About 4.6% of people in the U.S. over 12 years old have hypothyroidism¹. This condition means the thyroid gland doesn’t make enough thyroid hormones. It can slow down the body’s metabolism, causing symptoms that affect daily life.

Most hypothyroidism, about 95%, is due to thyroid gland problems, known as primary hypothyroidism². Women are more likely to have it than men, and it’s more common with age². In the U.S., it’s more common in white people and Mexican Americans than in African Americans².

Key Takeaways

• Hypothyroidism is a common condition where the thyroid gland doesn’t produce enough thyroid hormones, leading to a slowdown in the body’s metabolism.
• Approximately 95% of hypothyroidism cases are due to issues in the thyroid gland itself, categorized as “primary hypothyroidism.”
• Hypothyroidism is more common in females and the occurrence increases with age.
• Simple blood tests can determine if a person has hypothyroidism, even in individuals without symptoms.
• Treatment for hypothyroidism aims to restore thyroid hormone levels to the normal range and alleviate symptoms.

What is Hypothyroidism?

Hypothyroidism is when the thyroid gland doesn’t make enough thyroid hormones. These hormones, T4 and T3, help control the body’s metabolism, temperature, and heart rate³. Without enough hormones, the body’s metabolism slows down, causing symptoms.

Understanding Hypothyroidism

Hypothyroidism affects the thyroid gland and its ability to make enough thyroid hormones. This imbalance slows down the body’s metabolism, causing physical and mental symptoms³⁴. Knowing about hypothyroidism’s causes, risk factors, and effects is key to managing it.

Hashimoto’s disease, an autoimmune disorder, is a main cause of hypothyroidism⁵. Other causes include thyroid surgery, radiation, and some medicines.

Hypothyroidism can happen to anyone, but it’s more common in women over 60³⁴⁵. People with thyroid issues, autoimmune diseases, or neck radiation risks are more likely to get it.

Spotting hypothyroidism early and treating it is important. It can lead to high cholesterol and, rarely, myxedema coma³⁴⁵. Knowing symptoms like fatigue and weight gain helps in getting the right medical care.

“Hypothyroidism is a common condition that affects the thyroid gland’s ability to produce sufficient hormones, leading to a slowdown in the body’s metabolism and a range of symptoms.”

In summary, hypothyroidism is a complex issue needing a deep understanding of its causes and effects. By being informed and getting the right medical help, people can manage their hypothyroidism and stay healthy³⁴⁵.

Prevalence of Hypothyroidism

Hypothyroidism is a condition where the thyroid gland doesn’t make enough thyroid hormones. It’s quite common in the United States⁶. The latest data shows about 4.6% of people in the US have it⁶. From 2009 to 2012, the number stayed around 9.6%⁶. But, it has gone up, reaching 11.7% by 2019⁶.

Most people with hypothyroidism don’t show many symptoms, but it can still affect their health and wellbeing⁶. The NHANES dataset shows 4.6% of Americans have it, with most being mild cases⁶.

Thanks to better testing and treatment, fewer people in rich countries don’t know they have thyroid disease⁷. But, we need more research in poor countries to understand how things like race and iodine intake affect thyroid health⁷.

Thyroid disorders, like hypothyroidism, affect a lot of people⁸. In fact, over 12% of Americans will get a thyroid condition at some point, and about 20 million have some thyroid disease⁸. Sadly, up to 60% of those with thyroid disease don’t even know they have it⁸.

With so many people having hypothyroidism, it’s key to know about it, its signs, and the need for early diagnosis and treatment⁶⁷⁸.,,

Risk Factors for Hypothyroidism

Hypothyroidism is when the thyroid gland doesn’t work well. It can happen to anyone, but some things make it more likely⁹.

Women and Older Adults at Higher Risk

Women over 60 face a bigger risk of getting hypothyroidism than men⁹. As people get older, they’re more likely to have thyroid issues¹⁰.

Autoimmune Disorders and Thyroid Conditions

If you have an autoimmune disease like Hashimoto’s, you’re more likely to get hypothyroidism⁹¹¹. Also, if you’ve had thyroid surgery or neck/chest radiation, you might face a higher risk⁹.

