HYPOTHYROID
What is Hypothyroidism?
If you have complaints such as fatigue, weakness, easy fatigue, chills, intolerance to cold, hoarseness and thickening of the voice, you should definitely read it.
What symptoms does the disease give?
Hashimoto’s is 6 times more common in women than men. Although there will be no symptoms in hypothyroidism, the signs and symptoms are due to the decrease in body metabolism and the functions of almost all organs have slowed down. As a result of this, weakness, weakness, easy fatigue, chills, intolerance to cold, hoarseness and thickening of the voice, swelling in the hands, face and legs, swelling around the eyes, dryness of the skin, coarsening or thickening, hair loss, muscle cramps, depression, sleep disorder, drowsiness Complaints such as constipation, menstrual disorder in women, weight gain, weakening of memory, difficulty in remembering, decrease in pulse rate, slowdown in movements, decrease in sweating may occur.
How is the disease diagnosed?
Free T4 and TSH measurement is sufficient for the diagnosis of hypothyroidism. Free T4 is low and TSH is high. Sometimes, the patient may have normal free T4 with elevated TSH. This condition is called subclinical hypothyroidism. The word subclinical indicates that the laboratory finding is abnormal, but the patient does not have clinical findings. Anti-Tg and anti-TPO antibodies are also checked in hypothyroidism. Anti-Tg is an antibody produced against a substance called thyroglobulin (tg), which is found in the follicles in the thyroid gland and used to store thyroid hormones. Anti-TPO is an antibody made against the Thyroid Peroxidase enzyme used for the synthesis of thyroid hormones. These antibodies are found high in Hashimoto’s thyroiditis and indicate persistent hypothyroidism. Initially, anti-TPO antibodies are high in the blood, while TSH, T3 and T4 hormones are normal. Later, as the disease progresses over time, thyroid insufficiency develops in the initial phase (only TSH is high, but T3 and T4 are normal) and then complete thyroid insufficiency (TSH is high, T3 and T4 hormones are low). Anemia is found in 30-40% of hypothyroid patients who have complete blood counts, and iron deficiency is found in 15%. You may also have a vitamin B12 deficiency. Creatinine phosphokinase (CPK) and prolactin (PRL) levels may be found to be high. Hypothyroid patients have high blood lipids (hyperlipidemia). While there is a slight increase in triglyceride levels, there is an increase in total cholesterol and LDL cholesterol levels. If the patient is not treated, the risk of coronary artery disease increases as blood fats will be found to be high.
How is the treatment done?
Hypothyroidism often develops very slowly and insidiously. Likewise, the patient’s response to treatment is gradual. It may take about a month and a half or longer for the patient to become euthyroid (the normal level of thyroid hormones in the blood). Therefore, the patient should be seen by the doctor for dose adjustment at intervals of 2 or 3 months until he becomes euthyroid. When euthyroid is formed, these intervals increase to 6-12 months. Hypothyroidism is a disease that requires lifelong treatment. Very rarely, spontaneous recovery may occur in 10-20% of patients with Hashimoto’s thyroiditis. Thyroid hormone (levothyroxine) is given in the treatment. The aim is to keep TSH and T4 levels within normal limits. If nodules are seen on ultrasound, thyroid scintigraphy and fine-needle aspiration biopsy may be required to rule out cancer.
