Hypothyroidism: symptoms and treatment in women

Hypothyroidism is a pathological condition of the body, resulting from a deficiency of thyroid hormones. Hypothyroidism has many symptoms that are very nonspecific, since thyroid hormones participate in the regulation of almost all organs and systems of man. Hypothyroidism can be hidden, not showing any symptoms at all, and can be so pronounced that it causes the comatose state of the patient. Hypothyroidism is much more common in women, especially the elderly. In what cases does hypothyroidism arise, how can it manifest itself, how it is diagnosed and how it is treated? You will receive answers to all these questions by reading this article.

Hypothyroidism is one of the most frequent endocrine disorders. First of all, it should be understood that this condition is not a separate disease. This is a clinical syndrome that develops as a result of a lack of thyroid hormones( thyroid hormones - thyroxine T4 and triiodothyronine T3).And the diseases that lead to the onset of hypothyroidism are quite a lot, and this is not necessarily a disease of the thyroid gland.

Hypothyroidism is more common in elderly people, its prevalence increases with age. According to statistics, the female sex prevails in the structure of the diseased. So, out of every 1000 women in Russia, 19 have hypothyroidism, and out of 1000 men - one.

How does hypothyroidism develop? Varieties of hypothyroidism

Normally, the thyroid gland produces hormones based on iodine that comes with food: triiodothyronine( T3) and thyroxine( T4).Thyroxine is less active and turns into triiodothyronine, which directly binds to the cells of the body, causing them to work properly. Thyroid hormones regulate many processes:

• metabolism;
• activity of the cardiovascular system;
• functioning of the gastrointestinal tract;
• reproductive function;
• level of immune protection;
• intellectual activity;
• emotions;
• condition of skin, hair, nails.

Virtually every sphere of human activity requires the participation of thyroid hormones. Without sufficient content of these hormones in any of these areas, there are violations, which is why hypothyroidism is clinically characterized by a variety of very diverse symptoms that seemingly have nothing to do with the thyroid gland.

The activity of the thyroid gland is regulated by the pituitary gland and the hypothalamus: organs located in the brain. Adjustment is carried out by means of a thyroid-stimulating hormone secreted by the pituitary gland. The pattern is quite simple: with a decrease in the production of T3 and T4, the release of thyroid stimulating hormone increases, which stimulates the production of T3 and T4.Accordingly, with an increase in the content of thyroid hormones, the production of thyroid-stimulating hormone decreases. Thus, the body adapts to the environmental conditions. The appearance of pathology in any part of this chain of regulation can lead to hypothyroidism.

If the problem occurs in the thyroid itself, hypothyroidism is primary, if the case is in the pituitary or hypothalamus, then such hypothyroidism is considered secondary. In addition, hypothyroidism can be congenital( eg, with abnormalities of the thyroid gland) or acquired( for example, after the removal of a part of the thyroid gland).The severity of clinical symptoms of hypothyroidism can be:

• latent( subclinical).In this condition, there are no symptoms of hypothyroidism, it can be detected only when determining the level of hormones in the blood;
• is a manifest. In this case, there is a detailed clinical picture.

Hypothyroidism is compensated and decompensated. The extreme degree of decompensation of hypothyroidism is a hypothyroid( myxedematous) coma.

Causes of hypothyroidism

The most common causes of hypothyroidism are:

• autoimmune thyroiditis( Hashimoto's disease);
• removal of part of the thyroid gland;
• trauma to the thyroid;
• taking medicinal preparations based on lithium( Quilinium, Contemnol, Litosan, Sedalit), the introduction of contrast agents based on iodine;
• acute deficiency of iodine and selenium in food;
• treatment with radioactive iodine, irradiation of thyroid tissue;
• pathology of the pituitary and hypothalamus( tumors, trauma, hemorrhage, surgery in this area and so on).

Symptoms of

In patients with hypothyroidism, working capacity decreases, often a headache. They constantly feel weak and tired.

For hypothyroidism is characterized by multiple organ failure, that is, the simultaneous presence of symptoms, indicating the pathology of various organs. A separately taken symptom of hypothyroidism is always nonspecific, which makes it difficult to diagnose this condition. One patient does not necessarily have all the symptoms at the same time. Usually, several of them prevail, while the others are either present in an erased form, or there are none at all. The severity of individual symptoms also fluctuates, sometimes they are simply mistaken for the manifestation of senile changes in the body( since hypothyroidism is more common after 55-60 years).

The main symptoms of hypothyroidism are:

• asthenic syndrome. Patients with hypothyroidism are disturbed by general weakness, lethargy, fatigue or a constant sense of fatigue. The memory decreases, the speed of thought processes, the efficiency decreases. Drowsiness is noted even with sufficient amount of sleep per day. The interest to life is lost, emotional dullness and indifference to everything that is happening are developing. Often there are numerous unpleasant sensations in the whole body: a feeling of crawling, numbness, tingling, burning and the like. May disturb headaches, pain in the muscles and joints;
• metabolic-trophic disorders. First of all, it is dryness of the skin( sometimes with an icteric shade), its puffiness( especially in the face and peripheral parts of the limbs, which gives the appearance of a man, sorry, awakened after a stormy libation before), fragility and increased hair loss. The nails are thin, loose, have a transverse or longitudinal striation. Such patients usually have an excess body weight, although they can eat quite a bit. This is due to excessive fluid retention in the body and a decrease in the rate of metabolic processes. Patients with hypothyroidism are always cold, even in the warm season, and frosts generally do not tolerate. Body temperature often falls below 36.6 ° C;
• tissue swelling. In addition to the puffiness of the face and limbs, with hypothyroidism, the voice is often coarsened by the swelling of laryngeal ligaments, the nasal breathing becomes difficult( it becomes difficult and snoring) due to the swelling of the nasal mucosa, the hearing worsens( due to swelling of the auditory tube and middle ear), lips thicken,in the language there are prints of teeth, speech is a little slowed( due to the slowness of the swollen tongue).As you can see, many of the symptoms seem to correspond with the natural process of aging of the body, therefore, they are not perceived as a pathology, neither by the patient himself, nor by others;
• reduction in heart rate( bradycardia) and lowering blood pressure( hypotension).When examining such patients, systolic blood pressure( "upper") is often reduced or normal, and diastolic( "lower") blood pressure is elevated. The ECG is characterized by a so-called low voltage( the amplitude of all the teeth is low), a negative T wave. It is possible to exudate fluid between the cores of the heart. In this case, pericarditis develops. A frequent manifestation of hypothyroidism is heart failure with shortness of breath and pain in the heart;
• problems with the gastrointestinal tract. The motor activity of the stomach and intestines slows down with hypothyroidism, food is delayed for a long time in each department, which leads to the appearance of gravity in the stomach, eructation, loss of appetite, flatulence, constipation, nausea. It is possible to increase the size of the liver( hepatomegaly) due to fluid retention in the connective tissue of the liver, the phenomenon of dyskinesia of bile ducts by hypotonic type;
• problems with the sex glands. Functioning of the thyroid gland is closely related to the secretion of sex hormones. When hypothyroidism in women, the menstrual cycle is broken up to the complete absence of menstruation, sometimes uterine bleeding is observed, the probability of becoming pregnant is approaching zero. It is possible to extract secretions from the mammary glands by the type of breast milk, the development of mastopathy. Sexual desire is reduced;
• anemia. Reduces both the total number of erythrocytes and the hemoglobin content;
• increased blood cholesterol and early vascular arteriosclerosis;
• prone to frequent infections due to decreased immunity.

The most formidable complication of hypothyroidism is the hypothyroid( myxedematous) coma. It can develop if hypothyroidism is not treated, or in extremely neglected cases. Myxedema coma is provoked by increased demands on the body when it is necessary to mobilize forces. These can be infectious diseases, psycho-emotional stress, hypothermia, the use of neuroleptics and barbiturates, physical trauma, surgery, food intoxication and the like.

Hypothyroid coma develops gradually. When it occurs, all the symptoms of hypothyroidism are amplified: the mind is depressed from drowsiness to coma, the heart rate slows and breathing slows down, the arterial pressure drops even more, the body temperature drops to 35 ° C and even lower, the body swells, urination decreases, dynamic intestinal obstruction develops,there is an effusion in the pleural, pericardial and abdominal cavity, the blood glucose level decreases, the hair on the head and in the axillae drop out. With increasing phenomena of respiratory and cardiovascular insufficiency without adequate treatment, the patient may die. Mortality with hypothyroid coma reaches 80%.

Diagnosis

Diagnosis of hypothyroidism is quite simple. The most important thing is to suspect his presence, taking into account all the symptoms that the patient has in common. Sometimes individual manifestations of hypothyroidism are not considered together, which leads to a belated diagnosis.

The main method of diagnosis, or rather confirmation, hypothyroidism are blood tests for the content of thyroid hormones. It is necessary to determine the content of thyroid-stimulating hormone( TSH), thyroxine( T4) and triiodothyronine( T3).With hypothyroidism, the TSH level may be elevated, decreased or even normal, but the levels of T3 and T4 are reduced.

All other diagnostic methods for hypothyroidism( ultrasound of the thyroid gland, determination of the level of autoantibodies to thyroid tissues, thyroid scintigraphy, magnetic resonance imaging of the brain, etc.) do not aim to confirm the presence of hypothyroidism, but to search for the true cause, that is,disease, of which he is a manifestation.

Treatment of

The main way to treat hypothyroidism today is substitution therapy with synthetic thyroid hormones. Most often, Levothyroxine( L-thyroxine, Eutirox) is used for this purpose. The dose is selected individually for each patient( usually prescribed in increasing dosage until the normalization of blood hormones).The minimum dosage of the drug is 12.5 μg. Levothyroxine should be taken in the morning for 20-30 minutes before meals.

The duration of the drug is determined individually and depends largely on the cause of hypothyroidism. So, for example, with autoimmune thyroiditis, substitution therapy is prescribed for life, with hypothyroidism due to taking certain medications - before the normalization of thyroid hormone levels in the blood. Sometimes, to achieve a normal level of hormones in the blood, it is necessary to take Levothyroxine for several months( this is especially true for elderly patients).With the constant admission of Levothyroxine, periodically it is necessary to take tests for the content of TSH, T3 and T4 in order to adjust the dosage.

If the cause of hypothyroidism is iodine deficiency in food, then increasing its intake( iodized salt), and sometimes even prescribing it in the form of drugs without appropriate substitution therapy, can contribute to recovery.

Most of the symptoms of hypothyroidism are completely reversible, the main thing is not to start the disease and not engage in self-medication. Do not be afraid of hormone replacement therapy. With an adequately selected dosage, side effects occur rarely, and the quality of life improves significantly. And do not discount on age: and in 70-80 years, well-being should be satisfactory!

Thus, hypothyroidism can be the result of various pathological processes in the human body. Symptoms of this condition are numerous and nonspecific. Diagnosis of hypothyroidism is not so difficult, the main thing is to suspect its presence. The main direction in the treatment is hormone replacement therapy, which allows to return the patient to a full life.

Specialist of the clinic "Siena-Med" tells about hypothyroidism:

Hypothyroidism Treatment of hypothyroidism Clinic and diagnosis of hypothyroidism

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