Medication and Genetic Factors

Some medicines, like lithium and amiodarone, can lead to hypothyroidism¹¹. If you have a family history of thyroid issues or certain genetic conditions, you’re at a higher risk¹¹.

Genes and environment both play a big part in hypothyroidism risk¹¹. Staying healthy, getting regular check-ups, and knowing the risks can help manage thyroid health.

“Understanding the risk factors for hypothyroidism is crucial in identifying those who may be more susceptible to the condition and taking appropriate preventive measures.”

⁹¹⁰¹¹

Hypothyroidism During Pregnancy

Hypothyroidism is when the thyroid gland doesn’t make enough hormones. It can happen during pregnancy or after having a baby¹². It affects 2 to 3 out of every 100 pregnancies¹². Graves’ disease, a type of hyperthyroidism, affects 1 to 4 out of every 1,000 pregnancies in the U.S¹².. If not treated, it can be dangerous for both the mom and the baby.

Pregnancy complications associated with untreated hypothyroidism include:

• Increased risk of pregnancy loss¹³
• Premature delivery¹³
• Preeclampsia¹³

It’s important for pregnant women to keep an eye on their thyroid hormone levels. They should work closely with their doctors¹⁴. Routine tests for hypothyroidism are not needed but are suggested for women with symptoms or a history of it¹⁴. Treatment involves thyroid hormone therapy, with doses adjusted as needed during pregnancy¹⁴. This treatment is vital for both the mom and the baby, as thyroid hormones help with brain development and growth¹⁴.

“Untreated thyroid conditions during pregnancy are linked to serious problems, including premature birth, miscarriage, and stillbirth.”¹³

Hypothyroidism in pregnancy can be tricky, but with the right care, risks can be lowered. This helps keep both the mom and the baby healthy.

Complications of Hypothyroidism

Hypothyroidism, if not treated, can cause serious health problems¹⁵. A big worry is getting a goiter, which means the thyroid gland gets too big¹⁵. People with hypothyroidism also might have high cholesterol and are at risk for heart issues like heart disease and failure¹⁶.

Another issue is peripheral neuropathy, which hurts the nerves and can make hands and feet feel numb, tingle, or weak¹⁵. It can also make it hard to have a baby because it affects ovulation and sperm production¹⁶.

For pregnant women, not controlling hypothyroidism can lead to serious birth defects and increase the chance of miscarriage, preeclampsia, and early birth¹⁶. In very bad cases, it can turn into a critical condition called myxedema coma, which is a medical emergency¹⁵.

Complication	Impact
Goiter	Abnormal enlargement of the thyroid gland
High Cholesterol	Increased risk of heart disease and heart failure
Peripheral Neuropathy	Nerve damage leading to numbness, tingling, and weakness in the extremities
Infertility	Difficulty conceiving due to disruptions in ovulation and sperm production
Birth Defects	Increased risk of neural tube defects, miscarriage, preeclampsia, and preterm birth
Myxedema Coma	Rare, life-threatening condition requiring immediate medical treatment

“Undiagnosed and untreated hypothyroidism can lead to a wide range of serious health complications that can significantly impact an individual’s quality of life. Early detection and proper management of the condition are essential to prevent these adverse outcomes.”

In summary, the risks of hypothyroidism show why catching it early and treating it is key. By doing so, people can avoid these serious problems and stay healthy¹⁵¹⁶¹⁷.

Symptoms of Hypothyroidism

Hypothyroidism, or an underactive thyroid, can show through many symptoms that may grow over time. The common symptoms include fatigue, weight gain, cold intolerance, dry skin, hair loss, heavy or irregular menstrual periods, a slowed heart rate, and depression.¹⁸ These symptoms can differ from person to person, and early stages might show only slight signs.

Feeling tired and lacking energy is often the first sign of hypothyroidism¹⁸. People might feel constantly exhausted, even after sleeping well. The metabolism slowing down can also cause weight gain, even with no changes in diet or exercise¹⁸.

Being more sensitive to cold is another symptom¹⁸. Those with hypothyroidism might feel cold more easily and struggle to warm up, even in mild weather. Dry, flaky skin and thin or brittle hair are also common, due to the reduced hormone levels¹⁸.

Women with hypothyroidism might have heavier or more irregular periods¹⁸. A slower heart rate and feeling depressed can also happen as the thyroid gland doesn’t work right¹⁸.

