Hypothyroidism is a disease caused by a decrease in thyroid function and a lack of hormone production. It is manifested by the slowing down of all the processes taking place in the body: weakness, drowsiness, weight gain, slowness of thinking and speech, chilliness, hypertonia, and in women with menstrual cycle disorders. In severe forms, myxoedema in adults and cretinism (dementia) in children develops. Complications of the disease are hypothyroid coma, heart, and vascular lesions: bradycardia, coronary atherosclerosis, coronary artery disease. Treatment of patients with hypothyroidism is performed artificially synthesized thyroid hormone.
The lack of thyroid hormones causes systemic changes in the functioning of the body. Thyroid hormones regulate energy metabolism in the cells of organs, and their deficiency is manifested in a decrease in oxygen consumption by tissues, a decrease in energy consumption and the processing of energy substrates. In hypothyroidism, the synthesis of various energy-dependent cellular enzymes, which are necessary for the normal vital activity of the cell, is disrupted. In case of neglected hypothyroidism, there is a mucinous (mucus) enema – a myxoedema, most pronounced in connective tissue. Myxoedema is developing as a result of excessive accumulation in the tissues of glycosaminoglycan, which, having increased hydrophilicity, retard water.
Classification and causes of hypothyroidism
- Hypothyroidism can be acquired and congenital (diagnosed immediately after birth and can have any genesis). The most common is acquired hypothyroidism (more than 99% of cases). The main causes of acquired hypothyroidism are:
- chronic autoimmune thyroiditis (direct damage to the thyroid parenchyma from the side of one’s own immune system). Leads to hypothyroidism years and decades after its onset.
- iatrogenic hypothyroidism (with the partial or complete removal of the thyroid gland or after treatment with radioactive iodine).
Symptoms of hypothyroidism
Clinical features of hypothyroidism are:
- the absence of specific signs, characteristic only for hypothyroidism;
- symptomatology, similar to manifestations of other chronic somatic and mental diseases;
- the lack of correlation between the thyroid hormone deficiency level and the degree of clinical symptoms: manifestations may be absent in the clinical phase or be strongly pronounced already in the phase of subclinical hypothyroidism.
- The clinical manifestations of hypothyroidism depend on its cause, the age of the patient, and the rate of increase in thyroid hormone deficiency. The symptomatology of hypothyroidism as a whole is characterized by polysystemic nature, although each individual patient is dominated by complaints and anxieties from any one organ system, which often prevents the correct diagnosis. Moderate hypothyroidism may not show any signs.
- With persistent and prolonged hypothyroidism, the patient has a characteristic appearance – swollen, puffy face, with a yellowish tinge, oedema of the eyelids, limbs associated with fluid retention in the connective tissue. The disturbing feeling of burning, tingling, muscle pain, stiffness, and weakness in the hands. The dryness of the skin, fragility, and dullness of hair, their thinning and increased loss are noted. Patients with hypothyroidism are in a state of apathy, inhibition. A severe form of the disease is characterized by a slowing of speech (as if “the tongue is braided”). There are changes in the voice (too low, hoarse) and hearing loss due to laryngeal oedema, tongue, and middle ear.
- In patients, there is a certain increase in weight, hypothermia, constant chilliness, which indicates a decrease in the level of metabolic processes. Violations of the nervous system are manifested by a deterioration of memory and attention, a decrease in intelligence, cognitive activity, interest in life. There are complaints of weakness, fatigue, sleep disorders (drowsiness during the day, difficulty falling asleep in the evening, insomnia). The general condition is manifested by a depressed mood, anguish, depression. Neuropsychiatric disorders in children older than 3 years and in adults are reversible and completely go away with the appointment of substitution therapy. With congenital hypothyroidism, the lack of substitution therapy le
- There are changes in the cardiovascular system: bradycardia, diastolic arterial hypertension of light form and formation of effusion in the pericardial cavity (pericarditis). There are frequent, then persistent headaches, the level of cholesterol in the blood rises, anaemia develops. On the part of the digestive system, a decrease in the production of enzymes, a deterioration in appetite, constipation, nausea, flatulence, can develop biliary dyskinesia, hepatomegaly.
- Women with hypothyroidism develop reproductive system disorders, which is associated with a malfunction of the menstrual cycle (amenorrhea, dysfunctional uterine bleeding), the development of mastopathy. A pronounced deficiency of thyroid hormones threatens infertility, less obvious hypothyroidism in some women does not prevent pregnancy but threatens her with a high risk of spontaneous miscarriage or the birth of a child with neurological disorders. And in men and women, there is a decrease in sexual desire.
- Clinical manifestations of congenital hypothyroidism often cannot help in its early diagnosis. The early symptoms include a bloated abdomen, umbilical hernia, muscle hypotension, a large tongue, an increase in the back fontanel and thyroid gland, and a low voice. If the treatment is not started in time, then at 3-4 months of life develop difficulty swallowing, decreased appetite, a small increase in weight, flatulence, constipation, pallor, and dryness of the skin, hypothermia, muscle weakness. At the age of 5-6 months, a delay in the psychomotor and physical development of the child manifests itself, a growing disparity is observed: the late closure of the fontanelles, the broad bridge of the nose, the increase in the distance between the pair organs, hypertelorism (between the inner edges of the eye sockets, the thoracic nipples).
Ellie Singh is a wellbeing mentor at a medical care centre in the United Kingdom. Moreover, she also supports all students in Essay Help for their educational journey.