How To Tackle With Hypothyroidism in Adults
29 February 2008What is this Condition?
In this disorder, thyroid hormone levels in the blood are too low because of a problem in the pituitary gland, thyroid gland, or hypothalamus (a crucial brain structure that governs many body functions). Hypothyroidism is most common in women. In the United States, the incidence is rising significantly in people ages 40 to 50.
What Causes it?
Hypothyroidism in adults is caused by inadequate production of thyroid hormone. Usually, this stems from thyroid gland dysfunction resulting from surgery (thyroidectomy), radiation therapy (particularly with radioactive iodine), inflammation, or chronic autoimmune thyroiditis (also called Hashimoto’s disease). Hypothyroidism may also occur if the pituitary gland fails to produce thyroid-stimulating hormone or if the hypothalamus fails to produce thyrotropin-releasing hormone.
Other causes include congenital errors of thyroid hormone synthesis, iodine deficiency (usually dietary), or use of antithyroid medications such as propylthiouracil (PTU).
What are its Symptoms?
Early symptoms of hypothyroidism are typically vague and include fatigue, forgetfulness, sensitivity to cold, unexplained weight gain, and constipation. Eventually, the person may experience mentally instability; dry, flaky, inelastic skin; puffY face, hands, and feet; hoarseness; swelling around the eyes; drooping eyelids; dry, sparse hair; and thick, brittle nails.
Other common symptoms include appetite loss, a swollen abdomen, abnormally heavy or long menstrual periods, decreased sex drive, infertility, impaired coordination, tremors, and involuntary rhythmic movements of the eyes.
Myxedema Coma
In people with hypothyroidism, infection, exposure to cold, and use of sedatives may trigger myxedema coma. This life-threatening emergency compromises many body systems. Myxedema coma usually develops gradually, but it may arise suddenly if stress aggravates severe or prolonged hypothyroidism. Without prompt treatment, myxedema coma can lead to shock and death.
Symptoms of myxedema coma include stupor, abnormally slow and shallow breathing, low levels of sodium and sugar in the blood, low blood pressure, and a reduced body temperature.
How is it Diagnosed?
Radioimmunoassay, a highly sensitive lab test, confirms hypothyroidism by showing low levels of the thyroid hormones triiodothyronine and thyroxine. Other lab findings that support this diagnosis include an increased level of thyroid-stimulating hormone when hypothyroidism is due to thyroid insufficiency; a decreased thyroidÂÂstimulating hormone level when hypothyroidism is due to hypothalamic or pituitary insufficiency; and elevated blood cholesterol and triglyceride levels.
How is it Treated?
The person with hypothyroidism receives gradual thyroid hormone replacement with Levoxine and, occasionally, Cytomel.
A person with myxedema coma receives treatment to support vital functions while restoring normal thyroid function. To support blood pressure and increase the pulse rate, Levoxine and hydrocortisone are given intravenously. To restore normal breathing, the person receives supplemental oxygen and respiratory support. Other supportive measures include fluid replacement and antibiotics for infection.
Tagged under:decreased sex drive, Hormones And Gland Disorders, Hormons And Gland Disorders, hypothalamus, symptoms of hypothyroidism, thyroid hormone levels, thyroid hormone synthesis thyroid stimulating hormone
