Hypothyroidism is a complex of symptoms that occur as a result of a lack of thyroid hormones. The causes can be both a violation of the function of the thyroid gland, and other diseases – endocrine and metabolic. Therefore, it is clear to answer the question-is hypothyroidism curable? – it is impossible. In this case, a thorough diagnosis is very important. If we can correctly determine the cause of hypothyroidism, we can assume that we are halfway to success. Far from the last role in this case is played by the attitude of a person to their health – the ability to identify alarming symptoms in time and consult a doctor significantly improves the result of treatment. Let’s find out what symptoms hypothyroidism manifests itself, how it is diagnosed and treated.
What is hypothyroidism?
Hypothyroidism is a deficiency of thyroid hormones. The norm of hormones, as well as the values characteristic of hypothyroidism, are shown in the table:
There are subclinical hypothyroidism, in which there are changes in the thyroid gland, but the clinic is not very pronounced, or there are no symptoms at all, and manifest – with a pronounced clinic.
Looking ahead a little, it should be noted that many doctors do not see the point of correcting the problem in the case of subclinical hypothyroidism, even without finding out its cause. Although changes in hormone levels are a reason to worry about your health. The running process will inevitably lead to the appearance of obvious symptoms of hypothyroidism, which can be very difficult to get rid of.
Symptoms of hypothyroidism
Thyroid hormone deficiency manifests itself in a very diverse way. The signs of hypothyroidism are non-specific, that is, very similar to the symptoms of other diseases:
- Weakness, drowsiness, apathy. In the morning, it is very difficult to get up and it is impossible to force yourself to do something. People with hypothyroidism are slow, each movement requires a lot of effort;
- Violation of sleep and wakefulness. Drowsiness during the day, and insomnia at night;
- Puffiness, especially pronounced around the eyes. Puffy face, facial expressions are almost absent;
- Dry skin, brittle nails, dull hair. Many people note hair loss;
- As a result of swelling of the laryngeal ligaments, the voice becomes hoarse;
- Slow and slurred speech due to swelling of the tongue;
- Hearing impairment due to edema of the Eustachian tube;
- Impaired memory, attention, thinking, slow reaction;
- Decrease in systolic blood pressure and increase in diastolic blood pressure;
- Rare pulse, shallow breathing, as a result of weakness of the respiratory muscles;
- Low body temperature, chills;
- Reduced intestinal peristalsis, constipation;
- No sweat;
- Weight gain up to 5-6 kg and at the same time a violation of appetite;
- Difficulty in outflow of bile;
- Pain and muscle cramps;
- Enlargement of the liver;
- Women have menstrual disorders, increased prolactin levels, and infertility;
- Men have erectile dysfunction and decreased libido;
- Children have a slowdown in the growth and renewal of bone tissue.
You don’t necessarily have the whole set of symptoms, but if you have 2-3 of them, it’s better to see a doctor.
Causes of hypothyroidism
There can be many causes of hypothyroidism. Depending on what caused the hormone deficiency, the following types of hypothyroidism are distinguished:
– Primary hypothyroidism develops as a result of a violation of the function of the thyroid gland itself, or after its partial or complete removal. Most often, hypothyroidism is caused by autoimmune thyroiditis and endemic goiter, which develops due to a lack of iodine.
It should be noted that partial removal of the thyroid gland does not always lead to a deficiency of its hormones. It happens that the function of the lost organ is completely performed by the remaining cells.
– Secondary or central hypothyroidism-a consequence of the problems of the main controlling organs of the endocrine system-the pituitary gland and hypothalamus. As a result, the thyroid gland does not receive stimulating signals and slows down its work. This situation occurs as a result of injuries and hemorrhages of the brain, as well as quite rare diseases – tumors of the pituitary gland and hypothalamus.
– Tissue hypothyroidism. You won’t find this definition in most sources. This is due to the fact that science does not stand still, and what literally yesterday did not have a clear explanation, today has already been studied. Otherwise, tissue hypothyroidism is called peripheral. It is caused by a violation of the sensitivity of target organ tissues to thyroid hormones. Let’s take a closer look at this point.
It is necessary to briefly consider the physiology of thyroid hormones in order to understand how tissue hypothyroidism develops. So, T3 (triiodothyronine) is much more active than T4 (thyroxine) and it is synthesized by the thyroid gland in a smaller amount. Both hormones get to the sensitive organs with the blood using special transport proteins. In the tissues, the iodine atom is split off from T4, and it turns into the active form of T3. This process is controlled by the enzyme deiodinase. Normally, some of the thyroxine is converted to active T3, and some to inactive or reversible rT3.