Even though hypothyroidism’s symptoms can be subtle, it’s key to know the signs and get medical help if needed. Catching it early and treating it is important for managing it and avoiding problems¹⁸.

Symptom	Description
Fatigue	Persistent feelings of tiredness and low energy, even after adequate rest18.
Weight Gain	Unintentional weight gain due to a slowed metabolism18.
Cold Intolerance	Increased sensitivity to cold temperatures and difficulty warming up18.
Dry Skin	Flaky, dry skin as a result of reduced hormone production18.
Hair Loss	Thinning or brittle hair caused by the underactive thyroid18.
Menstrual Changes	Heavier or more irregular menstrual periods in women18.
Slow Heart Rate	A lower than normal heart rate due to the thyroid’s reduced function18.
Depression	Feelings of sadness, hopelessness, and lack of motivation18.

The symptoms of hypothyroidism can vary in how severe they are and how they develop over time¹⁹. Some people might just have mild symptoms, while others might find it harder to manage their daily life¹⁹. It’s important to recognize the signs early and get medical help to manage the condition and prevent problems¹⁸.

“Hypothyroidism is a condition where the thyroid gland doesn’t produce enough thyroid hormones, leading to a slowdown in the body’s metabolism.”

Causes of Hypothyroidism

Hypothyroidism can come from many sources. The main cause is an autoimmune disorder called Hashimoto’s disease. This happens when the body attacks the thyroid gland by mistake²⁰. Hashimoto’s disease is the top autoimmune issue causing hypothyroidism, but we don’t know exactly why it starts²⁰. It often happens with other immune system problems like type 1 diabetes and vitiligo²⁰.

Thyroiditis, or inflammation of the thyroid gland, can also cause hypothyroidism²⁰. Babies born with an underactive thyroid, known as congenital hypothyroidism, are usually found through newborn tests²⁰. Damage from surgery or radiation to treat thyroid issues can also lead to hypothyroidism²⁰.

Some people get hypothyroidism from problems with the pituitary gland, which controls the thyroid²⁰. Certain medicines for mental health, heart rhythm issues, cancer, and hepatitis C can also cause it as a side effect²⁰. Iodine deficiency is a big cause worldwide, but not much in the U.S. because of iodized salt²⁰.

Studies show links between hypothyroidism and being small at birth and in childhood²¹. It can also happen after childbirth in women, leading to thyroid problems²¹. Genetic research has found certain genes linked to hypothyroidism and thyroid issues²¹.

Studies have found many older people have hypothyroidism, especially in the Framingham Study²¹. There are also cases of central hypothyroidism, affecting the pituitary gland, with some inherited and others not²¹.

“Understanding the diverse causes of hypothyroidism is crucial for proper diagnosis and effective management of this condition.”

Diagnosis of Hypothyroidism

To diagnose hypothyroidism, doctors use blood tests to check thyroid hormone levels²². The main test is the TSH test, which measures TSH in the blood²². A high TSH and low thyroid hormone T-4 means you might have hypothyroidism²². If TSH is high but T-4 and T-3 are normal, it’s called subclinical hypothyroidism²².

TSH tests help diagnose and manage hypothyroidism, and they guide the right medicine dose²². People with hypothyroidism take synthetic thyroid hormone daily to balance hormone levels²². Doctors adjust the medicine based on TSH tests, usually every 6 to 8 weeks²².

Missing thyroid medicine can bring back symptoms, and skipping a dose might mean taking two the next day²². Some medicines and foods can affect how well the thyroid medicine works²². Avoiding certain medicines, like desiccated thyroid extract, is advised due to inconsistent hormone levels²². Pregnant women should also avoid it to protect the baby²².

For babies with hypothyroidism, see a pediatric endocrinologist right away²². Adults can start with a primary care doctor before seeing an endocrinologist²².

Hypothyroidism Statistics	Data
Clinical hypothyroidism prevalence in the U.S. general population	0.3%23
Prevalence in people older than 65 years	Higher than general population23
Females vs. males	7 times more common in females (40 out of 10,000 vs. 6 out of 10,000)23
Thyroid hormone resistance syndrome occurrence	1 out of 40,000 live births23

Some things can make you more likely to get hypothyroidism²⁴. Women get it more often than men²⁴. If you have a family history of thyroid issues or other autoimmune diseases, you’re at higher risk²⁴. Some women get thyroid problems right after having a baby²⁴. Hashimoto’s thyroiditis is a common cause and is an autoimmune condition²⁴.

