Postoperative hypothyroidism and the consequences of surgical treatment
As a result of a decrease in the production of thyroid hormones, a disease occurs such as hypothyroidism, which is characterized by symptoms from many organs and systems. In some cases, patients undergo surgical removal of the thyroid( thyroidectomy), after which a persistent life-long diagnosis of postoperative hypothyroidism develops.
In what cases is the thyroid removed?
The decision to make a resection of the thyroid gland or completely remove it is given to surgeons for a reason. The doctor who offers this method of treatment is guided, first of all, by an analysis of the cytological examination of thyroid tissue.
The main reason for removal are such analysis answers as papillary carcinoma, anaplastic carcinoma or a follicular tumor. This means that the thyroid gland develops a tumor process that can threaten the life of the patient.
There are also cases of compression of the neck( with trauma), large goiter that occur with diffuse-toxic goiter, and also with toxic adenoma, when the tumor is benign, but causes a syndrome of intoxication of the whole organism.
Of course, the doctor faces the task of postoperative management of patients and substitution therapy with the help of thyroid hormone analogs.
disease manifests After surgery, all the signs that are characteristic of hypothyroidism gradually increase and differ in great variety. Often problems with diagnosis arise due to the appearance of several syndromes at the same time. In view of the fact that the clinical manifestations of the disease are manifold, the diagnosis of hypothyroidism after removal of the thyroid gland is difficult.
Syndromes arising after removal of the thyroid gland, are as follows:
- Syndrome of metabolic disorders and thermoregulation mechanisms - there is an increase in weight, down to obesity, and a drop in body temperature. These processes eventually lead to atherosclerosis, impaired vascular wall permeability and to cardiovascular diseases.
- Syndrome of dermatopathy and intradermal disorders - on the face, around the eyes, in the area of the lips, tongue and on the body appear swelling( delay intracellular and intercellular fluid).In this case, the lips are enlarged, and the tongue ceases to fit in the mouth, and the teeth are visible on it.
- The syndrome of impaired vision, taste and hearing - the voice becomes hoarse, breathing through the nose becomes difficult, and taste sensitivity decreases.
- Syndrome of changes from the nervous system - comes drowsiness, lethargy, fatigue, bad mood, irritability, inhibition. Movement in patients is slow and unhurried, and concentration of attention is reduced.
- Cardiac dysfunction syndrome - in these cases they speak of a "myxedematous" heart, which is characterized by jumps in blood pressure, a violation of the rhythm and heart rate.
- Syndrome of damage to the digestive system - manifested as an increase in the liver and spleen, stagnation of bile, decreased enzymatic function and appetite, flatulence and chronic constipation. In severe cases, nausea and vomiting occur.
- Anemic syndrome - in which the amount of hemoglobin is reduced, and blood clotting is impaired.
- Syndrome, which reduces sexual desire( in men) and the menstrual cycle is broken( in women).
- Respiratory syndrome - in which often during sleep there is a violation of the process of inhalation of the air( apnea).Due to the decrease in lung volume, patients complain of frequent inflammatory lung diseases.
Treatment of postoperative hypothyroidism
Postoperative hypothyroidism of the thyroid gland is considered by some surgeons a complication, but many physicians tend to believe that hypothyroidism after surgery becomes the norm of life and its way, rather than a complication. Naturally, it is important for patients to understand the importance of taking medications( thyroid hormone substitutes) throughout the rest of their lives.
In case of a disease, postoperative hypothyroidism is reduced only to replacement therapy with analogues of thyroid hormones. The invention of a drug such as L-thyroxine made the process of taking medications uncomplicated for patients after removal of the gland. In its structure, this drug is not much different from the hormone of thyroxine, produced by man.
The advantages of such therapy are as follows:
- The reception of thyroxine completely restores the function of the thyroid gland.
- Generation of thyroxin by the gland during the day has a constant rhythm, in connection with which a single dose of L-thyroxin at the same time is sufficient.
- The selected dose of the drug rarely changes in quantity, except during pregnancy, changes in body weight and intake of other medications.
- The drug is affordable for most patients.
- The quality of life of patients after surgery does not differ from the rhythm of life before surgery( under the condition of taking the drug).
- The drug has a high percentage of oral bioavailability.
- The effect after admission occurs in 24-48 hours, and the drug itself is in the plasma for 7 days after drug discontinuation. This allows patients to feel satisfactory, even if during the day the patient forgot to take the medicine.
- When analyzing blood for thyroid-stimulating hormone for 2-3 months of continuous intake, the necessary amount for health is observed.
Thus, postoperative hypothyroidism is well adjusted with the help of thyroid-stimulating hormone analogues, which allows patients to completely eliminate all syndromes and symptoms of this disease.