Thyroid Insufficiency (Hypothyroidism)
The underactivity of the thyroid gland is called 'hypothyroidism'. Hypothyroidism is a disease caused by the thyroid gland secreting insufficient hormones. Since thyroid hormones (T4 and T3) are low in the bloodstream, metabolism slows down and complaints and symptoms occur due to this situation.
One of the diseases that cause hypothyroidism is'Hashimoto thyroiditis'< A disease called /strong> comes. This disease is a condition that occurs when the thyroid gland is damaged for an unknown reason. In Hashimoto's thyroiditis, there is first a goiter, but over the years the gland shrinks and becomes unable to secrete hormones. The most important laboratory feature of Hashimoto's thyroiditis is the high level of substances called "anti-TPO" and "anti-Thyroglobulin antibodies" produced by the body against its own thyroid gland in the blood. The frequency of Hashimoto's thyroiditis is increasing in society. One of the other causes of hypothyroidism is thyroid gland surgery. Hypothyroidism develops when there is not enough tissue left to secrete hormones after thyroid surgery. Therefore, it is necessary to measure and monitor thyroid hormones in patients undergoing thyroid surgery. In cases where the whole or almost all of the thyroid gland is removed, one of the thyroid hormone drugs called Levotiron, Tefor or Euthyrox must be taken and this treatment must continue for life.
In patients treated with radioactive iodine, hypothyroidism develops because the thyroid gland is destroyed and not enough hormone can be secreted. Sometimes, rarely, hypothyroidism may develop after certain medications (lithium, amiodarone, interferon, interleukin) and radiotherapy to the head and neck. Hypothyroidism is also common in diabetics, those with anemia, and those with rheumatoid arthritis. It is also common in women over the age of 60. It is also necessary to investigate hypothyroidism in patients with high blood fat levels (such as cholesterol, triglycerides). Hypothyroidism should also be looked for in patients with depression, women who do not have children, or women with menstrual irregularities.
What complaints and findings develop in a patient with hypothyroidism?
1. Weakness, weakness, easy fatigue
2.Coldness, intolerance to cold
3.Hoarseness and deepening of the voice
4.Swelling in hands, face and legs
5.Swelling around the eyes
6.Drying, coarsening or thickening of the skin
7.Hair loss
8.Muscle cramps
9.Depression, sleep disorder, drowsiness
10.Constipation
11.Menstrual irregularities
12.Weight gain
13.Weakening of memory, difficulty in remembering
14.Decrease in pulse rate
15.Slowness in movements
16.Decrease in sweating
With which test is hypothyroidism diagnosed?
The most important test is 'measurement of TSH level in the blood'. If the TSH level is above normal, this suggests hypothyroidism in the patient. Free T4 levels are low in the blood. A patient with low free T4 level and high TSH level has significant hypothyroidism. If only TSH is high butT4and T3 levels are normal, we can talk about mild thyroid insufficiency. This condition also needs to be treated. If left untreated, significant hypothyroidism may develop in 5% patients. 30-40% of patients with hypothyroidism who underwent complete blood count have 'anemia' and 15% have iron deficiency. ' is detected. Also'Vitamin B12 deficiency'may also occur. In patients with hypothyroidism, levels of 'prolactin', a hormone specific to women, may be found to be high. In these patients, prolactin levels are moderately elevated and decrease with thyroid hormone treatment. If the patient's thyroid hormone levels are within normal ranges but prolactin levels are still high, other causes should be investigated.
What are the treatment options for hypothyroidism patients?
Lifelong treatment of hypothyroidism. It is a necessary disease. Very rarely, spontaneous recovery may occur in 10-20%of patients with 'Hashimoto thyroiditis'. Hypothyroidism treatment is done by giving thyroid hormone tablets to normalize the missing thyroid hormones in the blood. These medications are recommended by your doctor depending on the severity of the disease. It starts at the same time. The patient is called for control at regular intervals and the dose of the drug is adjusted. The goal of treatment is to normalize T4 levels in the blood and ensure that the TSH level is within normal limits. Drug therapy is a lifelong treatment and should not be interrupted. You should go for a check-up every 6 months - 1 year and have your TSH level checked. Sometimes it may be necessary to increase or decrease the dose of the medication. Since it is necessary to adjust the dose of the drug in hypothyroid women who become pregnant, a check-up should be made within the first month of pregnancy. Hormone medication should be taken on an empty stomach, at least half an hour before eating. Other medications should not be taken with the same meal as other medications may impair the absorption of the thyroid hormone medication. Especially iron medications, antacids (such as Talcid) or calcium medications impair the absorption of thyroid medications. Patients with Hashimoto's thyroiditis must eat non-iodized salt. Patients with heart disease and hypothyroidism should be checked more frequently than usual, as these medications may cause side effects. Some patients with hypothyroidism (especially those with Hashimoto's thyroiditis) have high anti-TPO and anti-Thyroglobulin antibodies. These antibodies are substances in protein structure that cause or cause the disease. There is no decrease in their levels with treatment. There is no medicine yet to reduce their levels. These antibodies need to be checked when diagnosed. There is no need to check it later during treatment follow-up. Although it has been found in recent years that taking selenium reduces these antibodies, this information is still at the research stage.
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