Diagnosing hypothyroidism is key to managing it and getting your thyroid to work right. Knowing how it’s diagnosed and what affects it helps you work with your doctors to handle this common thyroid issue²²²³²⁴.

Treatment for Hypothyroidism

Hypothyroidism is a condition where the thyroid gland doesn’t make enough hormones. It’s usually treated with synthetic thyroid hormone replacement medication, like levothyroxine²⁵. This medicine helps replace the hormones the thyroid can’t make. It helps get the thyroid and metabolism back to normal²⁵.

Finding the right dose of levothyroxine can take time. The dose may change until it’s just right²⁵. Patients might need blood tests to check their hormone levels and make sure the medicine is working²⁵. Some people feel better soon after starting treatment. But for others, it might take a few months to see the full effects²⁵.

People with hypothyroidism usually take levothyroxine every day for life²⁵. It’s best to take it in the morning, on an empty stomach²⁶. Avoid taking other medicines or eating for at least 30 minutes after taking it. This helps your body absorb the medicine better²⁶. Sticking to the treatment plan is key to managing the condition well and living a good life²⁶.

Levothyroxine is usually safe, but too much can cause side effects. These might include sweating, chest pain, headaches, diarrhea, and vomiting²⁵. If this happens, the doctor might need to adjust the dose²⁶.

Using levothyroxine and triiodothyronine (T3) together is not common in the UK. There’s not enough proof it works better than just using levothyroxine²⁵. Also, taking too much thyroid hormone can lead to serious problems like heart rhythm issues, strokes, and bone problems²⁵.

Pregnant women with hypothyroidism need special care. The right treatment is important for both the mom and the baby²⁵. Keeping thyroid hormone levels right during pregnancy helps the baby grow well²⁷.

“Consistent adherence to treatment is crucial to keeping hypothyroidism under control and managing symptoms effectively.”

Key Considerations in Hypothyroidism Treatment	Details
Medication	Levothyroxine, a synthetic thyroid hormone replacement
Dosage Adjustments	Gradual adjustments over time to find the optimal dose
Timing of Medication	Taken daily, preferably on an empty stomach in the morning
Monitoring	Regular blood tests to ensure hormone levels are within the normal range
Adherence	Consistent adherence to the treatment regimen is crucial for managing the condition

Following the right treatment plan helps people with hypothyroidism manage their condition well. With the right medicine, regular checks, and lifestyle changes, most people can keep their thyroid hormone levels healthy²⁷²⁵²⁶.

Dietary Considerations in Hypothyroidism

For people with hypothyroidism, what they eat is very important. The thyroid gland needs iodine to make thyroid hormones. So, getting enough iodine is key²⁸. But, if you have autoimmune thyroid issues like Hashimoto’s disease, too much iodine can make things worse²⁸.

It’s best to talk to a healthcare provider or a dietitian about what to eat. They can tell you what foods to avoid or what supplements you might need²⁸. Studies show that changing your diet can help people with Hashimoto’s thyroiditis feel better²⁸.

• Gluten-free diets, autoimmune elimination diets, and anti-inflammatory diets help people with Hashimoto’s thyroiditis²⁸.
• Not getting enough nutrients can make hypothyroid symptoms worse. This includes vitamins D, zinc, thiamine, B6, iodine, magnesium, and selenium²⁸.
• Iodine not getting enough of it is the main cause of hypothyroidism worldwide²⁸.
• Selenium is key for thyroid health and can lower thyroid antibodies in Hashimoto’s thyroiditis²⁸. The National Institutes of Health suggest adults shouldn’t take more than 400 mcg of selenium a day²⁸.
• Not having enough zinc can affect thyroid function, and taking supplements might help²⁸.
• Not having enough vitamin D is common in people with hypothyroidism and can make symptoms worse²⁸.
• Not having enough vitamin B12 is also common and might need supplements²⁸.
• Not having enough magnesium is linked to thyroid problems and an increased risk of hypothyroidism²⁸.

