From the Research
Uncontrolled hypothyroidism does not typically lead to excessive perspiration, as it is more commonly associated with decreased sweating and intolerance to cold temperatures. Hypothyroidism is characterized by an underactive thyroid gland producing insufficient thyroid hormones, which slows down many bodily functions, including sweat production 1. The reduced metabolic rate in hypothyroidism results in reduced heat production and consequently less need for cooling through perspiration. Common symptoms of hypothyroidism include fatigue, weight gain, dry skin, hair loss, constipation, and feeling cold 2, 3, 4. Excessive sweating (hyperhidrosis) is actually more characteristic of hyperthyroidism, where the thyroid is overactive 5. If someone with diagnosed hypothyroidism experiences excessive sweating, this might indicate either overtreatment with thyroid medication (causing iatrogenic hyperthyroidism) or the presence of another medical condition that should be evaluated by a healthcare provider.
Some key points to consider in the management of hypothyroidism include:
- The most common cause of hypothyroidism is chronic autoimmune thyroiditis (Hashimoto's thyroiditis) 1
- Levothyroxine monotherapy is the standard treatment for hypothyroidism, which is safe and inexpensive, restores thyroid function tests to within the reference range, and improves symptoms in the majority of patients 1
- Some patients may experience persistent symptoms of ill health despite normalisation of thyroid function tests biochemically, and a substantial proportion of patients on levothyroxine have thyroid-stimulating hormone concentrations outside the reference range 1
It is essential to note that the diagnosis of hypothyroidism is typically made on biochemical grounds through serum thyroid function tests, and treatment is simply replacement with exogenous hormone, usually levothyroxine (Synthroid) 4. The deadly manifestation of hypothyroidism is myxedema coma, which requires prompt treatment with exogenous hormone to decrease the high mortality rate 4.
In terms of evaluating and managing hyperhidrosis, it is crucial to differentiate primary from secondary origins through history taking and clinical examination, and sometimes blood tests and consultation with a specialist (endocrinologist, neurologist) are necessary to establish the diagnosis 5. The management of secondary hyperhidrosis involves the treatment of the underlying cause, while the management of primary hyperhidrosis depends on its severity and the sites affected 5.