Hypothyroidism – what is it? Symptoms, Causes, and Treatment.
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Hypothyroidism – a syndrome that develops with a low concentration of thyroid hormones, is one of the most common diseases of the endocrine system.
Congenital hypothyroidism is especially dangerous, and if in time, immediately after the birth of the child, treatment is not started, an irreversible damage to the intellect, the development of mental retardation may occur.
This disease may not occur for a long time. This occurs as a result of a gradual, inconspicuous onset of the pathological process. At the same time, in the mild and moderate stages of thyroid hypothyroidism, the patients’ state of health is satisfactory, the symptoms are erased. The disease occurs in 1% of young people and in 10% of the elderly.
Why does hypothyroidism occur, and what is it? Considering hypothyroidism, the causes of which can be caused by a variety of factors, experts note that in the first place, they depend on the form in which the disease occurs. To date, there are two forms of the disease:
The most common acquired form of the disease. The main reasons for its development are called the following:
_ chronic autoimmune thyroiditis – damage to the thyroid gland by its own immune system, which can lead to hypothyroidism in the years and even decades after the appearance;
_ iatrogenic hypothyroidism – develops after complete or partial removal of the thyroid gland or after therapy with reactive iodine;
_ taking thyreostatics in the treatment of diffuse toxic goiter;
Significant iodine deficiency in water and food.
Congenital hypothyroidism appears as a result of:
_ congenital aplasia and hypoplasia (decrease) of the thyroid gland;
_ congenital structural disorders of the hypothalamic-pituitary system;
_ hereditary defects in the biosynthesis of thyroid hormones (T3 and T4);
_ exogenous effects (the presence of maternal antibodies in autoimmune pathology, the use of medications) in the prenatal period.
For example, penetrating the placenta, maternal thyroid hormones compensate for the control of the development of the fetus with thyroid pathology, but after the birth of the baby, when the level of maternal hormones in his blood drops sharply, their deficiency can cause irreversible underdevelopment of the child’s central nervous system (cerebral cortex particular).
The child manifests violations of the development of the skeleton and other organs, and most importantly – mental retardation to varying degrees, not excluding complete cretinism.
Primary hypothyroidism is associated with pathology of the thyroid gland, leading to a decrease in the mass of the glandular tissue of the thyroid gland and inhibition of the synthesis of the hormones thyroxine and triiodothyronine. This may be a consequence of aplasia or agenesis of the thyroid gland, autoimmune processes, iodine deficiency, and selenium deficiency.
Secondary hypothyroidism is associated with a loss of the tropic function of the pituitary gland (a decrease in thyrotropin production). Insufficient intake of thyroid hormones in the body leads to a violation of protein, carbohydrate metabolism, flattening of the sugar curve after glucose loading, to a violation of lipid, water-salt metabolism.
According to the degree of manifestation, the following forms of the disease are distinguished:
_ latent, or subclinical, form – there are no clinical manifestations, an increase in the level of thyroid-stimulating hormone (a hormone that increases the activity of the thyroid gland) is detected with a normal level of triiodothyronine and thyroxine (thyroid hormones);
_ the explicit form is the appearance of signs of hypothyroidism.
Symptoms of Hypothyroidism
The severity of symptoms depends on the degree of dysfunction of the thyroid gland. Usually hypothyroidism develops gradually. Patients do not notice the symptoms of the disease for a long time and do not consult a doctor. They often complain of lethargy, unwillingness to move, a sharp deterioration in memory, drowsiness, swelling, dry skin, constipation.
Manifestations of hypothyroidism are many-sided, individual symptoms are nonspecific:
_ obesity, lowering body temperature, coldness – a constant feeling of cold due to a slowdown in metabolism, yellowness of the skin, hypercholesterolemia, early atherosclerosis;
_ myxedema edema: swelling around the eyes, imprints of teeth on the tongue, difficulty in nasal breathing and hearing loss (swelling of the mucous membranes of the nose and auditory tube), hoarseness of the voice;
_ drowsiness, slowdown of mental processes (thinking, speech, emotional reactions), memory loss, polyneuropathy;
_ shortness of breath, especially when walking, sudden movements, pain in the region of the heart and behind the sternum, myxedema heart (decreased heart rate, increased heart size), hypotension;
_ tendency to constipation, nausea, flatulence, enlarged liver, biliary dyskinesia, gallstone _ disease;
_ dryness, brittleness and hair loss, brittle nails with transverse and longitudinal grooves;
_ menstrual irregularities in women.
Over the course of the disease, the patient’s appearance changes, movements become slower, the look indifferent, the face is round, puffy, swollen, especially in the lower eyelids, the lips are cyanotic, and a slight blush on the pale face is also bluish. Patients freeze in any weather.
The skin is pale, sometimes with a yellowish tint due to the increased amount of carotene in the blood, cold to the touch, dry, rough, thickened, peeling. Peeling of the skin is often most pronounced on the front surface of the legs. Excessive keratinization and thickening of the superficial layers of the skin on the knees and elbows (symptom of Bera) are characteristic.
