Hypothyroidism is a condition in which the thyroid gland produces an insufficient amount of hormones necessary to maintain normal metabolic processes. This endocrine imbalance has a systemic effect on the body, causing a variety of clinical manifestations, from fatigue and depression to serious cardiovascular and nervous system disorders. Hypothyroidism is estimated to affect millions of people worldwide, but the disease often goes undiagnosed in its early stages due to nonspecific symptoms.
Causes of hypothyroidism
Congenital hypothyroidism develops due to abnormalities in the formation of the thyroid gland or hypothalamic-pituitary system, which can be caused by genetic factors, fetal intoxication or iodine deficiency. Autoimmune diseases in the mother, accompanied by an increase in antibodies to thyroid cells, can cause similar problems in the child.
Acquired hypothyroidism is most often associated with autoimmune thyroiditis, when the body produces antibodies against thyroid cells, which impairs its function and reduces hormone production.
Disease can also occur against the background of the following problems:
- iodine deficiency in the body;
- exposure to ionizing radiation;
- taking certain medications;
- thyroid cancer;
- certain infectious diseases, such as tuberculosis;
- surgical removal of the gland or part of it;
- brain lesions involving the pituitary gland and hypothalamus (stroke, tumors, etc.).
Diagnosis of hypothyroidism
Diagnosis of hypothyroidism is based on laboratory tests that allow you to detect abnormalities in thyroid function at the earliest stages, even before the appearance of a pronounced clinical picture. The main method is the determination of the level of thyroid-stimulating hormone (TSH) and free thyroxine (free T4) in serum.
- Thyroid-stimulating hormone (TSH) is a key marker for assessing thyroid function. In primary hypothyroidism, TSH levels are elevated because the pituitary gland is trying to stimulate an underactive thyroid gland to produce hormones. In secondary hypothyroidism associated with pituitary gland damage, TSH levels may be low or normal.
- Free T4 – its low level confirms the presence of the disease, since thyroxine is the main thyroid hormone responsible for the regulation of metabolism. It is important to measure the free fraction of the hormone, as it more accurately reflects the hormonal status of the patient.
- Determination of antibodies to thyroid peroxidase is performed to detect autoimmune Hashimoto’s thyroiditis, which is a frequent cause of the disease. The presence of these antibodies indicates autoimmune destruction of the thyroid gland.
Treatment of hypothyroidism
The main method of hypothyroidism treatment is hormone replacement therapy with levothyroxine preparations – a synthetic analog of thyroxine (T4). The goal of therapy is to restore normal levels of thyroid hormones and eliminate clinical manifestations of the disease.
- Levothyroxine is prescribed in individually adjusted doses, depending on the degree of hormone deficiency, the patient’s body weight, age and the presence of comorbidities. The initial dose may be low in elderly patients or in those with cardiovascular disease to minimize the risk of complications.
- Monitoring of treatment efficacy includes regular laboratory tests. Maintaining TSH levels within normal limits is a key criterion for the adequacy of replacement therapy. It is important to remember that with an insufficient or excessive dose of hormones can develop symptoms of hypothyroidism or hyperthyroidism, which requires timely correction of dosage.
- Dietary correction. It is important that patients with the disease maintain adequate levels of iodine in the diet. However, with autoimmune Hashimoto’s thyroiditis, excess iodine can worsen the course of the disease, so the diet should be selected with caution and under the supervision of a doctor.
- Medication management. Levothyroxine should be taken on an empty stomach, at least 30 minutes before a meal, as food, especially food containing calcium and iron, can reduce its absorption. Some medications, such as antacids or iron preparations, may also interact with levothyroxine, which requires an adjustment of the regimen.
- Duration of treatment. Hypothyroidism generally requires lifelong therapy. However, the dosage can vary depending on the patient’s condition, comorbidities and changes in body weight, which requires regular checkups with an endocrinologist.
- Replacement therapy allows to fully control the symptoms of the disease and maintain normal hormone levels, which significantly improves the quality of life of patients.
Prevention
The main method of prevention of hypothyroidism is to eat enough iodine. If a person lives in a region where it is not enough, it is recommended to periodically drink appropriate preparations or enrich the diet with iodized products. The reception of the trace element is especially important during pregnancy, since they reduce the risk of the disease in the fetus.
It is also important to timely treat diseases that can cause disorders of thyroid function, and consult a doctor for any malfunctions in the body.
Complications of hypothyroidism
If hypothyroidism is not diagnosed and treated in time, it can lead to various complications that significantly worsen the patient’s health. One of the most serious is myxedema – a severe form of hypothyroidism, which can cause a slowdown of all metabolic processes in the body, up to coma. Also, a chronic decrease in thyroid hormone levels can lead to cardiovascular diseases such as hypertension and atherosclerosis, as well as increase the risk of myocardial infarction. In women, this disease can cause fertility problems and in children it can cause physical and mental developmental delays. Therefore, it is important not to delay treatment to avoid long-term health consequences.
Conclusion
Hypothyroidism is a common but often unnoticed condition that can seriously affect health if not diagnosed and treated in a timely manner. The importance of early diagnosis and proper treatment is that correct replacement therapy allows patients to maintain normal thyroid hormone levels and effectively control symptoms, improving quality of life. It is important to follow doctors’ recommendations, monitor diet and undergo regular medical checkups, especially for people at risk of developing hypothyroidism. Prevention based on adequate iodine intake and treatment of diseases affecting thyroid function also play a key role in preventing this disease.
