Hypothyroidism

гипотиреоз Hypothyroidism is a disease caused by a decrease in thyroid hormone production of the hormone thyroxin, as a result of which, due to a lack of thyroid hormones in the body, various systemic disorders occur. Hypothyroidism is considered one of the most common diseases of the endocrine system. In adults, the extreme form of G. is myxedema, and in children - cretinism

Causes

This disease is different for primary and secondary.

Primary GI is directly associated with impaired function and structure of the cells directly the thyroid gland itself (surgical interventions on the thyroid gland, chronic infections of the autoimmune nature, congenital anomalies, etc.).

Secondary G. occurs due to hypothalamic and pituitary disorders (traumatic, tumor and infectious lesions), because of which the secretion of thyroid-stimulating hormone of the pituitary gland decreases.

In a number of recorded cases, the causes of G. are not clear - this is the so-called idiopathic hypothyroidism

Symptoms

There is a noticeable slowdown in almost all metabolic processes (protein, lipid, basic, metabolism of mucopolysaccharides) occurring in the human body.

In most cases, this disease in the initial stages develops gradually and almost imperceptibly. . Mental and physical fatigue, general weakness, drowsiness, decreased efficiency, memory loss and headaches occur.

Changes occurring in the human body in hypothyroidism:

- A puffy, pale, masked face. Edema and ovulation of the eyelids. Speech becomes fuzzy and slowed due to edema of the tongue and vocal cords

- Reduces the secretion of sweat and sebaceous glands, there is a fragility of nails and hair. The skin becomes edematous, thick and cold to the touch (sometimes with icteric outflow)

- Developing hypotension (lowering blood pressure), bradycardia (heart rate is significantly reduced), there are pains and quite unpleasant sensations behind the sternum and in the heart. Even with minor physical exertion, shortness of breath occurs

- There is a significant decrease in appetite, there is nausea and flatulence. Bile in the gallbladder stagnates (possibly the occurrence of intestinal obstruction and the formation of stones) due to a decrease in the tone of the musculature of the bile duct and intestine

- There is a lack of oxygen due to reduced ventilation of the lungs. и пневмонии. There is a propensity to develop bronchitis and pneumonia. Reduces the excretion of fluid by the kidneys

- There is inhibition, the intellect decreases, speech slows down, there is increased nervousness and irritability. Insomnia at night and drowsiness during the day. Violated the sensitivity of the limbs, there are neuralgias that are accompanied by muscle pain

- Approximately 70% of patients have decreased absorption of vitamin B12 and iron in the gastrointestinal tract, as a result of which the so-called "tyriogenic anemia" develops, and because of the slow absorption of glucose, blood sugar is reduced

. - Reduces sexual desire, it is possible to develop infertility .

- Even despite the almost complete lack of appetite - patients significantly increase in weight

- In children, G. may manifest as a shortening of limbs and a lag in the growth of the skeleton

Possible complications

In some cases, hypothyroidism can lead to quite severe complications: acute or chronic heart failure, cretinism, hypothyroid coma.

Hypothyroid coma is the most severe, and in some cases even fatal complication, which develops due to the fact that long-term treatment has not been carried out G. Or it was carried out, but not qualitatively (elderly women are most affected). Symptoms of hypothyroid coma:

- Decreased urination

- Reduced blood pressure

- Breathing and heartbeats become rare

- Skin cold, dry, icteric

Treatment of hypothyroidism

Treatment of all forms of G. is based on the use of substitution therapy (synthetic analogues of thyroid hormones - levothyroxine, etc.) are used. The effect comes already during the first month of treatment. Treatment with thyroid hormones should be carried out very carefully, and each patient should be individually adjusted to constant monitoring of the ECG, cholesterol level, pulse and complaints of pain in the heart.

Duration of treatment is determined depending on the causes that caused the development of G. and the general condition of the body, and can be as several months or years, and for life.

The substitution therapy for arterial hypertension or tachycardia is carried out with synthetic thyroid hormones (thyroxine, thyroidin, thyrotomus, triiodothyronine, thyreocomb, thyrotomus-forte) in combination with p-blockers (tracicore, anaprilin).

In the event that there is an iodine deficiency, it is prescribed in the appropriate dosage form and in a dosage appropriate to the particular case. Self-medication with iodine is highly undesirable, since in the case of an incorrect dosage, the activity of iodine can worsen the state of the thyroid gland

Prophylaxis and prognosis

Preventive measures to prevent the emergence and development of hypothyroidism are considered sanation of the nasopharyngeal area and prevention, and, if necessary, qualitative treatment of infectious diseases.

For adults with a properly selected adequate treatment, the prognosis of further life is quite favorable. But in children with congenital G. even with optimal treatment, it is almost never possible to restore the normal functioning of the brain, as a result of which development of cretinism is possible, and growth retardation is not excluded.