<\/span><\/h2>\nAbnormal levels of circulating thyroid hormone (thyroxine) and underlying diseases can cause alterations in the appearance of the skin, hair<\/span> and nail<\/span>. The thyroid gland may be overactive, resulting in hyperthyroidism<\/span>or underactive, resulting in hypothyroidism<\/span>, discussed here.<\/p>\n<\/span>What is hypothyroidism?<\/span><\/h2>\nUnlike hyperthyroidism, in hypothyroidism, the thyroid gland is underactive and causes a reduction in thyroxine production.<\/p>\n
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<\/span>Who gets hypothyroidism?<\/span><\/h2>\nHypothyroidism can occur at any age and sex<\/span> but it is seen more frequently in women during the menopausal years (ages 40 to 50).<\/p>\n\n- Women are eight times more likely to be affected than men.<\/li>\n
- Hypothyroidism is common in people with a personal or family history of autoimmune<\/span> disorder such as type 1 diabetes, harmful anemia<\/span>, vitiligo, lichen sclerosus and Addison's disease.<\/li>\n
- \nGenetic<\/span> Conditions associated with hypothyroidism include Down syndrome<\/span>, Turner syndrome and cystic<\/span> fibrosis<\/span>.<\/li>\n<\/ul>\n
<\/span>What causes hypothyroidism?<\/span><\/h2>\nThere are several causes for hypothyroidism.<\/p>\n
<\/span>Autoimmune thyroiditis<\/span><\/h3>\nAutoimmune thyroiditis is also known as atrophic<\/span> thyroiditis or Hashimoto's disease when goiter is present.<\/p>\n\n- This is the most common cause of hypothyroidism in adults.<\/li>\n
- \nAntibodies<\/span> against the trigger of the thyroid gland inflammation<\/span> and destroys thyroxine-producing cells.<\/li>\n<\/ul>\n
<\/span>Subacute thyroiditis<\/span><\/h3>\nSubacute thyroiditis is also known as De Quervain's thyroiditis.<\/p>\n
\n- Thyroiditis is inflammation of the thyroid gland.<\/li>\n
- Subacute thyroiditis follows a virus infection<\/span> or pregnancy<\/li>\n
- The gland is painful and tender for several months.<\/li>\n
- Thyroiditis is usually self-limited and resolves spontaneously without treatment.<\/li>\n
- It initially causes a temporary overproduction of thyroid hormone (hyperthyroid phase), which is then followed by underproduction (hypothyroid phase) before thyroid function returns to normal.<\/li>\n<\/ul>\n
<\/span>Iodine deficiency<\/span><\/h3>\nThe element iodine is crucial for the synthesis of thyroxine.<\/p>\n
\n- Iodine deficiency is the most common cause of hypothyroidism worldwide, especially in areas where iodine is less available, including certain regions of Southeast Asia and Africa.<\/li>\n<\/ul>\n
<\/span>\nIatrogenic<\/span> hypothyroidism<\/span><\/h3>\nHypothyroidism can arise from medications.<\/p>\n
\n- Excessive intake of carbimazole or propylthiouracil is used to treat hyperthyroidism.<\/li>\n
- Radioactive iodine (used to treat hyperthyroidism)<\/li>\n
- Amiodarone, an iodinated medication used in heart disease, which can induce hyperthyroidism and hypothyroidism.<\/li>\n
- Lithium, often used for mental illness and eating disorders. It can also induce hyperthyroidism and hypothyroidism.<\/li>\n
- Alpha interferon<\/li>\n
- \nInterleukin<\/span>-2<\/li>\n
- Contrast media containing iodine<\/li>\n
- Thyroid surgery<\/li>\n<\/ul>\n
<\/span>\nCongenital<\/span> hypothyroidism<\/span><\/h3>\nCongenital hypothyroidism or cretinism,<\/span> may result from the absence or incomplete development of the thyroid gland, defects in thyroid hormone metabolism<\/span> or hypothalamic<\/span>pituitary axis dysfunction<\/span>. It's strange.<\/span> <\/span><\/p>\n\n- \nIncidence<\/span> is approximately 1 in every 4,000 live births<\/li>\n
- Most commonly seen in multiple pregnancies (twins)<\/li>\n
- There is a 2:1 female to male ratio<\/li>\n
- It may be due to a genetic defect. <\/li>\n<\/ul>\n
Rare causes of hypothyroidism<\/span><\/p>\nRare causes of hypothyroidism include:<\/p>\n
