Hypothyroidism

General characteristic of a disease

The hypothyroidism is the endocrinological disease arising because of disturbance of balance in an organism of thyroid hormones.

The subclinical hypothyroidism – the easiest form of pathology is most often diagnosed. Women are most often subject to it 50 years are aged more senior.

At a subclinical hypothyroidism aberrations only of TTG hormone (thyritropic hormone) are observed, and the amount of other hormones of a thyroid gland is, as a rule, not broken.

Types of a hypothyroidism

On a pathogeny it is accepted to distinguish primary, secondary and tertiary forms of a disease. Primary hypothyroidism results from pathologies of a thyroid gland. The autoimmune thyroiditis acts as often its reason of development. Perhaps also development of primary hypothyroidism after a thyroid gland operation, after treatment by drugs-tireostatikami or radiations by a radioiodine.

The secondary form of a disease is quite often called a pituitary hypothyroidism, and tertiary – a hypothalamic hypothyroidism. Secondary and tertiary forms of a disease are provoked:

• tumors гипоталамо - pituitary system,
• insufficiency of a diaphragm of the Turkish saddle in a body of a wedge-shaped bone of a skull,
• necroses and heart attacks of a hypophysis,
• IDCS,
• brain inflammations, etc.

However primary form of a hypothyroidism of a thyroid gland most often meets. To Vesta with a subclinical hypothyroidism they reach 10% on prevalence of a disease among the population.

Such high rates are caused by an iodine deficiency in an organism, caused by deterioration in an ecological situation and improper feeding.

Inborn hypothyroidism

The special form of a disease is represented by an inborn hypothyroidism. It is diagnosed on average for one on 4 thousand newborns. Among the reasons of an inborn hypothyroidism of a thyroid gland call an aplasia or a dysplasia of body, genetically caused disturbances of production of thyroid hormones.

The increased risk to give birth to the child with an inborn hypothyroidism exists also at women with autoimmune diseases of a thyroid gland. It is also worth referring to number of the reasons of an inborn hypothyroidism treatment by thyreostatic drugs of pregnancy in time.

The child with an inborn hypothyroidism at a prenatal stage of development receives maternal hormones of a thyroid gland. After the birth the level of thyroid hormones in an organism of the kid promptly falls. Inability of a thyroid gland of the newborn to independently produce hormones affects development of the child. First of all suffer bark of his brain.

At the untimely beginning of replaceable hormonal treatment of a hypothyroidism of an inborn form development of mental retardation is possible. Also the skeleton and internals suffer from deficit of thyroid hormones at an inborn hypothyroidism.

Hypothyroidism symptoms

In the first days of life of the child it is possible to diagnose only 5% of cases of an inborn hypothyroidism. Suspicions about existence of this serious disease can arise at a neonatolog if the newborn has following symptoms of a hypothyroidism:

• the hyperbilirubinemia (jaundice) lasts more than a week,
• the blown-up stomach,

• umbilical hernia,
• deep hoarse voice,
• the back fontanel and thyroid gland are increased,
• hypotonia (the lowered tone of muscles).

By 3rd month of life join symptoms of a hypothyroidism of a thyroid gland:

• loss of appetite,
• the complicated swallowing,
• meteorism,
• deviations from norms of set of weight and linear growth,
• pallor and dryness of integuments.

In 9 months at an inborn hypothyroidism there is obvious a delay of psychomotor development of the child.

Symptoms of a hypothyroidism of the acquired form have the specifics. First, the disease has no typical signs which are found only at this type of endocrinological pathology. And, secondly, expressiveness of symptoms of a hypothyroidism depends on degree of deficit of thyroid hormones.

So the subclinical hypothyroidism, for example, can be shown:

• increased fatigue,
• sensitivity by cold,
• frequent attacks of a depression,
• increase in weight,
• small physical endurance,
• hair loss,
• disturbances of a menstrual cycle,
• ache in joints.

At the same time manifestation of all above-mentioned symptoms of a hypothyroidism of a subclinical form is not obligatory. Manifestation of only several separate signs of a hypothyroidism is characteristic of 15% of patients.

At explicit deficit of thyroid hormones become a part of a clinical picture of a hypothyroidism of a thyroid gland:

• puffiness,
• apathy,
• poverty of a mimicry,
• yellowness of integuments,
• hypophrasia,
• decrease in memory and intelligence,
• disturbances of a cordial rhythm,
• dyskinesia of bilious ways,
• functional disturbances in work of intestines,
• infertility.

Symptom of a hypothyroidism of a thyroid gland of the most severe form is hypothyroid, it is a myxedematous coma.

Diagnosis of a hypothyroidism

The acquired hypothyroidism of a thyroid gland is diagnosed by test for determination of level of thyroid hormones in blood. At the isolated increase in thyritropic hormone the diagnosis "a subclinical hypothyroidism" is made to the patient.

Simultaneous increase in level of thyritropic hormone and decrease in thyroxine – the basis for diagnosis "the acquired manifest hypothyroidism".

Due to a large number of nonspecific symptoms of a hypothyroidism of difficulty arise only when determining indications for check of level of hormones of a thyroid gland. The subclinical hypothyroidism is often diagnosed routine inspection in time.

Diagnosis of an inborn hypothyroidism of a thyroid gland is carried out on the 5th day of life when at the newborn the level of maternal thyroid hormones decreases in blood.

Treatment of a hypothyroidism

At the acquired form of a disease replaceable hormonal treatment of a hypothyroidism is appointed. The standard in treatment of a hypothyroidism are drugs on the basis of left thyroxine (L-T4): Sintroid, Levoksin, Levotroid, etc. Only initial dosages and speed of their increase can differ. Digestion of hormones of a thyroid gland at replaceable treatment of a hypothyroidism happens for 15-20%.

At a subclinical hypothyroidism treatment can not be required. If the patient has no explicit symptoms of deficit of hormones of a thyroid gland, it needs only dynamic observation not to pass a disease complication.

However correction of level of thyroid hormones prior to the planned pregnancy is obligatory for all women with the diagnosed subclinical hypothyroidism. Replaceable treatment of a hypothyroidism should not stop and in time the pregnancy.

Optimum terms to start treatment of a hypothyroidism of an inborn form – 1-2 week of life. On this term it is possible to prevent disturbances of physical and mental development of the child. And further, than replaceable treatment of a hypothyroidism, subjects a high probability of weak-mindedness and lag in physical development will be begun later.

Efficiency treatment of a disease is quite high. Regress of symptoms of a hypothyroidism is observed already 1-2 weeks of therapy later. Worst of all people of advanced age react to it.

Treatment of a hypothyroidism, as a rule, lifelong. However in certain cases, for example, at Hashimoto's syndrome perhaps independent recovery of functions of a thyroid gland.

At disturbance of activity of a thyroid gland, work of other systems of an organism is broken. Gipoterioz is the frequent reason of obesity, and obesity can lead to other troubles.