Hypothyroidism

General characteristics of the disease

 Hypothyroidism

Hypothyroidism - a endocrinological disease that occurs due to an imbalance in the body of the thyroid hormones.

The most frequently diagnosed subclinical hypothyroidism - the easiest form of pathology. He is most often affects women over the age of 50 years.

With subclinical hypothyroidism observed deviations from the norm only hormone TSH (thyroid stimulating hormone), and the number of other thyroid hormones is usually not impaired.

Types of hypothyroidism

Pathogenesis to distinguish between primary, secondary and tertiary forms of the disease. Primary hypothyroidism results from abnormalities of the thyroid gland. Often it serves the cause of autoimmune thyroiditis. Perhaps the development of primary hypothyroidism after surgery on the thyroid gland after treatment with radiation-tireostatikami or radioactive iodine.

The secondary form of the disease is often called the pituitary hypothyroidism, and tertiary - the hypothalamic hypothyroidism. Secondary and tertiary forms of the disease provoked:

  • tumors of the hypothalamic - pituitary system,
  • failure of the diaphragm sella in the body of the sphenoid bone of the skull,
  • myocardial necrosis and the pituitary gland,
  • DIC,
  • inflammation of the brain, and others.

However, the most common form of primary hypothyroidism is thyroid. Vesta with subclinical hypothyroidism they reach 10% of the prevalence of the disease among the population.

Such high rates are due to iodine deficiency in the body caused by environmental degradation and malnutrition.

Congenital hypothyroidism

A special form of the disease is congenital hypothyroidism. He diagnosed an average of one to four thousand. Neonates. Among the causes of congenital hypothyroidism is called thyroid aplasia or dysplasia of the organ, genetically caused disorders produce thyroid hormones.

The increased risk to have a baby with congenital hypothyroidism also exists in women with autoimmune thyroid disease. Among the causes of congenital hypothyroidism should also include treatment thyreostatics during pregnancy.

A child with congenital hypothyroidism in the prenatal stage of development gets maternal thyroid hormones. After birth, the level of thyroid hormones in the baby rapidly decreases. The failure of the thyroid gland to produce hormones on their own newborn affects the development of the child. First of all it affects the cortex of the brain.

At the beginning of the untimely hormone treatment of hypothyroidism congenital form may develop mental retardation. From deficiency of thyroid hormones in congenital hypothyroidism also suffer the skeleton and internal organs.

Symptoms of hypothyroidism

In the first days of life of the child fails to diagnose only 5% of cases of congenital hypothyroidism. Suspicions about this serious disease may have neonatologist if the newborn has the following symptoms of hypothyroidism:

  • hyperbilirubinemia (jaundice) lasts more than a week,
  • bloating,
  •  Symptoms of hypothyroidism
  • umbilical hernia,
  • low husky voice,
  • increased rear fontanelle and thyroid gland,
  • hypotonia (low muscle tone).

By the third month of life to the symptoms of hypothyroidism, thyroid join:

  • loss of appetite,
  • difficulty swallowing,
  • flatulence,
  • deviation from the norms of weight gain and linear growth,
  • pallor and dryness of the skin.

At 9 months with congenital hypothyroidism becomes apparent delay in psychomotor development of the child.

Symptoms of hypothyroidism acquired forms have their own specifics. First, in the absence of typical symptoms of the disease, found only in this type of endocrinological diseases. And, secondly, symptoms of hypothyroidism depends on the degree of deficiency of thyroid hormones.

Because subclinical hypothyroidism, for example, can be shown:

  • fatigue,
  • sensitivity to cold,
  • frequent bouts of depression,
  • weight gain
  • low physical endurance,
  • hair loss,
  • menstrual irregularities,
  • aching joints.

It is not necessary manifestation of the above symptoms subclinical hypothyroidism. For 15% of patients characterized by the manifestation of a few specific signs of hypothyroidism.

When thyroid hormone deficiency explicit part of the clinical picture of hypothyroidism thyroid are:

  • swelling,
  • listlessness,
  • Poverty facial expressions,
  • yellowness of the skin,
  • slowing of speech,
  • loss of memory and intellect,
  • heart rhythm disorders,
  • biliary dyskinesia,
  • functional disorders of the intestines,
  • infertility.

Symptoms of hypothyroidism the thyroid gland is the most severe form of hypothyroid, she myxedema coma.

Diagnosis of hypothyroidism

Acquired Hypothyroidism thyroid is diagnosed by a test to determine the level of thyroid hormones in the blood. When an isolated elevation of thyroid stimulating hormone patient diagnosed with "subclinical hypothyroidism."

The simultaneous increase in thyroid stimulating hormone and a decrease of thyroxine - the basis for the diagnosis of "acquired overt hypothyroidism."

Due to the large amount of non-specific symptoms of hypothyroidism difficulties arise only in determining the indications for checking the level of thyroid hormones. Subclinical hypothyroidism is often diagnosed in time to routine inspection.

Diagnosis of congenital hypothyroidism the thyroid gland is performed on the 5th day of life when the newborn is reduced blood levels of maternal thyroid hormones.

Treatment of hypothyroidism

When acquired form of the disease is assigned to hormone treatment of hypothyroidism. The standard in the treatment of hypothyroidism are preparations based on levothyroxine (L-T4): Synthroid, Levoksin, Levotroid etc. Only the original can be different dosage and rate of increase. Assimilation of thyroid hormones in the substitution treatment of hypothyroidism occurs at 15-20%.

With subclinical hypothyroidism treatment may not be necessary. If the patient has no obvious symptoms of deficiency of thyroid hormones, it only needs to be dynamic observation, not to miss a complication of the disease.

However, all women diagnosed with subclinical hypothyroidism required correction level of thyroid hormones before the planned pregnancy. Substitution treatment of hypothyroidism should not stop in time and the pregnancy itself.

 Treatment of hypothyroidism

The most favorable time to initiate treatment of hypothyroidism congenital form - 1-2 weeks of life. This term can be prevented violations of physical and mental development of the child. Further, the later will be started substitution treatment of hypothyroidism, the greater the likelihood of dementia and the backlog in physical development.

The effectiveness of the treatment of the disease is quite high. Regression of the symptoms of hypothyroidism has been observed after 1-2 weeks of therapy. The worst thing for her to react the elderly.

Treatment of hypothyroidism tend life. However, in some cases, such as the syndrome of Hashimoto's possible self-recovery of thyroid function.

In case of violation of the thyroid gland, disrupt the operation of systems. Hypothyroidism is a common cause of obesity, and obesity can lead to other troubles.





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