All you wanted to know about primary hypothyroidism

Primary hypothyroidism is a disease of the thyroid gland, in which iron begins to reduce the production of thyroid hormones( thyroxine and triiodothyronine).These hormones participate in metabolic processes, increase oxygen consumption in tissues, and play an important role in the processes of growth and development of children. Without appropriate treatment in adults, a complication such as myxedema can develop, and in children a pathology of mental development or cretinism develops.

Causes of primary hypothyroidism

In recent years, the number of people infected with primary hypothyroidism has been growing steadily, and many researchers associate this process with the deterioration of the ecological situation and a decrease in immunity in patients. In addition to primary hypothyroidism, there is a secondary form of it, when a failure in the system causes pathological processes in the hypothalamic-pituitary system.

It is proved that the primary hypothyroidism occurs due to the following reasons:

• Harmful effect of aggressive factors( damage to the gland tissue).
• Prolonged intake of certain groups of medicines( vitamin A, lithium preparations, adrenal hormones and others).
• Iodine deficiency in the body, which leads to inadequate production of hormones.
• Inflammatory diseases of the gland tissue.
• Complete or partial removal of the thyroid gland.
• The heredity factor and genetic predisposition.
• Irrational nutrition.
• Treatment in which radioactive iodine is used.
• Atrophy or hypoplasia of the thyroid gland.

In some cases, the causes of primary hypothyroidism remain unclear, then they speak of a form of the disease, such as idiopathic hypothyroidism.

Symptoms of the disease

Nevertheless, when examining women over the age of 65 years, signs of this disease can be found in every tenth woman. In those cases when the symptoms of the disease are poorly expressed or not expressed at all, and when a diagnosis is established, they speak of a disease such as primary subclinical hypothyroidism.

The clinical picture of the disease is characterized by the fact that the symptoms for a long period of time may not appear or patients do not notice them, writing off them for the consequence of physical and emotional overload.

If all symptoms of hypothyroidism are pronounced, then they speak about the manifest form of the disease. In the case of primary hypothyroidism, the symptoms are the following:

• Drowsiness, chronic fatigue syndrome, lethargy.
• Decreased memory, forgetfulness, decreased active mental activity.
• Decreased concentration of attention.
• Irritability, nervousness and fatigue.
• Deterioration of well-being when a season of heat or sharp cold comes.
• Laxity, pallor and dry skin.
• Hair loss and increased brittle nails.
• Appearance of muscle pain and muscle strength reduction.
• Appearance of edema of unknown origin. Edema in hypothyroidism is characterized by a uniform distribution throughout the body and the absence of pits with pressure.
• Unexplained weight gain.
• Chronic constipation, gassing in the intestines, decreased appetite.
• Decreased potency and sexual activity in men.
• Early menopause or menstrual irregularity in women.
• Secondary or primary infertility.
• Slow growth in children in adolescence.
• Pain in the heart, rhythm disturbance, shortness of breath.
• Reduction of pulse, narrowing of the gap between the parameters of systolic( upper) and diastolic( lower) pressure.
• Anemia of unknown etiology.

The diagnosis is made on the basis of examination, complaints from the patient, examination data and clinical analyzes.

Treatment and therapy

At the appearance of the first signs of the disease, it is necessary to immediately see a doctor, undergo a clinical examination and, if necessary, take a course of treatment. Diseases of the endocrine gland is handled by an endocrinologist. When setting the diagnosis of hypothyroidism, the primary treatment is reduced mainly to the reception of thyroid hormones. In this case, this therapy is called a substitution therapy.

It is very important to establish the cause of the disease and eliminate it in time. This will help reduce the risk of complications and the emergence of many symptoms of the disease. However, etiological treatment( treatment of the underlying causes) in most cases does not give a proper result, so thyroid preparations and iodine preparations are used in hypothyroidism.

The following medicines are used for treatment:

• Thyreoidin is a preparation that is a hood of the thyroid glands of cattle. Produced in tablets in a dose of 0.05 and 0, 1 d. The content of iodine in them can be 0.1-0.23%.
• L-thyroxine( eutiroks) - a synthetic analogue of the hormone of thyroxine. Produced in tablets, dosage of 50-100 mcg. The therapeutic effect comes in 24-48 hours after the beginning of admission. This drug is prescribed mainly to patients with cardiovascular diseases, since it does not have a negative cardiogenic effect.
• Triiodothyronine is a synthetic analogue of a similar hormone of the thyroid gland. Produced in tablets, the dosage is 20-50 μg. In comparison with thyroxine, the effect produces only 4-6 hours after the beginning of the admission. This drug has biological activity, 5-10 times higher than the activity of thyroxin.

Principles of primary hypothyroidism treatment are as follows:

1. Drugs containing thyroid hormones are taken by the patients for life.
2. Selection of medicines should be performed only by an endocrinologist, who takes into account the patient's condition, age and severity of the disease. Also, the doctor takes into account the concomitant diseases and the compatibility of substitution therapy with other medications.
3. If the patient is an elderly patient, then the dosage of thyroid hormones begins with minimal doses, and the increase in the number of drugs occurs only under the control of the general condition and ECG data.
4. An increase in the dose of hormones occurs only under the supervision of a doctor and after receiving a positive result from small dosages of medications.
5. According to the indications, it is possible to carry out combined therapy, using more than one drug of substitution therapy.