Description
Hypothyroidism is a condition where there isn’t enough thyroid hormone in your bloodstream and your metabolism slows down.It happens when your thyroid doesn’t create and release enough thyroid hormone into your body. This makes your metabolism slow down, affecting your entire body. Also known as underactive thyroid disease, hypothyroidism is fairly common.
When your thyroid levels are extremely low, this is called myxedema. A very serious condition, myxedema can cause serious symptoms, including:
A low body temperature.
Anemia.
Heart failure.
Confusion.
Coma.
This severe type of hypothyroidism is life-threatening.
In general, hypothyroidism is a very treatable condition. It can be controlled with regular medications and follow-up appointments with your healthcare provider.
Congenital anomalies are one of the main causes of the global burden of disease, and low- and middle-income countries are disproportionately affected. These areas are also less likely to have facilities to treat reversible conditions such as clubfoot, leading to more pronounced and long-lasting effects.
Summary Listen
- The thyroid is a butterfly-shaped gland in the neck that regulates the body's metabolism, acting like an engine. Thyroid disorders are common, with hypothyroidism being more prevalent than hyperthyroidism. Diagnosis relies on both clinical assessment and laboratory testing. Iodine is crucial for thyroid hormone production, primarily obtained through iodized salt.
- Anatomy and physiology review emphasizes the follicle structure, the importance of iodine in T3 and T4 production, and the pituitary gland's role in regulating thyroid hormone release via TSH. The hypothalamus-pituitary-thyroid axis, a feedback mechanism, maintains hormonal balance. T3 and T4, the primary thyroid hormones, are mostly protein-bound in the bloodstream, with the free hormone fraction being biologically active.
- Hypothyroidism and hyperthyroidism have contrasting symptoms, although some can overlap, necessitating careful history taking and physical examination. Key history-taking points include neck swelling, voice changes, growth impairments in children, drug usage, radiation exposure, and family history of autoimmune diseases. Physical examinations include looking for edema, skin changes, heart rate abnormalities, and reflex delays.
- Laboratory testing includes TSH, free T4, and T3. TSH is the most sensitive first-line screening test. The timing of the TSH test isn't critical, but morning is preferred. TSH normal ranges vary with age, especially in infants and during pregnancy. Treatment of hypothyroidism is mainly based on levothyroxine.
- Subclinical hypothyroidism, characterized by elevated TSH and normal T4, may not always require treatment, depending on symptom severity and age. Anti-TPO antibody testing can help predict progression to overt hypothyroidism. Treatment with levothyroxine should be individualized and monitored regularly with TSH testing adjustments every 4-6 weeks.
- Non-compliance, interference with absorption, and issues with drug potency can affect treatment outcomes. Hypothyroidism is more common in women and diabetics, and it can worsen insulin resistance and lipid profiles. Special considerations apply during pregnancy, where hypothyroidism can lead to adverse outcomes for both mother and child, necessitating strict TSH control. Postpartum thyroiditis requires careful monitoring and treatment as needed.
Sample Certificate
About the Speakers
Dr .Sujata Chakravarti
Consultant Family Physician and Principal Medical Officer - General Medicine - Fortis Healthcare
Comments
Comments
You must be logged in to leave a comment.