Hypothyroidism. What is this disease, symptoms, causes, how to treat men, women, pregnancy. Clinical Guidelines 2019

By hypothyroidism understood not a specific disease. It can only be a syndrome that developed against the background of poor thyroid function, can not cope with their functions. For this reason, many developing thyroid abnormalities.

The causes of disease

There are many reasons that cause disturbances in the production of thyroid hormones. Among them may be as natural, caused by a genetic predisposition, and the reasons that have appeared as a result of improper treatment. The main ones are:

• receiving radioactive iodine;

Such treatment is usually administered in cases of excessive hormone production or hyperthyroidism. It, in turn, can cause inverse changes in the body and lead to hypothyroidism.

• autoimmune destruction;

The body can sometimes be observed malfunction of the immune system, in which it begins to struggle with their own cells and tissues. In such cases, it may be affected and the thyroid gland, which is under the negative influence begins to produce small amounts of hormones.

• operations carried out on the thyroid gland;

Removing and thyroid disorder capable integrity entail disorders in hormone production processes or even its termination. In this case, only help hormonal drugs.

• exposure;

Radiation therapy to the head and cervical spine, designed to fight with cancer may lead to malfunction of the thyroid and hypothyroidism in particular.

• medications.

Medications have a strong impact on the body, in some cases, negative. Therefore, when taking any medication is best to consult a doctor. In addition to the main causes of hypothyroidism, there are other conditions that can cause this syndrome, but they are much rarer.

These include:

The cause of hypothyroidism	Description
Congenital malformations	Children may be born with a defect in the structure and development of the thyroid gland due to various reasons. And to identify the breach before birth is very difficult.
Violations of the pituitary or hypothalamic function	In such cases, hypothyroidism develops in benign neoplasms pituitary where it can not produce the right amount of thyroid stimulating hormone.
Pregnancy	Pregnancy can induce autoimmune disorders that cause hypothyroidism.
Lack of iodine in the body	Iodine is important for thyroid function and with his lack of it begins to operate properly. As a result, there is development of the disease.

Risk factors

Hypothyroidism may occur in any person exposed to the causes of pathology. However, there are groups of people who are more prone to develop this disease.

Such individuals likely to develop in times above, and include:

• women who have reached the age of 60:
• People who are in relationship with those who have been diagnosed with thyroid pathology works;
• People who are ill with autoimmune diseases;
• Patients who underwent surgery on the thyroid gland;
• Patients treated with the head, neck or thoracic ray procedures;
• people who take drugs that contain iodine or hormones.

For people at risk, more likely to get much higher, so you must every year to be screened in order to detect abnormalities at an early stage of development and does not run for disease.

classification of diseases

Hypothyroidism time appearance in the human body can be acquired or congenital. Last appears during a child's development in the womb, and are diagnosed shortly after birth. The reason for its development are abnormalities in the hypothalamus and pituitary gland, or structural abnormalities of the thyroid gland.

The most common is the acquisition of hypothyroidism, it is found in 99% of cases. The main causes of acquired autoimmune disease marked pathology, surgery, treatment tirestatikami and lack of iodine in food.

Hypothyroidism are divided into groups depending on the degree of violation of norms:

• primary;

For this stage of development is characterized by increased production of thyroid-stimulating hormone by reason of defects that develop in the thyroid gland.

• secondary;

The second stage is characterized by lack of T4 and thyroid stimulating hormone due to deviations in the pituitary.

• tertiary.

This level appears due to violations of the hypothalamic function.

Rarer groups are considered secondary and tertiary hypothyroidism, disorders developing in the pituitary and hypothalamus, which reduces control over the thyroid work. Primary hypothyroidism is most often diagnosed. In the event that the reason for the appearance of this disease is not detected, it is considered idiopathic.

Separately classified peripheral hypothyroidism. It is also called tissue or transport. This type of disease is detected in the event that the body fabric resistant to hormone secreted thyroid.

Symptoms of disease in women, men

Symptomatology of hypothyroidism is quite varied and can manifest itself in different ways for each patient individual as the time and duration of the first signs of the disease and the extent of their gravity. It depends on the state of human health and how strong the lack of the hormone.

The most common symptoms include:

• fast fatiguability;
• dry skin;
• strong sensitivity to low temperatures;
• and a rare solid stool;
• slight weight gain;
• appearance of edema;
• hoarseness in his voice;
• muscle weakness;
• increased cholesterol in blood tests;
• deterioration in the quality of hair (dry, loss, dullness);
• memory problems;
• bradycardia or reducing heart rate;
• depressed emotional state.

