Reduced thyroid function is detected in many people. Often the lack of thyroid hormone is prolonged and invisibly, without the expressed clinical manifestations. This facilitates occurrence of complications, especially of the central nervous system.

Why can develop a lack of thyroid hormones

The lack of thyroid hormones (hypothyroidism) develops for a variety of reasons. As is known, the regulation of thyroid function is done by the hypothalamus of the brain and primary pituitary endocrine gland. Therefore, the reduction in thyroid function can occur not only when the disease of the body itself, but also in various diseases governing its systems.

In connection with this, divided into primary hypothyroidism (associated with thyroid disease), secondary (associated with the disease and a decrease in the secretion of pituitary TSH), and tertiary (associated with the disease hypothalamus). In addition, hypothyroidism are caused due to lower cell receptor sensitivity of tissues to the action of the thyroid hormones (thyroid hormone).

Primary hypothyroidism is divided into congenital and acquired. Congenital hypothyroidism associated with underdevelopment (and sometimes complete lack of) of the thyroid gland, as well as with an inherited defect of enzymes necessary for the synthesis of thyroid hormones. Acquired forms of primary hypothyroidism develops after removal of the thyroid gland (e.g., cancer) after exposure to radiation (from the environment or in the treatment of cancer), the use of certain medications (drugs lithium glucocorticoid hormones overdose of vitamin A), in tumors of the thyroid gland, lack of iodine in the environment.

Secondary hypothyroidism occur against decrease of pituitary thyroid stimulating hormone (TSH), which regulates the thyroid gland. TSH stimulates the secretion of thyroid hormone Thyroid hormones: mechanism of action and physiological effects   and its lack gland function decreases. Such changes occur for tumors, inflammations and hemorrhages in the pituitary gland. In addition, it inhibits the formation of TSH drugs such as reserpine, apomorphine, tsiklodol and others.

Tertiary hypothyroidism occur when there is insufficient secretion of hormones of the hypothalamus. Hypothyroidism occurs on a background of tumor diseases and hemorrhages in the hypothalamus.

What are the symptoms of hypothyroidism

Hypothyroidism is primarily manifested reduction of metabolic processes in the body, so can be affected any organs and tissues. Slows carbohydrate metabolism and glucose uptake in tissue cells, which leads to a reduction in the energy required for other exchanges. In this regard, the decay in protein metabolism prevails over the synthesis and metabolism of fat extends incorrect, resulting in a lot of toxic products that contribute to the formation of atherosclerosis.

Onset of the disease is always discreet, that is why hypothyroidism and related disorders are often detected only in the later stages. And in the beginning there is a weakness, lethargy, apathy, depression Depression - a little more than a bad mood . The patient is constantly freezing, it is half asleep, his movements slow. It appears dryness and flaking of the skin, loss of eyelashes, eyebrows and hair, heavy swelling under the skin, increases weight, heart rate becoming rare.

The next stage is memory impairment, muscle cramps, increase in depression. Formed a characteristic appearance of the patient: a person sedentary, swelling, reduced facial expression, slow speech, sallow skin, eyelashes and eyebrows almost there. There are loss of appetite, persistent nausea, bloating, and constipation.

Reduced thyroid function also leads to the progression of chronic diseases, including diseases of the cardiovascular system, the formation of cardiovascular disease, malfunction of liver and kidney failure, loss of vision and hearing.

Diagnosis and treatment of hypothyroidism

The diagnosis of hypothyroidism can be set by a blood test for hormones. After that, find out the causes of hypothyroidism: examine all relevant bodies: the thyroid, pituitary and hypothalamus.

Treatment of hypothyroidism is reduced to substitution therapy and symptomatic treatment. Whenever possible, try and eliminate the cause of the disease (eg, pituitary tumor).

Substitution therapy is drugs containing thyroid hormones. Most often appointed by a L-thyroxine Thyroxine - the main thyroid hormone . First appointed by a small dose of the drug, and then, as the body gets used to speed up metabolism, the dose is increased, and is individually controlled by the levels of hormones in the blood. Appointed as drugs that reduce cholesterol in the blood, antioxidants Antioxidants: the truth about the notorious benefits   (vitamins E and C), hepatoprotectors (phosphogliv, Essentiale).

With hypothyroidism easier to handle in the early stages of the disease.

Galina Romanenko

The term "non-toxic goiter" refers to an increase in thyroid Increase in thyroid - that underlies the disease It is not associated with excessive production of thyroid hormones and the development of malignant tumors. Under the influence of certain factors thyroid can increase in size, which leads to the formation of the crop - visible tumor in the region of the gland.

Among the most likely causes of goiter include iodine deficiency in the diet, and disruption of the pituitary gland, which leads to an excess of thyroid-stimulating hormone. Typically, goiter formation occurs slowly and gradually, sometimes for several years.

Although in theory the formation of goiter is not dangerous to human health, in most cases, we recommend removal of the crop, which is growing, can pinch the trachea and obstruct breathing and swallowing. Characteristic for goiter symptoms - shortness of breath, cough, feeling short of breath and "clogged" the throat. The only way to remove the symptoms in these cases - removal of goiter surgically.

