Hypothyroidism: the advice of the specialist doctor

Interview with Professor Jean-Louis Wémeau, Chief of the Endocrinology Department at Lille University Hospital.

What are the complications of hypothyroidism?

If hypothyroidism is spotted and treated properly, there are no symptoms. And this is the case 90% of the time. On the other hand, if one misses the point, the illness worsens, then it gives very painful complications: a general slowing down, a big tiredness, a fall of the hair, muscular, digestive troubles ... even a coma, in certain cases. A hypothermic coma, it could be seen. We get to be so diminished that we forget to breathe! But, this kind of complication is really rare. Other complications of hypothyroidism: pericarditis or inflammation of the heart envelope, or atherosclerosis with arterial hypertension, angina pectoris and possibly myocardial infarction. But, again, with the current means of recognition and treatment of the disease, these complicated forms become rare.

Does the treatment cause complications?

No. If the dosage of hormone treatment is correct, this treatment gives no complication, since it compensates for a lack, with a natural product, since it is the same product as the hormone manufactured by the body. Of course, you have to be careful not to give a dose too sharply, it could reveal heart problems, it makes sense. Overdose can be dangerous. This is what happens when some people take to lose weight, so it can cause heart rhythm disorders, a state of excitement.
You should never take thyroid hormone to lose weight because you lose more muscle and bone than fat tissue. But, in most cases, the right dosage is quickly found by the doctor and there is no side effect.

There are borderline hypothyroid cases, for example, when TSH is elevated, but T4 is normal, and there are no clinical signs. What should be done in these cases?

There is debate on the issue, among the doctors. Should subclinical hypothyroidism be treated or not? This poses many questions to the doctors. If the TSH is above 10, treat it. If it is between 4 and 10, it is discussed: if the woman is pregnant, if she wants a child, if she has a goiter, if she has cholesterol ... Beyond 60, there is not bad reasons that push not to treat. It has been noted that high TSH, with a rather low T4 level, is common among centenarians ...

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