Underactive thyroid (hypothyroidism)
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The symptoms of an underactive thyroid (hypothyroidism) can be very different, depending on how old the person concerned. but typical example, weight gain and lethargy.
Hypothyroidism usually develops gradually, therefore, symptoms often show late. The treatment Hypothyroidism is basically medicinal (L-thyroxine, levothyroxine), to compensate for the lack of hormones.
What is hypothyroidism?
An underactive thyroid (hypothyroidism) means that the body is not sufficient with the thyroid hormones thyroxine (T4) and triiodothyronine (T3) is supplied. For this purpose, different causes in question.
The thyroid is the most common hormonal disorders. The incidence of hypothyroidism increases with age:
in the adulthood a hypothyroidism usually develops insidiously. Initially, the person usually notice little or no discomfort. Symptoms usually occur only with a stronger sub-function and can be individually different.
However, there are some men Hypothyroidism typical symptoms:
A rare symptom of hypothyroidism is myxedema coma:
As a result of an increased incorporation of certain substances (protein-sugar-acid compounds) in the Subcutaneous fat the skin is distended often doughy in people with hypothyroidism (so-called. myxedema), Particularly in the region around the eyes and on the back of the hand. By myxedema of the vocal cords and tongue voice can sound rough and washed out.
A very rare, severe occurrence of myxedema is the Myxoedema coma. It can arise when hypothyroidism long time is treated inadequately or is not recognized and added other factors that weaken the patient (for example, infection, surgery). Symptoms of Myxödemkomas are:
As a result of an untreated hypothyroidism delayed with him newborn both physical and mental development. In Germany there is a statutory screening (Screening) of all newborns for hypothyroidism. If hypothyroidism found takes place directly following treatment with tablets.
newborn with hypothyroidism have after birth the following symptoms:
children, whose hypothyroidism is not treated, can develop the following symptoms:
Hypothyroidism is treated with drugs which contain the necessary thyroid hormones. The iodine-containing thyroid hormones T3 and T4 stimulate them cell metabolism and are necessary for normal body growth. An active ingredient which is often used in an underactive thyroid for treatment is levothyroxine (L-thyroxine).
The really effective hormone is triiodothyronine - there is formed in the blood of L-thyroxine by an iodine atom from this is split off.
there is a congenital hypothyroidism, the missing hormones must be replaced immediately to ensure that the development of the brain and other organs is not affected. Thanks to the newborn screening doctors recognize the innate forms of hypothyroidism after birth, so that treatment can begin immediately in the first days today. Affected need the hormones lifelong regularly taking.
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Adults with a pronounced (manifest) hypothyroidism need to take regularly and permanently thyroid hormones to achieve a sufficient concentration.
Treatment with thyroid hormones begins gewöhnich with a low dose, which is then slowly increased. Of the hormonal status should periodically using a blood test checked in order to adjust the dose if needed. Side effects do not occur at the correct dosage.
If hypothyroidism is not treated, it can be a so-called in rare cases Myxoedema coma have as a consequence. Then intensive medical help necessary. It includes:
An underactive thyroid (hypothyroidism) can have many causes:
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When a Defective thyroid leads to hypothyroidism, it is a primary hypothyroidism. The cause is then so in the organ itself.
Such hypothyroidism can innate be, for example, if the thyroid is missing completely or is too small. Congenital hypothyroidism can also occur when the Jodverwertung is disturbed by a genetic fault. So, although the body has enough iodine is available, but it can not be installed in the thyroid hormones it.
Much more common is hypothyroidism but the course of life acquired. The cause of this is usually a loss or destruction of original functioning thyroid tissue, for example by:
Radioiodine therapy is used to treat a thyroidaboutfunction used. By means of radioactive radiation is excessively destroyed hormone producing tissue. In some cases, this leads to an underactive thyroid.
Hypothyroidism can be caused in rare cases, by an extreme lack of vital (essential) trace element iodine. This is facilitated by the fact that in Germany include some regions to iodine deficiency areas.
Secondary hypothyroidism occurs when it is due to Disorders of the pituitary (hypophysis), is, for example, by tumors, a misuse of the thyroid to the thyroid stimulating hormone (TSH). The thyroid itself is completely intact. This form of hypothyroidism very rare.
In the tertiary Hypothyroidism is a disturbance of hypothalamus before, so not enough thyrotropin releasing hormone (TRH) are produced. This allows the control loop between the brain and thyroid is interrupted and the thyroid gland is not stimulated to produce thyroid hormones.
Possible causes are complex defects question tumors or inflammation. This form of hypothyroidism is very rare in front.
In congenital hypothyroidism (hypothyroidism), the diagnosis is made thanks to a statutory provision nowadays usually very early: Every newborn thyroid function is between the third and fifth day of life (so-called. Newborn Screening) Were examined. In this case, is using a few drops of blood that are taken from the heel, the Levels of certain thyroid hormones certainly. This test is carried out when there is a suspicion of hypothyroidism in older children, adolescents or adults.
The thyroid function also provide an information as to present what form of hypothyroidism.
As often an inflammation of the thyroid gland, the so-called Hashimoto's thyroiditis, is a cause of underactive thyroid gland, should have a blood sample in the presence specific antibodies to be examined. They arise in the context of this autoimmune disease and are called TPO antibodies and thyroglobulin antibodies. They attack healthy body's own tissue, which then loses its function.
using a ultrasound (Sonography) can be checked the condition of the thyroid gland, and also found for example, whether nodes are present. Statements about the functioning of the thyroid gland can not be taken in this way, however.
When an underactive thyroid (hypothyroidism) is treated with the necessary thyroid hormones, you can usually with a uncomplicated course expect: efficiency or lifetime are limited in any way.
If hypothyroidism in babies treated in time with drugs is the development of the infant not endangered. Congenital hypothyroidism can, however, untreated lead to complications: children with untreated congenital hypothyroidism remain mentally and show a developmental disorder (So-called. Cretinism).
Typical long-term consequences an underactive thyroid in children are:
A inadequately treated or unrecognized hypothyroidism can result in rare cases, during the so-called myxedema coma, which by itself
In this case, immediately intensive medical help necessary.
It is not possible to prevent an underactive thyroid (hypothyroidism), nor to cure it. One can only keep the symptoms using the treatment in check.
causes strong iodine deficiency hypothyroidism, you can improve the iodine supply through the consistent use of iodized table salt. It is recommended also to eat fish twice a week because fish contains a lot of iodine. To meet the daily needs sure you can take in consultation with your doctor in addition iodine preparations.
But beware: In pregnancy and lactation other reference values for iodine requirements apply!
www.jodmangel.de information on iodine deficiency