Even though iodine is important for thyroid health, in developed countries, thyroid issues from iodine lack are rare²⁹. Most people get enough iodine from their diet, so extra isn’t needed²⁹. Too much iodine can cause hyperthyroidism in some people²⁹.

Some foods and supplements, like walnuts, soybean flour, and iron supplements, can affect how well thyroid hormone medicine works²⁹. Biotin in hair and nail products can also mess with thyroid hormone tests, so stop taking them before testing²⁹.

Making diet changes and using supplements can really help with hypothyroidism and its symptoms. With help from healthcare professionals, people with hypothyroidism can eat better and feel better overall²⁸.

“Iodine is essential for individuals with properly functioning thyroids to produce thyroxine, especially crucial for pregnant women for the baby’s brain development.”³⁰

Some foods like brassicas (cabbage, cauliflower, and kale) can cause goitre if eaten too much³⁰. But, eating a balanced diet with lots of nutrients can really help people with hypothyroidism³⁰.

Some supplements, like ginger and carnitine, might help with hypothyroid symptoms, but we need more studies³⁰. It’s also best to avoid foods high in iodine like kelp and sea moss, as they can mess with thyroid function³⁰.

Working with healthcare professionals and making smart food choices can really help people with hypothyroidism manage their condition and improve their health and well-being.

Hypothyroidism and Mental Health

The link between hypothyroidism and mental health is well-known³¹. Studies show that too much thyroid hormone or low thyroid-stimulating hormone (TSH) can raise dementia risk³¹. Subclinical hypothyroidism also affects memory and increases stroke and heart disease risk³¹.

Hypothyroidism affects mental health in many ways³². Those with thyroid issues often face emotional and mental challenges, especially with hyperthyroidism and hypothyroidism³². Anxiety, depression, and mood swings are common³². Concentration and memory issues are more frequent with thyroid underactivity³².

The connection between hypothyroidism and mental health issues is clear³³. The NIH says 5% of Americans have hypothyroidism, and up to 60% of them also have depression³³. A study found 63% of hypothyroidism patients also suffer from anxiety³³.

Overt hypothyroidism greatly lowers mood and thinking skills, while subclinical hypothyroidism has a smaller effect³³. In one study, subclinical hypothyroidism was linked to depression in people under 60³³.

Fixing the thyroid issue and managing hormone levels is key to good mental and cognitive health in hypothyroidism³¹. Treating the thyroid often helps improve mental health symptoms. Medication, therapy, or both can help³³.

In summary, hypothyroidism and mental health issues like depression and anxiety are closely linked³³. Testing for thyroid problems is crucial when psychiatric symptoms appear³³. Proper thyroid treatment and hormone management can greatly improve mental and cognitive health³¹³²³³.

Living with Hypothyroidism

Living with hypothyroidism means you need to manage it well and make lifestyle changes. You must work closely with your doctors to find the right medicine and check your thyroid hormone levels often³⁴. It’s important to take your medicine as told, or your symptoms might come back³⁴. You might also need to change your diet, handle stress better, and sleep well to help control your symptoms and stay healthy.

It’s key to store and handle your levothyroxine medicine right³⁴. This medicine loses its strength over time. Keep it at room temperature, away from moisture, heat, and sunlight³⁴. Also, remember that caffeine can affect how well your body absorbs levothyroxine, so wait 30 minutes before drinking caffeinated drinks³⁴.

Finding the right medicine and dosage can take time³⁴. Different brands of levothyroxine can affect you differently, changing how you feel and manage your symptoms³⁴. Blood tests every 12 months are key to check your thyroid levels and make sure you’re on the right dosage³⁴. If you gain or lose a lot of weight, you might need to adjust your medicine³⁴. Also, when you go through menopause, you might need different amounts of levothyroxine³⁴.

Making lifestyle changes can really help with hypothyroidism³⁵. Aim for at least 30 minutes of exercise five times a week for your health and thyroid³⁵. Exercise boosts your metabolism, fights fatigue and muscle pain, controls appetite, lowers blood sugar, raises serotonin, and reduces stress³⁵. Getting advice from a doctor or nutritionist can help you eat right and get the nutrients you need³⁵.