Reversible triiodothyronine (rT3) is needed by our body to protect against excess molecules of active triiodothyronine. After all, as you know, an excess of thyroid hormones is no less harmful than their lack. Connecting to the receptors, it does not allow the active T3 to join. However, it should be noted that the normal amount of gT3 is insignificant.
In the event that the deiodinase enzyme is not enough, more reversible T3 is formed, it blocks the receptors and does not allow the active T3 to work. Thus, in the body, thyroid hormones may be enough, but they can not have their effect.
Increased rT3 levels are not the only cause of hypothyroidism. Fabric hypothyroidism may also be associated with a violation of the transport of hormones and a decrease in the sensitivity of receptors to them. We will not discuss in detail the complex mechanisms of these violations. It will be more useful to find out what causes can lead to tissue hypothyroidism. As it turned out, there are quite a lot of them:
- Conditions that are accompanied by metabolic disorders (fasting) and tissue resistance to insulin (obesity and diabetes mellitus);
People with obesity and type II diabetes almost always have at least subclinical hypothyroidism.
- The defect of trace elements and vitamins necessary for the synthesis of thyroid hormones and the work of enzymes-iodine, selenium, zinc, iron, copper, magnesium, vitamins D, A, B3, B6, B2;
- Chronic anemia, both iron-deficient and B12-deficient;
- Adrenal fatigue syndrome (with chronic stress, for example). Initially, a large amount of the hormone cortisol is produced, and then the resource is depleted and it becomes much less. And then another as provoking hypothyroidism;
- Deficiency of the hormones of happiness-serotonin and dopamine;
- Kidney and liver diseases;
- Alcohol abuse;
- Intoxication, chemical effects, including drugs that inhibit the functioning of the thyroid gland.
People often ask the question – what to do if the thyroid hormones are normal, but there are clear signs of the disease? This situation can often be observed in tissue hypothyroidism. I would like to reassure you, but I can’t. There is still a problem, and we should pay attentionto it .
Diagnosis of hypothyroidism
There are several methods for diagnosing thyroid hormone deficiency.
- Temperature Test
This study is carried out at home, and it will be good if you take temperature measurements before the visit to the doctor and provide the data to the specialist.
The temperature measurement is carried out in the morning, as soon as you wake up. It is advisable not to get out of bed, in order to avoid data distortion. The temperature is measured under the tongue and the data is recorded. If it is below 36.5 within 5 days – this is a reason to suspect hypothyroidism.
With hypothyroidism, the body temperature is consistently low, but this picture is characteristic not only of a deficiency of thyroid hormones. When the adrenal glands are depleted, hypothermia will also be present, with the only difference that it is unstable. For example, yesterday it was 35.9, today it is 36.4, and tomorrow it is 36.1. As we already know, the depletion of the adrenal glands leads to hypothyroidism. Therefore, a jagged temperature graph may indicate that there is a problem with the adrenal glands and thyroid hormones at the sametime .
- Ultrasound of the thyroid gland
Ultrasound of the thyroid gland can show both changes in the organ (increase in size, nodes, etc.), and a normal picture. This study helps to find out whether the thyroid gland is the cause of hypothyroidism or not.
- Blood test for thyroid hormones and TSH
The level of thyroid hormones allows you to determine the very fact of the presence or absence of hypothyroidism. The level of TSH (thyroid-stimulating hormone) will show the presence of abnormalities in the regulation of thyroid function by the pituitary gland and hypothalamus. With a lack of hormones T3 and T4, the body turns on the compensation mechanism — the synthesis of TSH increases in order to stimulate the thyroid gland.
Ultrasound and blood hormones are the basic minimum for confirming hypothyroidism. If there are no organic changes in the thyroid gland, but there are signs of hypothyroidism, they begin to search for the root cause of this condition. To do this, additional tests are taken:
- General blood test
Specify the presence of iron deficiency anemia. To do this, you need to evaluate the number of red blood cells, hemoglobin and color indicator of blood. Iron deficiency anemia is indicated by an increase in reticulocytes (young red blood cells).
- Blood test for trace elements and vitamins
This analysis will help to determine the deficiency of vitamins and trace elements necessary for the synthesis of hormones, the conversion of T4 into T3 and the effect on the cells and the body as a whole. These are iodine, selenium, zinc, iron, copper, magnesium , vitamins D, A, B3, B6, B2.