An endocrinologist may suggest the presence of hypothyroidism in characteristic manifestations:
_ severe weakness, decreased performance;
_ dry skin, hair loss, brittle nails.
To confirm the diagnosis, certain diagnostic tests are prescribed:
A blood test for thyroid hormones: with the help of it, a quantitative indicator of thyroxine and triiodothyronine in the blood is studied. Normally, their concentration is 2.6-5.7 mmol / L and 9.0-22.0 mmol / L, respectively. With hypothyroidism, these indicators will be significantly lower than normal. In addition, it is very important to examine the patient’s blood for thyroid stimulating hormone (TSH) of the pituitary gland: with the help of this manipulation, it is determined what the nature of hypothyroidism in a woman is, that is, primary or secondary.
Thyroid scintigraphy with radioactive iodine. In this study, the accumulation of radioactive iodine introduced into the body in the gland tissue occurs. It is carried out to study the structure and function of the thyroid gland.
Computed tomography of the brain with suspected pituitary tumor (an area of the brain that regulates the functional activity of the thyroid gland).
Ultrasound of the thyroid gland.
The differential diagnosis is carried out with other endocrinopathies: growth retardation and nanism, encephalopathies, Down’s disease, chondrodystrophy, rickets, Hirschsprung’s disease.
Thanks to the achievements of the pharmaceutical industry, which allows the artificial synthesis of thyroid hormone, modern endocrinology has an effective way to treat hypothyroidism in women. Therapy is carried out by replacing the thyroid hormones that are missing in the body with their synthetic analogue – levothyroxine (L-thyroxine).
If possible, it is necessary to eliminate the cause of the development of acquired hypothyroidism, for example:
_ cancel drugs that cause a decrease in the activity of thyroid hormones,
_ treat thyroiditis,
_ normalize the intake of iodine in food.
Manifestation (clinical) hypothyroidism requires the appointment of replacement therapy, regardless of the patient’s age and associated pathology. The treatment option is individually prescribed, the initial dose of the drug and its rate of increase.
Given the daily intake of thyroid hormones, the prognosis is favorable: patients lead a normal lifestyle. In cases where there is no treatment for hypothyroidism, clinical manifestations may worsen until the onset of mexedematous coma.
As mentioned above, hypothyroidism is characterized by a deficiency of thyroid hormones. If explained in simple words, this means that in the human body all metabolic processes are slowed down. That is why the diet for hypothyroidism of the thyroid gland should be low-calorie.
Food products must be selected with great care, because their action should be aimed at restoring and stimulating all oxidative processes. The easiest way is to reduce the amount of carbohydrates and fats.
The list of non-recommended products includes:
_ fatty meats (pork, lamb) and poultry (goose, duck);
_ liver (brain, liver, kidneys);
_ jam, honey limited;
_ mustard, pepper, horseradish;
_ strong tea or coffee, cocoa, Coca-Cola;
_ bread from premium flour, all pastries, cakes, pastries, fried products (pies, pancakes, pancakes);
_ fish caviar;
_ smoked and salted fish, canned fish;
_ fatty sausages;
_ margarine, lard, cooking oil;
_ all legumes;
_ meat, poultry and fish;
_ smoked meats, pickles;
_ cruciferous (all types of cabbage, turnip, radish, radish, turnip);
_ mushrooms in any form;
rich broths from
pasta and rice limited.
Recommended products include:
_ fish, mainly marine (cod, mackerel, salmon), rich in phosphorus, polyunsaturated fatty acids and iodine;
_ any fruits, especially persimmons, feijoa, kiwi, which are rich in iodine, as well as cherries, grapes, bananas, avocados;
_ vegetables with the exception of the cruciferous family, fresh herbs;
_ slightly brewed drinks (coffee and tea), tea with lemon or milk, freshly squeezed juices, decoctions of rose hips and bran;
_ low-fat milk and lactic drinks, as well as cottage cheese, sour cream – in dishes;
_ unsalted, low-fat and non-sharp cheese;
_ bread from flour of 1 and 2 grades, yesterday or dried, dry cookies;
_ lean meats, “white” chicken meat containing tyrosine;
_ low-fat varieties of sausages;
_ fresh vegetable salads seasoned with vegetable oil, vinaigrette, aspic;
_ butter with caution, vegetable oils – in dishes and during cooking;
_ protein omelets, soft-boiled eggs, yolk with caution;
_ cereals (buckwheat, millet, barley), casseroles and dishes from them;
seafood (mussels, scallops, oysters, seaweed, rolls and sushi from them).
Diet for hypothyroidism does not imply a sharp restriction of foods and the transition to special foods. The food system remains tasty and healthy, with some specific rules. Compliance with therapeutic nutrition has a beneficial effect on metabolic processes, and most importantly, mitigates the symptoms of the disease in the patient. Proper nutrition saturates oxygen cells and reduces the risk of developing severe forms of the disease.