Hypothyroidism - hypothyroidism

Hypothyroidism: symptoms, causes and treatment

The symptoms of hyperthyroidism (hypothyroidism) are often relatively nonspecific and sufferers often suffer for quite a while, before the suspicion of a disorder of thyroid function falls. Apparently baseless fatigue, low resilience, poor performance, impaired skin or mental problems may be related to hypothyroidism.

contents

• Hypothyroidism: symptoms, causes and treatment
• definition
• Symptoms of hypothyroidism
• Congenital hypothyroidism
• Acquired hypothyroidism
• Causes: Primary and secondary hypothyroidism
• diagnosis
• Treatment of hypothyroidism
• Naturopathy

definition

Thyroid hypofunction is characterized by a decreased or absent formation of hormones by the thyroid gland. Here it is distinguished between innate and acquired forms of the disease. In addition, based on the causes of a division into primary (cause directly in the thyroid gland) and secondary hypothyroidism (cause outside the thyroid gland) take place.

Thyroid hypofunction is a relatively widespread symptom of symptoms, although external changes in the form of a goiter are regarded as a typical sign, but are observed only in a small proportion of those affected. (Image: Gabriel Blaj / fotolia.com)

Symptoms of hypothyroidism

The hypofunction is less common than the hyperthyroidism (hyperthyroidism), but it is still not uncommon. Women are more likely to be affected than men, with the age at diagnosis usually being between 40 and 50 years for acquired forms of the disease. The possible complaints often differ significantly in the congenital and acquired forms of the disease. In the case of the former, massive developmental disorders may be threatened, while the acquired form is usually more likely to be associated with complaints such as poor performance or mental health problems. In both cases, however, a so-called myxedema coma, which is potentially fatal, threatens at worst. A more detailed description of the respective symptoms is given in the context of the information on the acquired and congenital forms of the disease.

Disorders of the thyroid function can have far-reaching consequences, with a hypofunction associated with, for example, fatigue, changes in the appearance of the skin and poor performance. (Image: bilderzwerg / fotolia.com)

Congenital hypothyroidism

The thyroid is butterfly-shaped in the cervical region and its main task is the formation and delivery of the thyroid hormones T3 (triiodothyronine) and T4 (L-thyroxine), which have a fundamental influence on growth and development (of brain and bone), the total metabolism, the oxygen consumption, heat production, nutrient metabolism, heart activity and much more. The thyroid gland needs iodine for hormone production.

Congenital hypothyroidism (cretinism) is caused by iodine deficiency of the mother or the fetus in pregnancy, a defect in hormone production (enzymopathy), the absence or malformation of the thyroid gland. Their consequences are sometimes dramatic. It threatens developmental deficits in terms of body growth, bone and maturity to mental and physical retardation. The affected infants are described as striking "drinking lazy" and movement-poor and also suffer from constipation.

An early diagnosis by the legally prescribed newborn screening in the first days of life serves the immediate medical adjustment of infants and decides on the further course of development. The drugs are needed for life, in contrast to the nerve and brain maturation, the body growth can be compensated later.

Acquired hypothyroidism

Acquired hypothyroidism manifests itself in a general slowing of physical and mental processes and rhythms: despite a reduced appetite, an increase in body weight may occur, constipation, a slowed heartbeat (bradycardia), increased hypersensitivity and a disturbed menstrual cycle. External signs include cool, dry skin (myxedema), eyelid edema, a hoarse, deep voice, and brittle, shaggy hair. The development of a so-called goiter on the neck, which is often considered to be typical of thyroid disease, may occur as well but is often absent.

The general inefficiency, which often comes along with depressive moods and lack of drive, is often misunderstood as depression or (in older people) as a symptom of old age. However, it can also be triggered drastic mental disorders to delusions by the hypothyroidism.

Causes: Primary and secondary hypothyroidism

According to their cause, the primary is distinguished from the secondary hypothyroidism.
In the primary form, the cause is the thyroid itself, e.g. as a result of inflammation of the thyroid gland (thyroiditis, especially Hashimoto's thyroiditis), after thyroid surgery or radiotherapy (radioiodine therapy). In secondary hypothyroidism, another member in the hormonal regulatory circuit is disrupted, which is upstream of the thyroid gland. If the pituitary gland is impaired in function (e.g., pituitary anterior lobe insufficiency), the thyroid receives no signal to produce and deliver its hormones. In addition to the pituitary gland, the hypothalamus can also be affected. In addition, hypothyroidism may be due to iodine deficiency.

Naturally, the cause is also heavy metal pollution, e.g. after amalgam removal and improper drainage, build-up of tension by different metal alloys in the mouth, chronic infections (for example with Eppstein-Barr virus, herpesviruses, Yersinia) or certain vaccines.

An ultrasound examination can provide information about the extent of thyroid changes. (Image: Alterfalter / fotolia.com)

diagnosis

Primary hypothyroidism is already diagnosed in many neonatal child screening programs. The diagnosis is often more difficult with acquired hypothyroidism, as unspecific symptoms such as poor performance or tiredness are not necessarily associated with a disturbance of thyroid function. If hypothyroidism is suspected, it can easily be checked by a blood test. The concentration of thyroid hormones, certain antibodies and other biomarkers are reliable indications of a disorder of thyroid function.

The extent of possible changes in the thyroid gland can be checked by imaging techniques such as ultrasound or scintigraphy and, if necessary, the removal of a tissue sample (biopsy) is also possible to determine the nature of the tissue changes.

Treatment of hypothyroidism

The therapy of hypothyroidism depends on its cause, the primary form is with a z.T. lifelong hormone supplement, which must be monitored by a doctor. Failure or inadequate treatment may lead to myxedema. In addition to increased symptoms of hypothyroidism, there are disorders of consciousness, seizures, hypothermia, respiratory disorders and electrolyte imbalance, which make immediate hospitalization absolutely necessary!

Naturopathy

Supportive or with mild thyroid hypofunction may naturopathic, e. be treated with a nutritional therapy, especially the regulation of the iodine balance is in the foreground. In addition to the consumption of iodine-rich foods is a waiver of certain foods (especially cabbage) advised that lead to an inhibition of iodine intake. Detoxification, purging and homeopathic remedies are also often used to treat hypothyroidism. (jvs, fp; updated 26.09.2016)
Specialist supervision: Barbara Schindewolf-Lensch (doctor)