Hypothyroidism, in general, has exactly the opposite effects as those of hyperthyroidism, although it may be caused by autoimmunity as well but a kind of immunity that destroys the gland rather than stimulates it. Most of the patients first have autoimmune thyroiditis, an inflammation of the thyroid glands. This causes deterioration and eventually, fibrosis of the gland or the replacement of thyroid tissue with connective tissue. Fibrotic tissue is incapable of producing thyroid hormone and a deficiency in the hormone occurs. In most cases, an enlagement of the thyroid gland is observed.

Around 50 milligrams of iodine are required every year for the normal functioning of the thyroid gland and for production of sufficient amounts of thyroid hormone. In some areas of the world like the Swiss Alps, the Andes, and the Great Lakes regions of the United States of America, there are less than adequate quantities of iodine in the soil for the foodstuffs to contain this yearly requirement. In the days when iodized table salt was not yet available, people from these areas developed extremely large thyroid glands called endemic goiters.


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