Hypothyroidism is the name of a disease caused by a decrease in the function of the thyroid gland, as well as a deficiency in the production of hormones by it. The pathology is serious, but thanks to the achievements of the pharmaceutical industry, it is possible to stop its progression. If you believe the reviews, you can live a full life with hypothyroidism. And since the topic is important, we need to pay a little more attention to its consideration now.
About pathology
The diagnosis of "hypothyroidism" in our time is quite common. This is a functional disorder of the thyroid gland, the cause of which lies in the long-term persistent deficiency of the hormones that it must produce. Or in reducing their biological effect.
The disease may not make itself known for a long time. The process of its development begins imperceptibly - there are no alarming symptoms. Only occasionally can a person be disturbed by depression or overwork.
Pathologymost common among women. It usually affects elderly patients.
Hormonal deficiency provokes systemic changes in the body. No wonder, because thyroid hormones keep energy metabolism in cells under control.
If there is a deficiency, then the tissues begin to consume less oxygen, and in general, the body's energy consumption decreases. Various substrates are also less actively processed. It also disrupts the production of energy-dependent cellular enzymes, without which the body cannot fully function.
Specificity of acquired disease
There are two types of hypothyroidism in women and men. It is always either congenital or acquired. Let's talk about the second type first. Because acquired hypothyroidism has a much higher prevalence - it is diagnosed in 99% of cases.
The reasons for its development can be identified in the following list:
- Chronic autoimmune thyroiditis. It is manifested by damage to the parenchyma of the thyroid gland. After him, hypothyroidism occurs decades later.
- Tyreostatics for the treatment of diffuse toxic goiter.
- Acute iodine deficiency.
- Iatrogenic hypothyroidism. It occurs when the thyroid gland is completely or partially removed, or some time after radioactive iodine therapy.
Rarer causes include the consequences of surgical operations, as well as tumor and inflammatorydiseases.
Pathology of an inherited species
Congenital hypothyroidism is diagnosed immediately after the baby is born. Unfortunately, this disease is fraught with irreversible underdevelopment of the central nervous system (cerebral cortex in particular). This is manifested by mental retardation, cretinism may even develop or the development of the skeleton and other organs may be disturbed.
What is the reason in this case? Violations that occurred during the intrauterine period. We are talking about congenital structural disorders of the hypothalamic-pituitary system or the thyroid gland.
It can also be caused by taking specific medications. Or the presence in the body of a pregnant woman of antibodies to the thyroid gland, which manifests itself in autoimmune pathology.
How, then, is the control of intrauterine development compensated? The woman's thyroid hormones pass through the placenta, and the balance is restored. But after birth, of course, their levels in the baby's blood drop sharply.
Classification
It also needs to be given a little attention, talking about what kind of disease it is - hypothyroidism. Depending on the level and severity of violations, three types are distinguished:
- Primary. The cause of its development is the pathology of the thyroid gland. TSH levels are elevated in this type of hypothyroidism.
- Secondary. It is associated with lesions affecting the pituitary gland. The level of T4 and TSH in hypothyroidism of the secondary type is reduced.
- Tertiary. The beginning of its development are dysfunctionshypothalamus.
Primary hypothyroidism is preceded by aplasia, inflammation, or hypoplasia of the gland. Also, the cause may be hereditary defects, total or subtotal thyroidectomy, or lack of iodine. Very rarely it is not possible to find out why the disease began to develop. But in such cases, the pathology is referred to as an idiopathic type.
Various damage to the hypothalamic-pituitary system leads to the development of secondary or tertiary pathology - radiation, surgery, tumors, hemorrhage, trauma.
It is customary to single out peripheral hypothyroidism, the occurrence of which provokes tissue resistance to hormones.
Symptoms
Now we can talk about the manifestations of hypothyroidism. The symptoms of pathology include:
- The absence of any specific signs that are characteristic only for this disease.
- Symptoms that are similar to manifestations of other diseases of somatic and mental origin.
- No relationship between the severity of symptoms and the level of hormone deficiency.