Thyroid Goiter treated only after a preliminary examination. Treatment in this case is selected for each patient individually on the basis of the survey results. If the crop is growing and it is expected that after a while begins to compress the surrounding organs, tissues, blood vessels and nerves, then it is removed surgically.

Basic principles of treatment of thyroid goiter

Thyroid goiter may be different. Treatment depends on the established diagnosis, the functional activity of the thyroid, goiter and growth opportunities squeezing their tissues, as well as the possibility of its transformation into a malignant tumor.

Thus, treatment of simple nontoxic goiter may differ significantly from the treatment of toxic goiter and diffukznogo of multinodular goiter, autonomous units which produce thyroid hormones.

In the early stage of the crop, with smaller sizes, recommended treatment with a synthetic form of thyroid hormone Thyroid hormones: mechanism of action and physiological effects . Under the influence of such drugs pituitary synthesizes less thyroid-stimulating hormone, so the size of the thyroid gland to normal. Such treatment often leads to a marked reduction in goiter, but helps to prevent further increase. If hormone replacement medications do not work, the only way out is the removal of goiter surgically.

Surgical removal of the crop is necessary in the case where the growth of the thyroid gland leads to the appearance of unpleasant symptoms - crop presses on the trachea, causing coughing, voice changes, difficulty breathing and swallowing. In the most dangerous cases, increased in size thyroid can pinch blood vessels in the neck.

Another indication for surgical removal of the crop - a suspicion of malignancy. Such cases are associated with the formation of multinodular goiter, in which only one node can be malignant. Since the risk of malignancy in multinodular goiter is less than five per cent, for most patients, surgical removal of the crop in connection with suspected cancer is not justified.

Finally, one of the rare causes goiter surgically remove - aesthetic unattractiveness. Often the crop is growing so much that it can be seen with the naked eye. In such cases usually recommended or surgically removing the crop or craw drug treatment to prevent further enlargement.

Treatment of a simple non-toxic (sporadic) goiter

Simple nontoxic goiter develops when there is insufficient absorption of iodine by the body of the patient. In many ways, his treatment depends on the diet. As part of the patient's diet should contain enough protein. From the diet should be excluded goitrogenic (strumogennye) food products, which block the absorption of iodine by the thyroid gland. These products include some varieties of cabbage (for example, cauliflower), turnips, rutabaga, turnips, soy, beans, radish, radishes Radish: useful properties and rules of use Peanuts.

Held as replacement thyroid hormone therapy (for example, L-thyroxine), the dose of which is selected for each patient individually, focusing on his condition and laboratory values ​​of hormones in blood. The normal dosage of hormones corresponds to a constant weight, normal pulse and blood pressure, normal hormone levels in the blood, the tendency to reduce the size of the thyroid gland.

If conservative treatment does not work, the thyroid gland increases in volume, compresses the surrounding organs and tissues, the crop is removed. Surgical treatment is carried out in the event that there is suspicion of degeneration of the crop into a malignant tumor.

Treatment of diffuse toxic goiter

Graves' disease develops when the thyroid gland produces much thyroid hormones, which are toxic to all tissues and organs.

Treatment usually begins with the application of thyreostatics. The most effective derivatives of thiouracil (methyluracil) and imidazole (Mercazolilum). These drugs accumulate in the thyroid gland and inhibit the synthesis of its hormones by inhibiting the enzymes involved in their formation. These medications are also prescribed to the surgical treatment of diffuse toxic goiter to eliminate the symptoms of hyperthyroidism, against which the operation could give many complications. After elimination of hyperthyroidism drugs reduce the dose, and in those cases where the long-term antithyroid therapy is elected by an independent method of treatment, gradually moving to the supporting doses. Welcome sign, indicates the possibility of recovery is to reduce the size of the crop.

If conservative treatment is ineffective or it is not promising at the beginning, then it is the surgical removal of the thyroid gland with subsequent lifelong replacement therapy with thyroid hormones. To eliminate the recurrence of the disease gland completely removed.

Instead of surgery is frequently used treatment with radioactive iodine (131 - iodine). This is a simple and effective method that leads to the same results as surgery. Thus radioactive iodine accumulates in the thyroid gland and decomposed with formation of beta particles, which destroy the cells of the thyroid gland. Complete destruction of the thyroid gland develops in about half a year after the procedure. Contraindications for treatment with radioactive iodine are pregnancy and breast-feeding Breastfeeding - a personal choice   feeding. Positive quality treatment with radioactive iodine are high efficiency in reducing the volume of the crop. So even after a single injection of radioactive iodine goiter size is reduced by one third or half.

Radioactive iodine is also used for the treatment of autonomous operating units multisite goiter when the patient is gradually formed in the thyroid gland actively operating components and appear pronounced signs of hyperthyroidism.

Treatment of thyroid goiter conducted strictly individual and depends on the results of the survey.