\n- \nInfiltration<\/span> of the thyroid gland granulomas<\/span> in <\/span>sarcoidosisor amyloid<\/span> in systemic<\/span> <\/span>amyloidosis.<\/span>\n<\/li>\n
- \nPituitary gland<\/span> disease that causes secondary hypothyroidism<\/li>\n
- Hypothalamic gland disease, causing tertiary hypothyroidism<\/li>\n<\/ul>\n
<\/span>What are the clinical characteristics of hypothyroidism?<\/span><\/h2>\nHypothyroidism causes a reduction in the body's metabolic rate. It is characterized by:<\/p>\n
\n- Cold periphery with thick pale and dry skin.<\/li>\n
- \nEczema<\/span> craquel\u00e9 \u2013 a form of dermatitis<\/span> in which there is a crazy pavement that divides the surface of the skin<\/li>\n
- A yellowish tone to the skin secondary to carotenamia<\/span>\n<\/li>\n
- Sparse, brittle hair that comes out in handfuls<\/li>\n
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Hair loss in the outer third of the eyebrows.<\/li>\n
- Slow growing, striated and brittle nails<\/li>\n
- Myxedema, resulting in swollen face, eyelids, hands and feet; a presentation of mucinosis<\/span>.<\/li>\n
- Delayed wound healing\n<\/li>\n<\/ul>\n
Other common systemic symptoms due to hypothyroidism include weight gain, cold intolerance, low mood, and menstrual disorders (irregular or heavy periods).<\/p>\n\n<\/span>Hypothyroidism<\/span><\/h5>\n<\/section>\n\n\n
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Carotemia<\/p>\n
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Dry Skin<\/p>\n
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Crackle eczema<\/p>\n<\/p><\/div>\n<\/section>\n
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The clinical features of congenital hypothyroidism include:<\/span><\/p>\n\n- \nHypotonia<\/span> and lethargy <\/li>\n
- Feeding difficulties, resulting in poor weight gain and lack of growth<\/li>\n
- Constipation<\/li>\n
- Hoarse cry with reduced crying frequency<\/li>\n
- Swollen appearance; large head with swollen limbs and genitals<\/li>\n
- Big previous<\/span> fontanel<\/li>\n
- Cold, mottled skin, especially on the extremities.<\/li>\n
- Flattened or flared nose associated with nasal obstruction<\/li>\n
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Macroglossia (enlarged tongue)<\/li>\n
- Preserve<\/li>\n
- \nUmbilical<\/span> hernia<\/li>\n
- Cardiac abnormalities: bradycardia<\/span>, cardiomegaly or pericardial effusion<\/li>\n<\/ul>\n\n
<\/span>Congenital hypothyroidism<\/span><\/h5>\n<\/section>\n\n\n
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Congenital hypothyroidism<\/p>\n<\/p><\/div>\n<\/section>\n
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<\/span>What are the complications of hypothyroidism?<\/span><\/h2>\nSerious complications can occur if hypothyroidism is not treated:<\/p>\n
\n- Cardiovascular heart disease, due to high levels of cholesterol<\/span> and triglycerides<\/span>\n<\/li>\n
- Myxedema coma (hypothyroid coma), characterized by hypothermia, reduced level of consciousness and seizures. Myxedema coma is a life-threatening medical emergency that requires urgent hospital treatment. The mortality rate is up to 50%, especially in the elderly.<\/li>\n<\/ul>\n
<\/span>How is hypothyroidism diagnosed?<\/span><\/h2>\nHypothyroidism is diagnosed with thyroid function tests (TFT).<\/p>\n
\n- \nSerum<\/span> TSH is usually high.<\/li>\n
- In pituitary or hypothalamic disease, TSH may be low or normal.<\/li>\n
- Serum T4 and T3 levels are usually low.<\/li>\n
- In subclinical hypothyroidism, TSH is slightly elevated in the presence of normal T4 and T3.<\/li>\n
- In euthyroid sick syndrome*, TSH, T4 and T3 are all low.<\/li>\n<\/ul>\n
* Euthyroid sick syndrome commonly occurs in patients suffering from serious non-thyroid diseases such as septicemia<\/span><\/span>burns and trauma<\/span>. It is usually transient and no treatment may be required, as thyroid function usually returns to normal after recovery from the illness.<\/p>\n\n\nInterpretation of thyroid function tests<\/caption>\n\n\n| –<\/td>\n | TSH<\/th>\n | Free T4 (thyroxine)<\/th>\n | Free T3 (triiodothyronine)<\/th>\n<\/tr>\n<\/thead>\n<\/tbody>\n |