Talking to others who have hypothyroidism can be really helpful³⁵. Joining a thyroid support group can give you comfort, advice, and a sense of belonging³⁵. Also, seeing your thyroid blood results can help you find the best levels for your health, as you might feel best at different TSH levels³⁵.

Managing hypothyroidism takes time, effort, and working together with your doctors³⁶. Symptoms can start to get better in two weeks, but it might take months for full recovery³⁶. If you still have symptoms after treatment, it could mean there’s something else going on, so it’s important to keep an eye on things and adjust your treatment if needed³⁶.

By understanding how to manage hypothyroidism and making lifestyle changes, you can play a big part in taking care of yourself and feeling better overall³⁶.

Conclusion

Hypothyroidism is a common thyroid disorder that affects many Americans, especially women³⁷. It’s important to know about its causes, symptoms, and treatments. Early diagnosis and proper treatment help people with hypothyroidism live healthy lives³⁷.

Autoimmune disorders like Hashimoto’s thyroiditis are the main cause of hypothyroidism in the U.S³⁸.. Working with healthcare providers and making lifestyle changes helps manage the condition. This can prevent complications from an underactive thyroid³⁷. It’s key to catch and treat hypothyroidism early, as it can worsen over time at a rate of about 5% a year³⁸.

Living a healthy life, with a balanced diet and regular exercise, helps manage hypothyroidism and boosts well-being. By spreading the word about early diagnosis and treatment, we can make sure those with hypothyroidism get the care they need. This helps them stay healthy and live fulfilling lives.

FAQ

What is hypothyroidism?

Hypothyroidism is when the thyroid gland doesn’t make enough thyroid hormones. This slows down the body’s metabolism.

How common is hypothyroidism?

It’s quite common, affecting about 5 out of 100 Americans over 12 years old.

Who is at a higher risk of developing hypothyroidism?

Women over 60, those with thyroid issues, autoimmune diseases, or neck/chest radiation are at higher risk.

Can hypothyroidism affect pregnancy?

Yes, it can lead to pregnancy issues like loss, premature birth, and preeclampsia for both mom and baby.

What are the potential complications of untreated hypothyroidism?

Without treatment, it can cause a goiter, high cholesterol, heart disease, infertility, and birth defects. In severe cases, it can be life-threatening.

What are the common symptoms of hypothyroidism?

Symptoms include feeling tired, gaining weight, being cold intolerant, dry skin, hair loss, irregular periods, slow heart rate, and depression.

What causes hypothyroidism?

It’s often due to Hashimoto’s disease, thyroiditis, or surgery/radiation therapy. Some medications can also cause it.

How is hypothyroidism diagnosed?

Doctors use blood tests to check thyroid hormone and TSH levels to diagnose it.

How is hypothyroidism treated?

Treatment involves synthetic thyroid hormone medication to restore normal thyroid function.

How can diet and lifestyle affect hypothyroidism?

Getting enough iodine is key, but those with Hashimoto’s should be careful. Managing stress and getting enough sleep helps too.

How can hypothyroidism affect mental health and cognitive function?

It can cause fatigue, depression, anxiety, memory issues, and trouble concentrating. Proper thyroid treatment helps with mental health and focus.