Women as hypothyroidism symptoms appear menstrual disorders of the reproductive system functions. The most serious consequences are sterility and a high risk of miscarriage. It is also possible the birth of a child with developmental disabilities. Men and women have decreased libido.

In this case, all of these symptoms may be not all but only part of them. They may also appear gradually, one by one. The duration of the disease symptoms or minimal symptoms may be more than one year.

Therefore it is recommended to have regular examinations, because in the absence of proper treatment of hypothyroidism can cause serious consequences, up to the confluence of a coma. Such an effect is due to the participation of hormones in all the vital processes and disruption in their development can cause various diseases.

Laboratory research

Hypothyroidism - a disease that doctors previously could not be detected until the moment has not shown any symptoms. Now there are highly sensitive method for determination of thyroid stimulating hormone in the blood.

Such diagnostic methods can detect abnormalities at an early stage of development and resolving them. It is recommended to take an annual examination by an endocrinologist. It is especially important to make older women (over 60 years) and during pregnancy, as during this period the woman's body is most susceptible to defeat.

Setting the level of TSH (thyroid stimulating hormone) is important for proper delivery diagnosis and treatment.

To do this, use the following methods of blood analysis:

• analysis for thyroxine or T4;
• analysis on the content of triiodothyronine or T3;
• analysis on TTG content.

In hypothyroidism there is deterioration of the thyroid gland works. Consequently, the proportion of T3 and T4 decreases in blood TSH content can be either above normal and below.

Also conducted other tests, such as:

• Blood biochemistry (used to determine cholesterol levels because it increases hypothyroidism);
• determining the content of autoantibodies in relation to the thyroid gland;
• Ultrasound examination of the thyroid gland;
• scintigraphy or biopsy using a fine needle.

To determine the congenital hypothyroidism on the 5th day after birth neonatal screening is conducted to determine the level of TSH.

There is also a condition called subclinical hypothyroidism, it is characterized by the normal content of these hormones, T3 and T4, and TSH above normal. This disease also needs to identify and therapy. Standard research methods are used to it.

treatment of the disease

Hypothyroidism, like any other disease, needs to be timely diagnosis and treatment. Otherwise possible serious and irreversible consequences that much more difficult to eliminate.

For the treatment of this disease are used as methods of traditional medicine and folk remedies. In addition, hypothyroidism obliges the patient to comply with a special diet. However, diet therapy, most often used as a supplement to the basic treatment.

Medicines for men

Men are less likely to develop hypothyroidism, have 8 times less likely to be diagnosed this disease.

However it occurs, so the following categories of drugs used to treat it:

• synthetic;
• natural.

Those and others aimed at the normalization of thyroid function and, accordingly, the restoration of the normal amount of hormone production. At the same time for different patients prescribed drugs, or the content of T3 or T4, depending on the indication and the human condition.

Basically, endocrinologists prescribe the following drugs:

Title	Category medication	Description	release Form	Structure	when to take	How to use	price, rub.
Levot-iroksin	Synthetic	White cream-vatye pills flat cylinder	Coated tablets 5 standards in a cardboard bundle of 10 pieces	levothyroxine sodium, lactose, magnesium stearate, talc, calcium hydrogenphosphate	In the morning on an empty stomach half an hour before a meal	Inside, the dosage is appointed by an endocrinologist	120
Lyoto ronin	Synthetic	White bi-convex tablets	Coated tablets 2 standard in a cardboard bundle by 25 pieces	Liothyronine, thyroid means	For half an hour before a meal	Inside, the dosage is appointed by an endocrinologist	from 8900
Thyroid-S	Natural	Hazel vatye bi-convex tablets	Coated tablets in a glass jar at 1,000	Extract of pig thyroid	For half an hour before a meal	Inside, the dosage is appointed by an endocrinologist	from 2200

Dosages are usually determined with the weight of the patient, where 1 kg falls from 1.6 to 1.8 mg of active substance.

There are different approaches in the treatment of hypothyroidism, which are determined by the degree of development of the disease and the individual condition of the patient. Therefore it is recommended to consult with the endocrinologist and to comply with all regulations.

Drugs for women

Hypothyroidism - a disease peculiar, mostly women. Especially during childbearing, and after 60 years of life.