- Diagnosis of diabetes mellitus, diseases of the kidneys, liver, gallbladder, intestines and other diseases that can cause hypothyroidism.
- Diagnosis of cortisol levels to determine the state of the adrenal glands.
This analysis is not informative enough, because, first, the level of cortisol varies depending on the biorhythms of a person. So, in the “larks” at 8 am, it can be high, and in the “owls” – on the contrary. In addition, at the beginning of the stress that ” torments” the adrenal glands, cortisol can be sky-high, and after a while it decreases to a minimum level. With chronic stress, it is difficult to guess what period the adrenal glands are in. Cortisol at the moment may still be normal, but at the same time there is a depletion of the adrenal glands.
Treatment of hypothyroidism
It would be more correct to say not the treatment of hypothyroidism, but the treatment of the disease that caused it. Although, in practice, most often this is exactly what they do – after seeing the symptoms and confirming their assumption with thyroid hormone tests, they begin to prescribe replacement therapy. Indeed, it is logical – not enough hormones, let’s add them! And what if the thyroid hormones are simply not absorbed by the tissues? And this, by the way, is not a rare case.
Given the variety of causes that can lead to thyroid hormone deficiency, there is no single treatment regimen for this condition. Each case requires an individual approach.
Let’s look at the methods of correction of hypothyroidism:
- Treatment of the underlying disease. Everything is clear here. In primary hyperthyroidism, the endocrinologist decides how to treat the thyroid gland. In case of secondary hyperthyroidism, a consultation with a neurosurgeon is necessary, since it may be an operation. If you have diabetes, then you need to compensate for it, because with high levels of insulin and sugar in the blood, it is impossible to restore the sensitivity of tissues to thyroid hormones.
- Replenishing the deficiency of vitamins and trace elements with the help of drugs or dietary supplements. This is exactly the case when supplements will be appropriate. By the way, vitamins and trace elements in small doses can be taken constantly.
- Normalization of the acidity of gastric juice is an important task. With hypothyroidism, hydrochloric acid is produced in smaller amounts and the acidity of the stomach juice decreases. As a result, some proteins and trace elements (including iron and vitamin B12) will be absorbed much worse.
- Fight against excess weight it plays an important role in tissue hypothyroidism. As we already know, obesity, diabetes and hypothyroidism are practically “friends” and excess adipose tissue affects the sensitivity of the tissue not only to insulin, but also to thyroid hormones. It should be remembered that the path to losing weight with insulin resistance and hypothyroidism is very difficult. Therefore, it is better to monitor the weight before the appearance of health problems.
- Loading with iodine is a fairly popular method of eliminating iodine deficiency, which consists in taking a large amount (50 mg per day or more) of this trace element. For this purpose, iodine preparations are used – Yodoral, Triiodine, and even a banal Lugol solution, which is pre-diluted in a glass of water.
An important condition! Before loading with iodine, you need to eliminate the deficiency of vitamins and trace elements, especially selenium. It is proved that a large amount of iodine with selenium deficiency has a detrimental effect on the thyroid gland and causes autoimmune thyroiditis. This also applies to the use of small doses of iodine in the form of iodized salt or water, for example.
Despite the abundance of various dietary supplements and iodine preparations, it is better not to joke with this trace element. Only a doctor can determine the need and dosage of iodine in each specific case on the basis of tests confirming its deficiency.
- Replacement therapy – replacement of hormone deficiency with drugs. To this end, use L-thyroxine is a synthetic analogue of the hormones of the thyroid gland. This medicine has a number of contraindications and side effects. Therefore, only an endocrinologist can choose the dosage. It’s a lot harder than it sounds. Do not be confused that the dose adjustment will take some time, this is a normal phenomenon. The fact is that there are no universal recommendations for the dosage of thyroid hormone drugs. Therefore, they start treatment with small doses, and observe how this affects the symptoms and blood parameters.
It must be said that not all patients perceive the synthetic analogue of thyroxine well, since it will be practically useless if the conversion of T4 to T3 is disrupted. In this case, you can use an analog of the hormone T3 or natural dry thyroid glands. The last remedy most likely you will not go to the pharmacy, you will have to order it in the online store.
Thus, the treatment of hypothyroidism is quite a complex process. The most difficult condition, which is difficult, and sometimes almost impossible to correct, is tissue hypothyroidism.
It is important not to ignore the processes occurring in the body, and when the first symptoms appear, consult a doctor.
Keep an eye on your thyroid health and stay healthy!