\n\n| (Primary<\/span>) hyperthyroidism<\/td>\n | Bass<\/td>\n | High<\/td>\n | High<\/td>\n<\/tr>\n |
\n| Secondary hyperthyroidism<\/td>\n | High<\/td>\n | High<\/td>\n | High<\/td>\n<\/tr>\n |
\n| Subclinical hyperthyroidism<\/td>\n | Bass<\/td>\n | Normal<\/td>\n | Normal<\/td>\n<\/tr>\n |
\n| Primary hypothyroidism<\/td>\n | High<\/td>\n | Bass<\/td>\n | Low or normal<\/td>\n<\/tr>\n |
\n| Secondary hypothyroidism<\/td>\n | Low or normal<\/td>\n | Bass<\/td>\n | Low or normal<\/td>\n<\/tr>\n |
\n| Subclinical hypothyroidism<\/td>\n | High limit<\/td>\n | Normal<\/td>\n | Normal<\/td>\n<\/tr>\n |
\n| Euthyroid sick syndrome<\/td>\n | Bass<\/td>\n | Bass<\/td>\n | Bass<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n Serum autoantibodies<\/span> are present in the 90-95% of autoimmune thyroiditis. They must include:<\/p>\n\n- Anti-thyroid peroxidase antibodies (TPO)<\/li>\n
- Anti-thyroglobulin antibodies.<\/li>\n<\/ul>\n
Complete blood count and inflammatory<\/span> markers, such as C-reactive protein<\/span>, are routinely included to detect anemia (commonly associated with hyperthyroidism) and systemic infection causing thyroiditis. Creatine kinase is tested to verify myopathy<\/span>and lipids<\/span> They are evaluated as hypercholesterolemia and hypertriglyceridemia common in hypothyroidism.<\/p>\nImages must include:<\/p>\n \n- \nUltrasound<\/span> of the thyroid gland, especially when hypothyroidism is associated with a goiter<\/li>\n<\/ul>\n
<\/span>What is the treatment for hypothyroidism?<\/span><\/h2>\nLevothyroxine is the first line of treatment to replace the lack of thyroxine in the body.<\/p>\n \n- The dose varies from 25 to 150 mcg daily.<\/li>\n
- A lower dose is prescribed initially and then gradually adjusted according to response and TSH level.<\/li>\n
- Regular blood tests are required to ensure that patients receive the correct dose of treatment.<\/li>\n<\/ul>\n
While side effects are rare, symptoms of hyperthyroidism can occur when too much thyroxine is taken; this includes diarrhea, irritability, sweating, and palpitations.<\/p>\n <\/span>What is the result of hypothyroidism?<\/span><\/h2>\nMost patients respond well to levothyroxine, and are usually on this medication for life.<\/p>\n<\/section>","protected":false},"excerpt":{"rendered":" Introducci\u00f3n Los niveles anormales de la hormona tiroidea circulante (tiroxina) y las enfermedades subyacentes pueden provocar alteraciones en la apariencia de la piel, cabello y u\u00f1as. La gl\u00e1ndula tiroides puede…<\/p>","protected":false},"author":8,"featured_media":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","format":"standard","meta":{"footnotes":""},"categories":[],"tags":[],"class_list":["post-14415","wiki","type-wiki","status-publish","format-standard"],"_links":{"self":[{"href":"https:\/\/doctorhoogstra.com\/en\/wp-json\/wp\/v2\/wiki\/14415","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/doctorhoogstra.com\/en\/wp-json\/wp\/v2\/wiki"}],"about":[{"href":"https:\/\/doctorhoogstra.com\/en\/wp-json\/wp\/v2\/types\/wiki"}],"author":[{"embeddable":true,"href":"https:\/\/doctorhoogstra.com\/en\/wp-json\/wp\/v2\/users\/8"}],"replies":[{"embeddable":true,"href":"https:\/\/doctorhoogstra.com\/en\/wp-json\/wp\/v2\/comments?post=14415"}],"version-history":[{"count":0,"href":"https:\/\/doctorhoogstra.com\/en\/wp-json\/wp\/v2\/wiki\/14415\/revisions"}],"wp:attachment":[{"href":"https:\/\/doctorhoogstra.com\/en\/wp-json\/wp\/v2\/media?parent=14415"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/doctorhoogstra.com\/en\/wp-json\/wp\/v2\/categories?post=14415"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/doctorhoogstra.com\/en\/wp-json\/wp\/v2\/tags?post=14415"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}} |