Image source:Hypothyroidism (Thyroid gland)
Definition:-Hypothyroidism is the inability of the thyroid gland to supply sufficient thyroid hormone. Mild, clinically insignificant can’t forms cause varying degrees of hypothyroidism that are extreme for life.
Signs and symptoms:-
Initial clinical features are somewhat unclear:
∗sensitivity to cold
∗unexplained weight gain, and constipation.
Progressively, distinct features of myxedema emerge:
∗Slow speech and thought Hoarseness
∗Puff y face ,hands, and feet
The risk factor:-
∗Although anyone can develop hypothyroidism, if you are at a risk:
∗Mainly in woman
∗Aging more than 60 years
∗Have a family history of thyroid disease
∗Autoimmune disease, such as type 1 diabetes or celiac disease
∗Have been treated with radioactive iodine or anti-thyroid drugs
∗Your neck or upper chest received radiation
∗Have had thyroid surgery
Hashimoto thyroiditis:- a chronic lymphocytic thyroiditis, is considered an autoimmune complaint.
Treatment of hyperthyroidism:- for example, radioactive iodine treatment, subtotals thyroidectomy, or administration of anti-thyroid agents
Surgical excision:- of thyroid gland
Goiter:- (enlargement of thyroid gland) Endomic goiter results from insufficient intake of dietary iodine. This common with iodine deficient soil and in areas of endemic malnutrition.
Sporadic goiter:- may follow ingestion of certain drugs or progatrin-containing foods (L-5-vinyl-2 thiosazolidone), which are inactive and converted to goitrin by hydrolysis.
»Inhibition of iodine in the iodine of goitron inhibits the binding of iodide to oxidized thyroglobulin, thereby reducing the production of thyroid hormone.
»Probutrin has been isolated in cabbage, bananas, peanuts, Brussels sprouts, mustard, rutabaga, kohlrabi, spinach, cauliflower and horseradish.
»Goitrogenic drugs include propilotrasil (PTU), iodides, amiodarone, and lithium.
Less common causes: – This includes acute (usually painful) and sub-acute thyroiditis, nodules, nodular goiter and thyroid cancer.
Amiodarone: – Its high iodine content can cause thyroid dysfunction (both hypothyroidism and hyperthyroidism) along with the effects of internal medication.
»This has direct toxic effects on T3 production, T3 receptor binding, and thyroid follicular cells.
»The iodine content of amiodarone has a direct toxic on the thyroid, and can cause both hypothyroidism and hyperthyroidism depending on other underlying disease conditions.
(> 90% cases of hypothyroidism) Gland destruction or dysfunction caused by disease or medical treatment
»Failure of gland development or congenital disability.
Secondary hypothyroidism: –
»Result of a pituitary disorder that inhibits TSH secretion. The thyroid gland is normal but lacks proper stimulation by TSH.
Tertiary hypothyroidism: –
»Refers to a condition in which the pituitary – thyroid axis remains intact, but the hypothalamus lacks the ability to stimulate the pituitary for TRH.
Subclinical hypothyroidism: –
»Refers to patients without clinical symptoms, a normal FT4, and elevated TSH levels. Currently, there is insufficient evidence to support treatment as non-treatment outcomes are minimal. However, pregnant women with subclinical hypothyroidism may benefit from T4 replacement.
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