Saturday, March 3, 2012

Hypothyroidism Myxedema

Hypothyroidism is a condition in which the thyroid gland is under-active (it is producing an insufficient amount of thyroid hormones).

Hypothyroidism is the most common thyroid disorder. Severe hypothyroidism can lead to a condition called myxedema, characterized by dry, thickened skin and coarse facial features. So Myxedema is also hypothyroidism but in its extreme form.



Who is at Risk:

As there is very insufficient amounts of circulating thyroid hormones in the body, and since the main purpose of thyroid hormone is to “run the body’s metabolism,” it is understandable that people with this condition will have symptoms associated with a slow metabolism. The estimates vary, but approximately 10 million Americans have this common medical condition. In fact, as many as 10% of women may have some degree of thyroid hormone deficiency. Hypothyroidism is more common than you would believe, and millions of people are currently hypothyroid and don’t know it. It is estimated to affect 3-5% of the adult population. It is more common in women than in men, and the risk of developing hypothyroidism increases with advancing age.

What Causes Hypothyroidism:

Hypothyroidism is most commonly a result of an autoimmune condition known as Hashimoto’s thyroiditis, in which the body’s own immune cells attack and destroy the thyroid gland. Since the activity of the thyroid gland is controlled by other hormones from the pituitary gland and the hypothalamus of the brain, defects in these areas can also cause under-activity of the thyroid gland (such as brain tumors). Previous surgeries on the thyroid or a history of irradiation to the neck are other causes of hypothyroidism. A condition like this can also occur when Hyperthyroidism (Grave’s disease or Toxic goiter) is treated with Radioactive Iodine (I-131) and as a result the thyroid tissue is destroyed resulting in less than normal production of thyroid hormones.

Can Iodine Deficiency lead to Hypothyroididm:

Yes. In areas of the world where there is Iodine deficiency in the diet, severe hypothyroidism can be seen in 5% to 15% of the population. Examples of these areas include Zaire, Ecuador, India, Pakistan, and Chile. Severe iodine deficiency is also seen in remote mountain areas such as the Andes and the Himalayas. Since the addition of iodine to table salt and to bread, iodine deficiency is rarely seen in the United States.

What Are The Symptoms Of Hypothyroidism

An under-active thyroid gland affects all organs and functions within the body, leading to both physical and emotional symptoms. Symptoms of hypothyroidism are usually very subtle and gradual and may be mistaken for symptoms of depression. The following are the most common symptoms of hypothyroidism. However, each individual may experience symptoms differently.
  • dull facial expressions, lack of drive, low mood
  • hoarse voice
  • slow speech
  • droopy eyelids
  • puffy and swollen face
  • weight gain, lethargy, body aches and pains
  • constipation
  • coarse and dry hair
  • coarse, dry, and thickened skin
  • slow pulse or bradycardia.
  • muscle cramps
  • confusion, memory loss, loss of libido (decreased sex drive)
  • increased menstrual flow in women (menorrhagia)
One reason of clinical depression is severe hypothyroidism so if you have depression, it is mandatory to get thyroid hormones evaluated from a good, reliable laboratory. As one of the reasons for hypothyroidism is raised TSH (Thyroid stimulating hormone) due to pituitary disturbances / diseases, it should be kept in mind that there are numerous cases of infertility in women which is due to hypothyroidism.

Diagnosis and Treatment:

Since hypothyroidism is caused by too little thyroid hormone secreted by the thyroid, the diagnosis of hypothyroidism is based almost exclusively upon measuring the amount of thyroid hormone in the blood. There are normal ranges for all thyroid hormones which have been calculated by computers which measure these hormones in tens of thousands of people. If your thyroid hormone levels fall below the normal range, that is consistent with hypothyroidism. These tests are very accurate and reliable and are so routine that they are available to everybody. Diagnosis is made by a doctor working in the field of endocrinology or an endocrinologist. The hormones are evaluated in a laboratory and methods like RIA (radioimmunoassay) give very accurate results of circulating hormones. In most cases the TSH (thyroid stimulating hormone) levels are found very high.

Treatment of Hypothyroidism:

The goal of treatment is to restore the thyroid gland to its normal function, creating normal levels of thyroid hormones in the circulating blood. Specific treatment for hypothyroidism will be determined by your physician based on:
  • Your age, overall health, and medical history
  • Extent of the disease
  • Expectations for the course of the disease
Treatment may include prescription of thyroid hormones (Thyroxine, Levothyroxine, Eltroxin) to replace the deficient hormones. Dosage of thyroid hormone may need to be increased over the years. Yearly or biyearly checkups are usually required to ensure that the proper dosage of thyroid hormones is taken. A patient usually takes thyroid hormones for the rest of his/her life. Remember you should not be shy in discussing with your doctor your blood hormone test results, symptoms, how you feel, and the type of medicine you are taking. The goal is to make you feel better, make your body last longer, slow the risk of heart disease and osteoporosis, in addition to making your blood levels normal. Sometimes that’s easy, when its not, you need a physician who is willing to spend time with you that you deserve while you explore different dosages and other types of medications (or alternative diagnoses).