Diseases of the thyroid gland are one of the most common forms of human pathology, which is associated with the deterioration of the ecological situation, insufficient intake of iodine in the body, negative changes in nutrition, and an increase in the frequency of autoimmune diseases. In terms of frequency and social significance, hypothyroidism occupies one of the leading places.

Hypothyroidism is a condition of the body that develops in response to a low concentration of thyroid hormones. The role of thyroid hormones in metabolism is very high, therefore, fluctuations in their content are immediately reflected in all organs and systems. The clinical expression of a significant decrease in thyroid hormones in adults is myxedema, in children – cretinism. 

Its development is based on insufficient thyroid function or other processes that affect hormonal metabolism. Distinguish between primary hypothyroidism, which develops with direct damage to the thyroid gland, secondary – in this case, the regulation of the activity of the organ by the pituitary gland suffers, and tertiary – with dysfunction of the hypothalamus.

Hypothyroidism causes:

1. Pathology of the thyroid gland:

• autoimmune thyroiditis;
• removal of the thyroid gland;
• radioactive iodine treatment;
• severe iodine deficiency;
• congenital aplasia or dysplasia of the thyroid gland.

2. Lack of production of thyroid-stimulating hormone (TSH) – a pituitary hormone that regulates the production of hormones by the thyroid gland:

• pituitary tumor;
• pituitary necrosis (Sheehan-Simmonds syndrome);
• tumor of the hypothalamus;
• operation in the hypothalamic-pituitary region.

Risk factors:

• age over 60;
• pregnancy in the last 6 months;
• childbirth;
• unfavorable family history;
• type 1 diabetes mellitus;
• Iron-deficiency anemia;
• rheumatoid arthritis;
• lupus erythematosus.

Symptoms of Hypothyroidism
Thyroid hormones affect the entire body, and hypothyroidism can occur in any organ system.
The most common symptoms of hypothyroidism are: depression, anxiety, dry skin, hair loss, memory impairment, irritability, insomnia, inability to concentrate, fatigue, feeling of numbness, seizures, impaired vision, fluid retention, weight gain, slow speech, voice coarseness, decreased appetite, constipation, infertility or miscarriages, absence or delay of menstruation.
If one of the symptoms persists for a long time or if three or more symptoms occur at the same time, you should consult your doctor.

Diagnosis of hypothyroidism

Which doctor should I go to?
Symptoms of hypothyroidism force the patient to consult a general practitioner, whose task is to suspect the disease and refer the patient to an endocrinologist. To establish a diagnosis of hypothyroidism, there are not enough complaints and physical examination data – additional tests must be prescribed.

Analyzes and examinations

1. An ultrasound examination of the thyroid gland allows you to safely and quickly identify possible disorders that have led to a decrease in hormone production.
2. Radioactive iodine uptake test – in hypothyroidism, the ability of thyroid tissue to capture iodine is reduced.
3. The main method for detecting hormonal disorders is a blood test for thyroid hormones. Triiodothyronine, thyroxine and thyroid-stimulating hormone are usually determined. In hypothyroidism, the levels of the first two hormones are reduced, and the level of the third is dramatically increased.
4. Blood and hair tests should be done to rule out the presence of mercury, lead, and other polluting chemicals in the body.

Why is it dangerous?
Without treatment, the manifestations of hypothyroidism are aggravated and general hypothyroid edema – myxedema – may develop.
The most dangerous complication of hypothyroidism is hypothyroid coma. It is accompanied by loss of consciousness and suppression of all body functions. Coma develops in patients who have not received hormone replacement therapy. The provoking factors are stress, infections, taking certain medications, stroke, myocardial infarction. The patient’s body temperature and blood pressure drop, respiratory and cardiovascular insufficiency increase. It is very difficult to get a patient out of a hypothyroid coma. The mortality rate is about 80%.

Treatment of hypothyroidism and rehabilitation of patients
Treatment of hypothyroidism consists in the artificial restoration of the level of the thyroid hormone – thyroxine. Attempts are being made to stimulate the resumption of the thyroid gland in the case of the alleged elimination of the probable cause of hypothyroidism. After examination and diagnosis of hypothyroidism, it is important to exclude iodine deficiency in food and not eat foods that interfere with the absorption of iodine. It is necessary to avoid stress, it is useful to use relaxation techniques.
With timely treatment started, the prognosis of the disease is favorable, since modern drugs allow maintaining the level of thyroid hormones in the norm.

Nota Bene!
Residents of areas with low iodine content in water and soil should regularly consume iodized salt and seafood.

Interesting fact

In the Alps, there used to be villages inhabited exclusively by cretins. The exact cause of the trouble remained unknown for a long time. Only in 1910, the Austrian psychiatrist Julius Wagner-Hauregg was able to prove that this was due to the low iodine content in local food.
The prevalence of hypothyroidism in the Russian Federation is 19 cases per 1000 population in women and 1 case per 1000 population in men.

Prevention of hypothyroidism
To prevent the development of hypothyroidism, it is necessary to ensure that the diet is complete and contains foods rich in iodine. It is necessary to treat thyroid diseases on time with adequate doses of thyroid hormones.