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When the thyroid gland fails to produce adequate amounts of hormones, hypothyroidism develops. Its treatment and prevention are extremely important for maintaining and strengthening health. In men, this condition is approximately eight times less common than in women.
Types and Forms of Hypothyroidism
The endocrine system regulates the functioning of internal organs by means of hormones. Vital processes throughout the body depend on their balance. Therefore, in hypothyroidism, dysfunction of several organs may occur simultaneously.
The following forms of the disease are distinguished:
Primary (thyreogenic) hypothyroidism. Occurs in 90% of cases. Characterized by disruption of the general structure of the thyroid gland, impaired secretory function, and its cells.
Secondary (pituitary) and tertiary (hypothalamic). These occur rarely, usually as a result of diseases of brain structures (adenohypophysis and hypothalamus). The consequence is acute thyroid hormone deficiency.
Peripheral (tissue). The main cause is resistance of various organs (brain, heart, liver) to thyroid hormones T3 and T4.
Classification also provides for the distinction of hypothyroidism into:
Congenital:
Primary (when thyroid hormone synthesis is impaired, thyroid cells are insensitive to TSH, maternal iodine intake during pregnancy is insufficient, the gland is absent, etc.).
Secondary (in hypopituitarism).
Acquired:
Primary (in iodine deficiency, treatment with radioactive iodine, thyroidectomy).
Secondary (following pituitary irradiation or dysfunction).
In congenital forms, structural abnormalities of the thyroid, pituitary, and hypothalamus are present from birth. Possible intrauterine factors include maternal medication intake or autoimmune reactions. If the fetus produces insufficient thyroid hormones, their levels may be compensated by the maternal organism. After birth, the infant’s hormone levels drop, which may cause underdevelopment of the cerebral cortex, leading to intellectual disability. Development of internal organs and the skeleton may also be impaired.
When the exact cause is unknown, the diagnosis of idiopathic hypothyroidism is established.
Depending on severity of clinical manifestations, the following are distinguished:
Latent hypothyroidism, with no characteristic signs.
Manifest (compensated and decompensated) course, with prominent symptoms.
Severe forms, complicated by pituitary adenoma, heart failure, or accumulation of fluid in body cavities.
Causes of the Disease
In most cases, hypothyroidism is associated with autoimmune diseases, in particular thyroiditis. Antibodies that normally protect the body begin to attack healthy cells and tissues, often targeting the thyroid gland. In response, the pituitary gland sends numerous regulatory hormones to the ovaries, endocrine organs, and the thyroid. As a result, antibodies progressively damage the gland, decreasing hormone production. To compensate, the gland enlarges.
Other causes include:
Thyroid surgery,
Treatment with radioactive iodine, antithyroid drugs, irradiation of the neck and head,
Smoking,
Heredity,
Medications (iodine-containing drugs and radiocontrast agents, salicylates, steroids, heparin, high-dose furosemide).
Symptoms of Hypothyroidism
The thyroid gland is one of the key "control centers" of the human body, yet it is highly vulnerable. With age, the risk of hypothyroidism increases. Its manifestations are nonspecific, therefore careful monitoring of one’s condition is essential.
Possible symptoms include:
Hair problems. Hypothyroidism often leads to hair loss, thinning of eyelashes, and loss of the outer third of the eyebrows. Hair becomes dry, brittle, and grows slowly.
Skin changes. The skin may acquire a greenish-earthy hue, feeling dense, dry, and loose due to iron-deficiency anemia and impaired blood supply.
Cold intolerance. Patients constantly feel cold, even in warm weather.
Chronic constipation. Inability to empty the bowel for 3–4 days is a warning sign.
Edema. Swelling may occur, particularly facial edema in the morning.
Dry skin, especially on heels. Frequent need for pedicure and appearance of cracks.
Rapid weight gain. Unexplained accumulation of extra kilograms, despite lifestyle efforts.
Apathy and depression. Persistent fatigue, negative thoughts, lack of energy despite sleep.
Menstrual irregularities. Caused by hormonal imbalance.
Joint and muscle pain. Lower calcium levels cause increased fragility of joints.
Hypercholesterolemia. Thyroid dysfunction disrupts lipid metabolism.
Possible Complications
Body weight increases, weakness, drowsiness, cold intolerance, slow thinking, and speech disturbances appear. In women, menstrual disorders are common. Severe iodine deficiency may result in myxedema (mucous edema).
Fluid may accumulate in the pericardium and pleural cavity, impairing breathing and cardiac activity.
Hypercholesterolemia may lead to coronary artery disease (CAD), ischemic stroke, myocardial infarction, and cerebral atherosclerosis.
