The term “hypothyroidism” is called a decrease in the activity of the thyroid gland. The extreme degree of this pathology is myxedema, or long-term thyroid hormone deficiency syndrome, caused by impaired synthesis, problems with receptor sensitivity to them. This is expressed in inhibition of metabolism and disorders of the nervous system, skin changes, malaise, headaches and many other symptoms. It occurs more often in women, less often in men.
Causes of hypothyroidism: negative effects
Hypothyroidism can often be the result of a primary lesion of the thyroid gland itself, due to which it begins to reduce the production of hormones. These can be organ surgery, removal of it in whole or in part, treatment with radioactive iodine, or radiation therapy in the neck area. May be adversely affected by taking iodine – containing drugs, the use of androgens or estrogens, glucocorticoids, sulfonamides. They provoke hypothyroidism, thyroiditis (autoimmune inflammation), acute or chronic lesions of the gland, tuberculosis, sarcoidosis. Possible hypothyroidism in gland hypoplasia.
Besides, hypothyroidism can be observed with an absolutely healthy gland, but with impaired functions of the organs of regulation – the pituitary and hypothalamus. Such lesions include inflammation or trauma, necrosis, hemorrhage, removal of the pituitary gland. There is an extremely rare deficiency of thyroid-stimulating hormone. It is also possible damage to the hypothalamus, a violation of the hypothalamic-pituitary communication.
The first symptoms: malaise, headache, decreased activity
Hypothyroidism usually develops gradually, as hormone levels decrease. Symptoms do not have a strict specificity, appear gradually, weighting as the disease progresses. Often, manifestations begin with subclinical hypothyroidism with mental or physical fatigue, decreased performance and memory impairment. Patients constantly feel weak with drowsiness, a headache is typical. It is provoked by stress, feelings, but the pain is not sharp, pressing and passes after a rest. Puffiness is gradually formed with the pasty face, people with hypothyroidism are constantly freezing, even in hot weather. Often, their hair falls out and badly breaks on the head and on the body of the body, bad nails. Skin changes as well, peeling and dryness are typical. Decrease in hearing can develop, voice timbre goes down to hoarse and low. Although pronounced change in appetite with its decrease, with the body weight increases, there is pain in the abdomen, nausea, indigestion.
Changes in the body: skin, sexual functions, neck size
With a decrease in thyroid function in patients, there may be complaints of persistent constipation, which are not eliminated by changes in diet and are poorly adjusted by drugs. Often there are failures in the menstrual cycle of women, problems with potency are detected in men. Frequent complaints are pain in the joints, spasms and soreness in the muscles, an increase in the size of the neck and a change in its shape.
Explicit hypothyroidism gives a more distinct symptoms, which is more specific than in the previous stage. The patient is usually slowed down, apathetic, has a blurry and slow speech, a low voice and flaccid gestures, facial expressions. The level of intelligence and memory are sharply reduced.
Typical skin changes, it is very dry, pale, has a yellowish tinge with peeling, especially in the elbows and knees. The skin due to swelling is not going to fold, supraclavicular fossa, inguinal zone smoothed. The patient has a swollen face with coarsened features, eyelids thickened, nose wings, tongue with lips. Body hair is sparse, on the head they fall out, dull, eyebrows can fall out, nails are badly broken.
Effect of thyroid hypofunction on organs
As the thyroid gland produces less and less hormones, the work and structure of the internal organs change. Thus, the borders of the heart expand, tones are muffled, the frequency of contractions slows down. Fluid in the pericardium can accumulate, cardiac contractility is disturbed up to heart failure. Blood pressure is reduced, and the systolic is more pronounced, with a completely normal or even elevated diastolic. When thyroid it works poorly, ascites and fluid accumulation in the chest cavity can occur. Constipations are pronounced, intestinal obstruction may develop due to a violation of the bowels, atrophic gastritis is formed with a decrease in acidity.
When hypofunction of the thyroid gland is severely expressed disorders of the nervous system with drowsiness, slowing down of speech and mental functions. Memory suffers significantly, there may be fainting, unsteady gait and instability, visual disturbances. On examination, tendon reflexes are reduced, sensitivity disorders occur in the area of fingers on the hands, myositis develops with compaction, tension and muscle pain.
On the part of the respiratory system, shortness of breath, frequent bronchitis and pneumonia, sluggish and prolonged course. The production of urine by the kidneys decreases, the tone of the urinary tract decreases, which leads to their frequent infections. From the side of blood, there may bethyrogenic anemia – iron deficiency and at the same time vitamin-B12-deficient, probably lowering blood glucose. Body temperature is lowered, fullness, swelling is detected, the thyroid gland can be atrophied, reduced and not palpable, or it can be enlarged and dense.
Diagnosis: reduced hormone levels
The basis of the diagnosis is the presence of typical clinical manifestations characteristic of hypothyroidism. But an accurate diagnosis is impossible without laboratory confirmation and identification of the cause of hypothyroidism – primary or secondary. The following steps are required to establish a diagnosis:
- detailed questioning of the patient about the appearance of symptoms and state of health lately;
- data from previous thyroid gland ultrasounds, if performed;
- clarification of information about operations on the gland, conducting iodine therapy, radiation, chemotherapy;
- obtaining information about the work of all internal organs, especially the heart and digestion.
It is necessary to conduct general blood and urine tests, biochemical tests, and blood clotting. It is especially important to evaluate the hormones of the thyroid gland (T3 and T4) and the pituitary gland (TSH). They are examined in the blood plasma, assessing hormones not only of the gland itself, but also of the pituitary, as well as hypothalamic. This gives indications of the primary or secondary origin of the pathology. In parallel with the level of hormones, blood tests are being conducted for the level of antibodies to thyroglobulin and peroxidase. thyrocytes .