. T3 does not | | | | the activity of the gland, and, therefore, one has to |
| playa significant! diagnostic role in the detection of | | | | depend on the levels of thyroid function tests in the |
| hypothyroidism, and its level may be found within | | | | blood. |