Congenital hypothyroidism in children may cause oligophrenia or cretinism, as well as delayed physical and sexual development and reduced immunity. In pregnant women, hypothyroidism increases the risk of congenital heart defects and other fetal malformations.
Other complications include male and female infertility, sexual dysfunction, reduced immunity, autoimmune disorders, and cancer.
The most dangerous complication is hypothyroid coma (mortality ~80%), occurring mainly in elderly patients with untreated hypothyroidism, often triggered by infections, hypothermia, or trauma. It is characterized by CNS depression, bradycardia, hypotension, hypothermia, edema, and intestinal obstruction.
Diagnosis
Diagnosis of hypothyroidism is difficult because symptoms are nonspecific and may mimic other diseases. After endocrinology consultation, laboratory tests are required:
TSH (often elevated),
T3 and T4 (low or normal),
Antibodies to thyroid tissue (to determine cause and need for long-term hormone replacement),
Serum iron levels (to detect anemia).
Thyroid hormones are protein-based; insufficient dietary protein impairs their synthesis. They also require iodine, measurable with specific testing.
Hypothyroidism also impairs conversion of beta-carotene into vitamin A. Yellowish discoloration of palms and soles may indicate deficiency, confirmable by analysis.
Ultrasound provides information on thyroid volume, structure, and possible nodules. Additional studies may include ECG, abdominal ultrasound, chest X-ray, and pulmonary function tests, especially in suspected complicated cases.
Treatment and Prevention
Prevention includes a balanced diet and iodine-rich foods. Early diagnosis and timely therapy are crucial.
Treatment in men and women is based on hormone replacement therapy. Dosage is individualized under endocrinologist supervision.
If hypothyroidism is secondary to another disease, the primary condition is treated. Iodine deficiency requires iodine preparations and a seafood-rich diet. If drug-induced, discontinuation of the medication resolves symptoms.
Treatment of Hypothyroidism at Expert Clinics
With age, prevalence of hypothyroidism increases (especially in women), occurring twice as often as in young people. In the elderly, diagnosis is complicated by mild symptoms resembling normal aging.
Therefore, only a comprehensive evaluation of all parameters affecting thyroid function allows physicians at Expert Clinics to develop the correct therapeutic strategy for hypothyroidism. Recovery is gradual. The main criterion for adequacy of treatment is the disappearance of clinical and laboratory manifestations. The treatment goal is normalization of TSH levels.
Types and Forms of Hypothyroidism
The endocrine system regulates the functioning of internal organs by means of hormones. Vital processes throughout the body depend on their balance. Therefore, in hypothyroidism, dysfunction of several organs may occur simultaneously.
The following forms of the disease are distinguished:
Primary (thyreogenic) hypothyroidism. Occurs in 90% of cases. Characterized by disruption of the general structure of the thyroid gland, impaired secretory function, and its cells.
Secondary (pituitary) and tertiary (hypothalamic). These occur rarely, usually as a result of diseases of brain structures (adenohypophysis and hypothalamus). The consequence is acute thyroid hormone deficiency.
Peripheral (tissue). The main cause is resistance of various organs (brain, heart, liver) to thyroid hormones T3 and T4.
Classification also provides for the distinction of hypothyroidism into:
Congenital:
Primary (when thyroid hormone synthesis is impaired, thyroid cells are insensitive to TSH, maternal iodine intake during pregnancy is insufficient, the gland is absent, etc.).
Secondary (in hypopituitarism).
Acquired:
Primary (in iodine deficiency, treatment with radioactive iodine, thyroidectomy).
Secondary (following pituitary irradiation or dysfunction).
In congenital forms, structural abnormalities of the thyroid, pituitary, and hypothalamus are present from birth. Possible intrauterine factors include maternal medication intake or autoimmune reactions. If the fetus produces insufficient thyroid hormones, their levels may be compensated by the maternal organism. After birth, the infant’s hormone levels drop, which may cause underdevelopment of the cerebral cortex, leading to intellectual disability. Development of internal organs and the skeleton may also be impaired.
When the exact cause is unknown, the diagnosis of idiopathic hypothyroidism is established.
Depending on severity of clinical manifestations, the following are distinguished:
Latent hypothyroidism, with no characteristic signs.
Manifest (compensated and decompensated) course, with prominent symptoms.
Severe forms, complicated by pituitary adenoma, heart failure, or accumulation of fluid in body cavities.
Causes of the Disease
In most cases, hypothyroidism is associated with autoimmune diseases, in particular thyroiditis. Antibodies that normally protect the body begin to attack healthy cells and tissues, often targeting the thyroid gland. In response, the pituitary gland sends numerous regulatory hormones to the ovaries, endocrine organs, and the thyroid. As a result, antibodies progressively damage the gland, decreasing hormone production. To compensate, the gland enlarges.