For the treatment of this disease in women and different groups of drugs used:

• synthetic;
• natural;
• mixed.

In this case, most prescribers are:

Title	Category medication	Description	release Form	Structure	when to take	How to use	price, rub.
L-thyroxine	Synthetic	White-creamy pills flat cylinder	Tablets coated on 5 standards cardboard unit of 10 pieces in each	Levoti-Roxin sodium, lactose, magnesium stearate, talc, calcium hydro phosphate ievy	Morning fasting stomach for 30 minutes. before meals	Inside, receiving the dose-assigned indiv idualno endok-Rhinology	120
Tireoidine	Natural	White biconvex tablets	Coated tablets (200 pieces) or powder (for children)	not known	In the morning on an empty stomach half an hour before a meal	By beginning with 5 ug received, then withdrawn dose-Chiva (recombination-enduetsya PROKONSIM-ultiro-vatsya a physician)	from 3800
Triiodo-thyronine	Synthetic	Biconvex round pink tablets	Coated tablets in a glass jar of 100 pieces	Lyoto ronin, tri-thyronine, thyroid means	Once daily in the morning for 30 minutes. before breakfast	Inside, receiving the dose-assigned individualistic a dually-endokr inologom	from 330
Thyreocombum	Mixed	Biconvex round white tablets	Coated tablets, 4 standard carton 10 pieces	Levot-iroksin, liothyronine, potassium iodide	Once daily in the morning for 30 minutes. before breakfast	Dosage wish to set up defined-endokr inologom-indiv-idualno	from 117

Usually when assigning tablets dosage determination is made individually for each patient. However, always starts with the reception of a smallest dose and gradually increased.

All preparations are aimed at normalizing the production of hormones T3, T4 and TSH, which is possible only after the restoration of normal functioning of the thyroid gland.

It should be remembered that all appointments should do endocrinologist, so as not to cause adverse effects. particular attention also needs to be taken to the treatment of hypothyroidism during pregnancy and lactation, so as not to harm the child.

Folk remedies

Hypothyroidism - a disease that requires immediate treatment immediately after detection. However, therapy can be not only traditional, but also folk.

There are many ways, among which the most popular and effective:

• infusions;

Alcohol tincture of lily of the valley is taken by mouth with a gradual increase in dose, starting with 5 drops and ending half a teaspoon. After the maximum dose is reached, to start reducing the reverse process to 5 drops.

To prepare this infusion should be placed dry flowers lily of the valley in a container, pour into it two-thirds of alcohol (15-20%) or vodka and leave for 7 days in a warm place. In this case, it is necessary to stir it regularly.

• compresses for external use;

Treatment of hypothyroidism can contribute not only to the different reception means inside but also outside of manipulation as a compress. To prepare it, you need to collect plant knotweed pepper or pepper popularly water, separate the leaves and pour over boiling water.

Then the greens need a bit of chop and mash, put on a piece of gauze or a bandage and cover with the second piece. Such compress overnight applying to the area where the thyroid is located within 14 days. If necessary, you can extend the course to 21 days.

• broths;

To prepare a decoction should be taken in equal proportions a dried lily and parsley and fresh cocklebur. Herbal mixture and add water to boil for 5 minutes. Take a decoction should be for 1 st. l. three times a day before meals.

• raw tools.

When hypothyroidism is very good vegetable juice. To make it, you need to press the 2 glass of carrot, beet and potato juice, mix them well and drink a quarter cup three times a day before meals. It is important to remember that the juice can not be combined with meat products.

Also compensate for the deficiency of iodine in the body can seaweed. So that it is well absorbed by the body, it is better to use dry. To prepare the dish you need to chop the cabbage and pour boiling water in equal proportions.

She needs to swell and mix with about 110-130 grams. low-fat cheese and 6 walnuts, then fill the 2 tbsp. l. sour cream. This salad should be divided into 2 meals in the morning and at lunch.

diet therapy

Dieting with hypothyroidism need to follow some rules:

• daily calorie intake should not exceed 2300 because the main task of diet - to exclude from the diet of all the products that are difficult to digest;
• the meat should be replaced with fish or other seafood;
• fruits and vegetables should be eaten fresh;
• once a week is necessary to arrange a fasting day;
• Products consumed baked or steamed;
• there must be frequently and in small portions;
• common salt is necessary to replace iodized.