In general, hypothyroidism in men and women is difficult to identify by some symptoms. Everything is very individual - the signs depend on the age of the patient, the cause of the pathology, and also on how quickly the hormone deficiency increases.
It should also be noted that the symptoms are polysystemic, but often patients complain of problems that manifest themselves only from some particular organ system.
Diseasebegins to manifest itself only in those cases when it proceeds steadily and for a long time. The patient can be recognized by the following features:
- Puffy and swollen face.
- Yellowish skin tone.
- Weakness and stiffness in the hands.
- Swelling of the limbs and eyelids associated with fluid retention.
- Burning sensation in the limbs.
- Dry skin.
- Dull and brittle hair, hair loss and thinning.
- Slowness and lethargy.
- Slow speech (typical of severe disease).
- Change in voice (it becomes more hoarse and low).
- Hearing loss caused by swelling of the middle ear, larynx and tongue.
- Hypothermia.
- Weight gain.
- Permanent chilliness, indicating a reduced level of metabolic processes.
- Weakened attention and memory.
- Decrease in intelligence, interest in life and cognitive activity.
- Sleep disorders and fatigue.
- Depression, depression, melancholy.
- Bradycardia.
- Arterial diastolic hypertension.
- Pericarditis.
- Anemia.
- High blood cholesterol.
- Decreased sex drive.
- Weak appetite with flatulence, nausea and constipation.
Pain in hypothyroidism of the patient is also disturbing - they are concentrated mainly in the muscles. As the disease progresses, the head begins to hurt.
In women, in addition to the above, reproductivesystem. There are malfunctions in the menstrual cycle, mastopathy develops, there may be dysfunctional bleeding.
Manifestations in infants
The diagnosis of "hypothyroidism" in newborns is easier to establish, since characteristic symptoms indicate the development of the disease. These include:
- Swollen belly.
- Muscle hypotonia.
- Umbilical hernia.
- Too big.
- Deep voice (determined by the cries of the baby).
- Enlarged thyroid and fontanel.
It is very important to urgently start treatment for hypothyroidism. If this is not done, then at 3-4 months of life complications will begin to develop. Among them:
- Difficulty swallowing.
- Weak appetite.
- Persistent flatulence.
- Weak weight gain.
- Constipation.
- Hypothermia.
- Dryness and pallor of the skin.
- Muscle weakness.
And at 5-6 months, a delay in physical and psychomotor development already begins. This is evidenced by the late closing of the fontanelles, too wide bridge of the nose, as well as hypertelorism, which manifests itself in an increased distance between paired organs.
Complications
It is difficult to avoid their development if such a sad diagnosis is made. Hypothyroidism is fraught with disruption of the central nervous system and the subsequent development of mental retardation, otherwise referred to as oligophrenia. Very rarely there is an extreme degree - cretinism.
Diseased childlags behind in sexual development and growth, often becomes infected with infections, and then is treated for a long time. In addition, it is either impossible or difficult for him to pass his own stool.
During pregnancy, the pathology is manifested by anomalies - pathologies of the development of internal organs, heart defects, as well as the birth of a baby with a functional insufficiency of the gland.
The most rare and severe complication is hypothyroid coma. It affects elderly patients with advanced pathology and serious comorbidities. The development of coma is usually promoted by trauma, hypothermia, infections, as well as medications that depress the activity of the central nervous system.
How does this condition manifest itself? For a coma, the symptoms are:
- Confused mind.
- Shortness of breath.
- Progressive CNS inhibition.
- Reduced temperature.
- Reduce blood pressure and heart rate.
- Urinary retention.
- Swelling of the body, hands and face.
- Intestinal obstruction.
Any complications are fraught with other consequences, which include coronary artery disease, ischemic stroke, atherosclerosis, myocardial infarction, infertility, chronically weakened immunity, cancer.
Diagnosis
Hypothyroidism in adults is established by an endocrinologist, who detects a decrease in thyroid function during the examination and clarification of complaints. Laboratory studies are also carried out:
- The level of autoantibodies is determined.
- The level is revealedthyroxine and triiodothyronine.
- Blood chemistry test in progress.