Other causes include:
Thyroid surgery,
Treatment with radioactive iodine, antithyroid drugs, irradiation of the neck and head,
Smoking,
Heredity,
Medications (iodine-containing drugs and radiocontrast agents, salicylates, steroids, heparin, high-dose furosemide).
Symptoms of Hypothyroidism
The thyroid gland is one of the key "control centers" of the human body, yet it is highly vulnerable. With age, the risk of hypothyroidism increases. Its manifestations are nonspecific, therefore careful monitoring of one’s condition is essential.
Possible symptoms include:
Hair problems. Hypothyroidism often leads to hair loss, thinning of eyelashes, and loss of the outer third of the eyebrows. Hair becomes dry, brittle, and grows slowly.
Skin changes. The skin may acquire a greenish-earthy hue, feeling dense, dry, and loose due to iron-deficiency anemia and impaired blood supply.
Cold intolerance. Patients constantly feel cold, even in warm weather.
Chronic constipation. Inability to empty the bowel for 3–4 days is a warning sign.
Edema. Swelling may occur, particularly facial edema in the morning.
Dry skin, especially on heels. Frequent need for pedicure and appearance of cracks.
Rapid weight gain. Unexplained accumulation of extra kilograms, despite lifestyle efforts.
Apathy and depression. Persistent fatigue, negative thoughts, lack of energy despite sleep.
Menstrual irregularities. Caused by hormonal imbalance.
Joint and muscle pain. Lower calcium levels cause increased fragility of joints.
Hypercholesterolemia. Thyroid dysfunction disrupts lipid metabolism.
Possible Complications
Body weight increases, weakness, drowsiness, cold intolerance, slow thinking, and speech disturbances appear. In women, menstrual disorders are common. Severe iodine deficiency may result in myxedema (mucous edema).
Fluid may accumulate in the pericardium and pleural cavity, impairing breathing and cardiac activity.
Hypercholesterolemia may lead to coronary artery disease (CAD), ischemic stroke, myocardial infarction, and cerebral atherosclerosis.
Congenital hypothyroidism in children may cause oligophrenia or cretinism, as well as delayed physical and sexual development and reduced immunity. In pregnant women, hypothyroidism increases the risk of congenital heart defects and other fetal malformations.
Other complications include male and female infertility, sexual dysfunction, reduced immunity, autoimmune disorders, and cancer.
The most dangerous complication is hypothyroid coma (mortality ~80%), occurring mainly in elderly patients with untreated hypothyroidism, often triggered by infections, hypothermia, or trauma. It is characterized by CNS depression, bradycardia, hypotension, hypothermia, edema, and intestinal obstruction.
Diagnosis
Diagnosis of hypothyroidism is difficult because symptoms are nonspecific and may mimic other diseases. After endocrinology consultation, laboratory tests are required:
TSH (often elevated),
T3 and T4 (low or normal),
Antibodies to thyroid tissue (to determine cause and need for long-term hormone replacement),
Serum iron levels (to detect anemia).
Thyroid hormones are protein-based; insufficient dietary protein impairs their synthesis. They also require iodine, measurable with specific testing.
Hypothyroidism also impairs conversion of beta-carotene into vitamin A. Yellowish discoloration of palms and soles may indicate deficiency, confirmable by analysis.
Ultrasound provides information on thyroid volume, structure, and possible nodules. Additional studies may include ECG, abdominal ultrasound, chest X-ray, and pulmonary function tests, especially in suspected complicated cases.
Treatment and Prevention
Prevention includes a balanced diet and iodine-rich foods. Early diagnosis and timely therapy are crucial.
Treatment in men and women is based on hormone replacement therapy. Dosage is individualized under endocrinologist supervision.
If hypothyroidism is secondary to another disease, the primary condition is treated. Iodine deficiency requires iodine preparations and a seafood-rich diet. If drug-induced, discontinuation of the medication resolves symptoms.
Treatment of Hypothyroidism at Expert Clinics
With age, prevalence of hypothyroidism increases (especially in women), occurring twice as often as in young people. In the elderly, diagnosis is complicated by mild symptoms resembling normal aging.
Therefore, only a comprehensive evaluation of all parameters affecting thyroid function allows physicians at Expert Clinics to develop the correct therapeutic strategy for hypothyroidism. Recovery is gradual. The main criterion for adequacy of treatment is the disappearance of clinical and laboratory manifestations. The treatment goal is normalization of TSH levels.
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