The thyroid gland is an important endocrine organ. Its main function is the production of specific hormones (triiodothyronine, thyroxine), which control the metabolism in the human body and affect all body systems. In this article, we will consider such a disease as myxedema. Causes and symptoms will also be described.
What is myxedema?
Thyroid diseases cause the development of two syndromes. The production of hormones can increase - this is hyperthyroidism syndrome. However, the most significant is the decrease in thyroid hormones, which is called hypothyroidism.
Myxedema is an extreme degree of hypothyroidism. This condition is characterized by mucous swelling of the tissues. Due to the lack of thyroid hormones, polysaccharide residues accumulate in the tissues, which attract water to themselves. The tissues are excessively filled with water, and mucous edema develops.
What causes myxedema?
Myxedema can occur at any age. Women suffer from this disease more often than men, the occurrence of myxedema in them often accompanies menopause. Hypothyroidism is of particular importance in newborns and young children. Due to the slowdown in metabolism, the physical development and psyche of the child are disturbed. If hypothyroidism is congenital (with aplasia or hypoplasia of the gland) and has not been treated, cretinism occurs - a special form of mental retardation in children.
In adults, myxedema is caused by damage to the thyroid tissue - hypothyroidism is called primary. However, the work of the gland is controlled by the pituitary gland through TSH - thyroid-stimulating hormone. Therefore, if the work of the pituitary gland is disturbed (tumor, circulatory disorders, injuries, congenital pathologies), secondary hypothyroidism occurs. Very rarely, tertiary hypothyroidism is caused by malfunction of the hypothalamus.
When the disease "myxedema" causes and symptoms are interconnected.
Thus, the main causes of myxedema are as follows:
- atrophic processes in the thyroid gland;
- inflammation of the gland (thyroiditis);
- tumors;
- injuries;
- removal of gland tissue (surgery for the treatment of hyperthyroidism);
- radiation exposure;
- treatment with iodine radionuclides;
- lack of dietary iodine;
- taking certain medications (amiodarone, corticosteroids, thyreostatics);
- infectiousdiseases (especially in a pregnant woman);
- injuries and diseases of the brain, etc.
Myxedema may develop as a result. Causes and symptoms are important when choosing treatment.
What symptoms accompany myxedema?
Since thyroid hormones affect all body systems, the manifestations of myxedema will be varied.
In severe deficiency of thyroid hormones, a person acquires a characteristic appearance - a “myxedematous face” is formed. The face is edematous, the edema is most pronounced on the eyelids and lips. The skin is pale, has an icteric tint, cold to the touch, peels off, loss of eyebrows, eyelashes and hair on the head is noted. The work of facial muscles is disrupted - the face is inactive, has an indifferent look.
The defeat of the nervous system is expressed in a change in the psyche. Movements become uncoordinated, sluggish. There is depression. Information from the outside is poorly perceived, the reaction to events is little expressed or indifferent. Drowsiness is noted, memory and attention decrease. Speech is slurred and slow.
There are fluctuations in blood pressure, often downward. The work of the heart muscle is disrupted, the heart rate decreases - a "myxedematous heart" is formed. The digestive system is also affected - there are chronic constipation, impaired motor activity of the biliary tract.
Mucoid edema develops.
The respiratory capacity of the lungs decreases, as a result of whichthere are periods of cessation of breathing during sleep. In addition, fluid often accumulates around the lungs, which also interferes with breathing. This phenomenon is called "myxedematous polyserositis".
Despite reduced appetite, a patient with myxedema develops obesity, elevated blood cholesterol is determined. Hearing decreases, hoarseness of voice occurs, nasal breathing is disturbed. Anemia often develops due to iron or folic acid deficiency. A good endocrinologist is needed here.
Women often have menstrual irregularities, reduced fertility and libido. Arthritis occurs, bone tissue is depleted in calcium, so fractures are easily formed. Children are lagging behind in growth and development compared to their peers.
What additional research is being done?
A good endocrinologist can diagnose myxedema by the appearance of the patient. However, to clarify the cause of the disease, as well as determine the tactics of treatment, a number of studies are needed. Diagnosis of myxedema in general is not difficult.