Source Links

1. Hypothyroidism (underactive thyroid): Symptoms and more – https://www.medicalnewstoday.com/articles/163729
2. Patient education: Hypothyroidism (underactive thyroid) (Beyond the Basics) – https://www.uptodate.com/contents/hypothyroidism-underactive-thyroid-beyond-the-basics
3. Hypothyroidism (Underactive Thyroid) – NIDDK – https://www.niddk.nih.gov/health-information/endocrine-diseases/hypothyroidism
4. Hypothyroidism: Symptoms, Causes, Treatment & Medication – https://my.clevelandclinic.org/health/diseases/12120-hypothyroidism
5. Hypothyroidism | Hashimoto’s Disease | MedlinePlus – https://medlineplus.gov/hypothyroidism.html
6. Hypothyroidism Prevalence in the United States: A Retrospective Study Combining National Health and Nutrition Examination Survey and Claims Data, 2009–2019 – https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9706417/
7. Global epidemiology of hyperthyroidism and hypothyroidism – Nature Reviews Endocrinology – https://www.nature.com/articles/nrendo.2018.18
8. General Information/Press Room | American Thyroid Association – https://www.thyroid.org/media-main/press-room/
9. Hypothyroidism (underactive thyroid) – Symptoms and causes – https://www.mayoclinic.org/diseases-conditions/hypothyroidism/symptoms-causes/syc-20350284
10. Hypothyroidism – StatPearls – NCBI Bookshelf – https://www.ncbi.nlm.nih.gov/books/NBK519536/
11. What Causes Your Thyroid to Be Underactive? – https://www.verywellhealth.com/hypothyroidism-causes-risk-factors-3231721
12. Thyroid Disease & Pregnancy – NIDDK – https://www.niddk.nih.gov/health-information/endocrine-diseases/pregnancy-thyroid-disease
13. Thyroid conditions during pregnancy – https://www.marchofdimes.org/find-support/topics/pregnancy/thyroid-conditions-during-pregnancy
14. Hypothyroidism and Pregnancy – https://www.hopkinsmedicine.org/health/conditions-and-diseases/staying-healthy-during-pregnancy/hypothyroidism-and-pregnancy
15. Hypothyroidism – https://www.hopkinsmedicine.org/health/conditions-and-diseases/hypothyroidism
16. Complications of Hypothyroidism: Fertility, Weight and More – https://www.healthline.com/health/hypothyroidism/complications
17. Hypothyroidism (Underactive Thyroid) – https://www.webmd.com/women/hypothyroidism-underactive-thyroid-symptoms-causes-treatments
18. Hashimoto’s disease-Hashimoto’s disease – Symptoms & causes – Mayo Clinic – https://www.mayoclinic.org/diseases-conditions/hashimotos-disease/symptoms-causes/syc-20351855
19. Symptoms of Hypothyroidism (underactive thyroid) – https://www.medicalnewstoday.com/articles/324535
20. Underactive thyroid (hypothyroidism) – Causes – https://www.nhs.uk/conditions/underactive-thyroid-hypothyroidism/causes/
21. Hypothyroidism: Practice Essentials, Background, Pathophysiology – https://emedicine.medscape.com/article/122393-overview
22. Hypothyroidism (underactive thyroid) – Diagnosis and treatment – Mayo Clinic – https://www.mayoclinic.org/diseases-conditions/hypothyroidism/diagnosis-treatment/drc-20350289
23. Hypothyroidism: Diagnosis and Treatment – https://www.aafp.org/pubs/afp/issues/2021/0515/p605.html
24. Diagnosing Hypothyroidism – https://nyulangone.org/conditions/hypothyroidism/diagnosis
25. Underactive thyroid (hypothyroidism) – Treatment – https://www.nhs.uk/conditions/underactive-thyroid-hypothyroidism/treatment/
26. How Hypothyroidism Is Treated – https://www.webmd.com/women/low-thyroid-treatment
27. Underactive thyroid (hypothyroidism) – https://www.nhs.uk/conditions/underactive-thyroid-hypothyroidism/
28. Best Diet for Hypothyroidism – https://www.healthline.com/nutrition/hypothyroidism-diet
29. Can certain foods improve thyroid function in people with hypothyroidism? – https://www.mayoclinic.org/diseases-conditions/hypothyroidism/expert-answers/hypothyroidism-diet/faq-20058554
30. Diets and supplements for thyroid disorders – https://www.btf-thyroid.org/diets-and-supplements-for-thyroid-disorders
31. Neuropsychiatric Manifestations of Thyroid Diseases – https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9938951/
32. Psychological symptoms and thyroid disorders – https://www.btf-thyroid.org/psychological-symptoms-and-thyroid-disorders
33. How Does Hypothyroidism Affect Your Mental Health? – https://www.verywellhealth.com/hypothyroidism-psychiatric-symptoms-5268248
34. Living better with hypothyroidism – https://www.btf-thyroid.org/living-better-with-hypothyroidism
35. Living Well With Hypothyroidism – https://www.verywellhealth.com/living-with-hypothyroidism-3231599
36. Patient education: Hypothyroidism (underactive thyroid) (Beyond the Basics) – https://www.uptodate.com/contents/hypothyroidism-underactive-thyroid-beyond-the-basics/print
37. Hypothyroidism – https://www.uspharmacist.com/article/hypothyroidism
38. Hypothyroidism – https://www.intechopen.com/chapters/69805