- Thyroid ultrasound, fine needle biopsy and scintigraphy in progress.
Congenital disease is detected on the 4th-5th day of a baby's life - an analysis is required to determine TSH.
Principles of Therapy
Treatment for hypothyroidism of the thyroid gland can only be prescribed by an endocrinologist. This is a serious disease, and amateur activity in terms of choosing medicines in this case (as in all others, however) can be fraught with serious consequences.
Therapy is aimed at replacing thyroid hormones with their synthetic analogue, which is L-thyroxine. If a disease of a manifest (clinical) type is diagnosed, then substitution treatment is also prescribed.
A latent pathology requires treatment if it is found in a pregnant woman or in one who plans to conceive in the near future.
If you believe the reviews left by patients with hypothyroidism, then the normalization of the condition begins in the first week after the start of medication. Within a few months of stable therapy, clinical symptoms disappear completely. But in debilitated and elderly patients, it takes longer.
Therapy among people with cardiovascular diseases requires special care. In them, L-thyroxine in excess can cause atrial fibrillation or angina pectoris.
If the disease was provoked by radiation therapy or removal of the gland,then synthetic hormonal preparations are prescribed. With hypothyroidism of this form, they must be taken throughout life. The same therapy is indicated for an autoimmune type of disease. Of course, patients need to be regularly examined by an endocrinologist, who will monitor the level of TSH and adjust the dosage of drugs.
If the pathology arose against the background of another disease, then it will be possible to normalize the function of the gland by eliminating the root cause.
The easiest way to cure hypothyroidism is caused by taking specific medications. You just need to stop taking them by choosing safe analogues.
When the cause is iodine deficiency, then the appointment of special vitamins is chosen as a therapeutic method. With this type of hypothyroidism, you also need to follow a certain diet, which implies a variety of diets with seafood and iodized s alt.
The worst case is a coma. Patients who encounter it are treated in the intensive care unit or intensive care unit. They can be saved by intravenous administration of thyroid hormones in large quantities. It is also mandatory to take glucocorticosteroids. Then, electrolyte, hemodynamic and hypoglycemic disorders are corrected.
But these are general clinical guidelines. Hypothyroidism is specific in each case, and therefore requires an individual approach to treatment.
Patient testimonials
They should be discussed in the end. It is logical that people who are faced with this disease want to know what are the prognosis for it, as well as how patients live,which it was diagnosed long ago.
If you believe the reviews, hypothyroidism is not a death sentence. With the congenital form, of course, everything depends on the timeliness of the therapy started. If the disease was detected immediately, then it is possible to prevent disorders in the development of the central nervous system.
The quality of life of people who follow the principles of compensatory therapy does not decrease. There are no restrictions - you just need to take L-thyroxine daily and eat foods enriched with iodine.
What about drugs commonly prescribed for hypothyroidism? In reviews, people often speak well of "Eutiroks" - this is a synthetic isomer of thyroxine, identical to it in its action. It not only normalizes hormonal balance, but also increases the need for oxygen in tissues, while simultaneously stimulating carbohydrate, fat and protein metabolism. Other positive effects include an increase in the functional activity of the central nervous system and the cardiovascular system.
Also, "Liothyronine" has proven itself well. It not only compensates for the deficiency of hormones, but also stimulates tissue growth and increases the rate of processing of nutrients entering the body. It is effective in all forms of hypothyroidism, as well as myxedema, goiter, pituitary diseases and obesity, provoked by metabolic failures.
The doctor may also prescribe Thyreocomb. As you might guess, this is a combination drug, which includes potassium iodide, liothyronine and levorioxin, as well as excipients.
Often Recommendedsuch a remedy as "Thyreoidin". It consists of natural hormones of natural origin, which are extracted from the organisms of cattle. "Thyreoidin" not only normalizes the hormonal balance, but also enhances the energy processes in the body, and has a positive effect on the liver, kidneys and nervous system.
It is important to remember that the endocrinologist selects the drug. If the remedy is ineffective, it is replaced with a more powerful analogue. The selection of the optimal dose obliges the patient to regularly donate blood for biochemical analysis several times a month.