Identify the main and auxiliary diagnostic methods. The main methods allow you to detect myxedema, and auxiliary methods are used to find the cause and clarify the form of the disease.
For examination, please contact: Moscow, Dmitry Ulyanov street, 11. The Institute of Endocrinology performs the following diagnostic procedures:
1. Basic:
- clinical examination by an endocrinologist;
- blood test for TSH and free thyroxine.
2. Auxiliary:
- Thyroid ultrasound;
- radioisotope scintigraphy;
- thyroid tissue biopsy;
- detection of specific antibodies to thyroid cells.
What does each study imply?
Endocrinologist appointments are inexpensive.
The doctor examines, palpates and listens to the internal organs (heart, lungs). The symptoms described above can greatly help the doctor in the diagnostic search.
In the blood test, a decrease in the content of free thyroxine is detected, but the most significant is the detection of elevated TSH. Allocate subclinical hypothyroidism, which is not accompanied by any symptoms and is detected more often by chance. It is the elevated level of TSH that is the first "alarm bell" regarding the development of hypothyroidism and myxedema in particular.
Ultrasound
Thyroid ultrasound allows you to visualize various formations in the tissue of the gland (nodules, tumors, calcifications). This method is considered easy to perform and relatively inexpensive, with sufficient information content. If myxedema is identified, treatment should be immediate.
Scintigraphy
The essence of radioisotope scintigraphy is the introduction of radioactive isotopes of iodine intravenously and the assessment of its accumulation in the thyroid tissue, the features of its distribution in it and excretion. If with ultrasound the doctor can only assess the structure of the gland, then with scintigraphy its function is evaluated. If there is a disease "myxedema", then a person often has a reduced accumulation of iodine preparations of a local or diffuse nature. In addition to function, this method evaluates the ongoing treatment of various diseases of the gland.
Biopsy
Thyroid biopsy involves taking a piece of tissue with special biopsy needles. Subsequently, it is subjected to microscopic and histochemical studies. This allows you to identify various diseases at the cellular level and recognize the tumor process in time.
Determination of antibodies to thyroid tissue becomes important in the absence of visible causes of myxedema. It is important to know that normally the thyroid gland does not cause the formation of protective proteins, because it is limited by a layer of connective tissue. But in some diseases, this capsule becomes thinner, and the gland tissue comes into contact with immune cells. As a result, antibodies are formed to the cells of the gland, which inhibit its function without changing the structure.
What is the treatment for myxedema?
Reception of an endocrinologist before starting therapy is mandatory.
Treatment for myxedema is easy and is hormone replacement therapy. However, it should be remembered that it is often not possible to restore the function of the gland itself, so taking drugs becomes mandatory and lifelong. Improvement in the condition is observed after 2-3 weeks of using special tools.
To relieve symptoms, L-thyroxine preparations ("Levothyroxine", "Eutiroks") andtheir counterparts. These drugs are synthetic substitutes for natural thyroid hormones. The dose of the drug is selected by the doctor individually in each case.
It should be noted that an overdose of the drug can lead to the reverse myxedema condition - hyperthyroidism, and an insufficient dose will have no effect at all. Taking other medicines may also impair absorption or increase the metabolism of L-thyroxine, so other specialists should be consulted about combined treatment.
Where can I go for help?
A general practitioner can suspect a disease during a physical examination. However, the treatment of myxedema is carried out by an endocrinologist in specialized hospitals. These can be endocrinological departments of city or regional hospitals. Patients are often referred to research centers in large cities for complex examination methods. One of these facilities is the "Endocrinological Research Center" (Moscow, Dmitry Ulyanov St., 11). The Institute of Endocrinology is known for the fact that competent specialists provide assistance in the treatment of myxedema and other diseases, and the most complex diagnostic and therapeutic procedures are carried out.
What is the prognosis of the disease?
In general, myxedema (causes and symptoms are described) is a completely correctable condition. Taking medication completely eliminates the above symptoms. However, an untimely visit to a doctor and non-compliance with the recommendations can lead to disastrous consequences.