To the list of banned products to use are:

• any alcohol-based beverages;
• beans;
• fat;
• roast;
• smoked;
• meat and meat products;
• cabbage and all cruciferous;
• sausage and sausage;
• sweets and flour.

During this period, allowed to eat:

• fruits;
• vegetables;
• greenery;
• seaweed;
• fish;
• seafood;
• milk products;
• berries;
• dried fruits;
• nuts;
• porridge.

Daily menu might be as follows:

meal	What You Can Eat
Breakfast	Skim cheese 2 chicken eggs Salad of cucumber and greens Sandwich (whole-grain bread and cheese) Yogurt or tea
Dinner	Braised turkey or chicken Mashed potato Salad of tomatoes and cucumbers; Fruit
Snack (snack)	Seafood or lean ham
Dinner	Cottage cheese or beef stroganoff Bread and butter Tea Fruit

To get the maximum effect of diet, you must comply with all its principles, and completely eliminate the products included in the list of banned. This is especially true of alcohol, because of its assimilation requires large amounts of T3 and T4 hormones.

Features of treatment in pregnancy

Hypothyroidism - a disease that is especially dangerous for women to bear a child. Therefore, in this period it is necessary to pass all the required examination. If they were identified during thyroid dysfunction, need to pass medical treatment.

It is aimed at correcting "mistakes" in the gland and normalize hormone production. Also not immediately eliminate all comorbidities, which can trigger a relapse.

For the treatment of pregnant women usually take the following measures:

• rate of hormonal preparations;

The dosage of synthetic drugs, which contain the T4 hormone is selected endocrinologist gradually joint regular monitoring of TSH and T3 in the blood. Control is 1 time in 2 weeks.

In this case, if the results of tests showed normal levels of hormones, then find the right dosage, otherwise the procedure is repeated. The treatment is also necessary in cases of subclinical hypothyroidism.

• receiving rate preparations containing iodine;

iodine therapy is used in cases where there is a low level of thyroxine in the blood and T4. At the same time the body is marked iodine deficiency. This measure makes it possible to reduce the dosage of hormonal preparations, or even to abandon them. In appointing yodoterapii important to consider violations of hormone production and the general condition of the patient to develop a certain treatment regimen.

• symptomatic therapy.

Such treatment appointed the doctor in the case of a patient hypothyroxinemia, which causes a malfunction of the organs and systems. In this case, commonly used nootropics; stimulators of the immune system; preparations containing vitamins and minerals, as well as stimulants of metabolism in tissues.

In the case of a woman diagnosed with compensated hypothyroidism, it is recommended to give birth naturally. Cesarean section is possible only by special indications.

Prognosis and complications

In the absence of timely examination and intervention hypothyroidism can cause serious health problems.

If untreated, hypothyroidism can cause a number of problems:

• heart and vascular diseases;
• mental health abnormalities;
• pathology of the reproductive system;
• developmental disorders.

Cardio-vascular system can develop disorders of the heart due to an increase blood cholesterol level, which clogs the vessels, thereby complicating the delivery of blood to the organs and tissues. On the occurrence of such status may also affect and subclinical hypothyroidism.

In turn, the excess of normal blood cholesterol increases the risk of atherosclerosis. Hypothyroidism can cause an increase in the size of the heart and lead to heart failure.

Depression and other psychological and emotional abnormalities can develop in the early stages of disorders of the thyroid gland. Also such pathologies affect the action of brain activity that leads to deterioration of memory and slowing of mental operations.

Development of an insufficient number of thyroid hormones can cause infertility because of irregular menstrual cycle and fertility decline.

As malfunction of the thyroid gland in the expectant mother may affect fetal development. Born children with disabilities may be congenital and different organs. Early treatment can help reduce the risk of disease and normalize intellectual activities and development of the child.

Children born with hypothyroidism tend to rise to deviations of mental development and physical health problems. However, such effects can be avoided by starting the treatment time.

Also, for all categories of the population, regardless of age, sex and state of health in the development of hypothyroidism is marked reduction in the activity of the immune system. Because of this, the patient is often observed viral and infectious diseases.

Thus, hypothyroidism - this is a very serious condition that can develop on the background of other diseases and cause health problems. It is especially dangerous because it is difficult to diagnose in the early stages due to asymptomatic.

However, regular inspections and strict adherence to an endocrinologist recommendations can significantly reduce the risk of adverse effects.

Registration of the article: Mila Friedan

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