INTRODUCTION:
The thyroid is a small, butterfly-shaped gland located at the front of the neck and controlled by the pituitary gland. Thyroid hormones play a vital role in the human body; hence, if the range of thyroid hormones fluctuates, it will cause many diseases like hypothyroidism and hyperthyroidism. In hypothyroidism, the level of thyroid decreases in the blood, which is a clinical syndrome characterized by a low metabolic state due to the low serum thyroid in the blood. Hypothyroidism is the most frequent clinical illness caused by thyroid hormone insufficiency and, if ignored, can result in major adverse health effects on various organ systems, with the cardiovascular system being the most thoroughly researched target. Elevated TSH concentrations identify subclinical hypothyroidism, which is often seen as an early symptom of thyroid failure. Hypothyroidism is characterized by nonspecific symptoms such as fatigue, lethargy, and dry skin. Although the diagnosis is simple, no one symptom can be used to identify patients with overt hypothyroidism, and many patients with subclinical hypothyroidism are silent.
Causes:
Thyroiditis is the most common cause of hypothyroidism. Swelling and inflammation harm the thyroid gland’s cells in persons with thyroiditis.
Causes of this problem include:
- The immune system attacking the thyroid gland
- Viral infections (common cold) or other respiratory infections
- Pregnancy (often called postpartum thyroiditis)
Hypothyroidism can also be caused by:
Certain medications, including lithium and amiodarone, as well as certain forms of chemotherapy
- Congenital (born) flaws
- Radiation therapy to the neck or brain to treat various malignancies
- To treat an overactive thyroid gland, radioactive iodine is employed.
- Surgical excision of a portion or the entire thyroid gland
- Sheehan syndrome is a disorder that can arise in a woman who bleeds excessively during pregnancy or childbirth and causes the pituitary gland (which governs the thyroid gland) to be destroyed.
- Pituitary cancer.
Symptoms:
Symptoms are often non-specific, with weariness, cold intolerance, and constipation being the most prevalent.
Depression, anxiety, psychosis, and cognitive deficits such as memory loss may all be present. Patients may manifest with ascites, rhabdomyolysis, and pericardial effusion in rare cases. Carpal tunnel syndrome, sleep apnea, hyponatremia, hypercholesterolemia, congestive heart failure, and chronic illnesses can also be present. Clinically, Hashimoto disease is difficult to distinguish; nonetheless, some characteristics are unique to this disorder, such as:
- Thickness in the throat
- Fatigue
- Thyroid hypertrophy without discomfort
- recurring neck pain and/or painful throat
Clinical examination:
- Enlarged thyroid gland
- Weight gain
- The slowness of speech and movements
- Dry skin
- Coarse and brittle hair
- Pallor and jaundice
- Dull facial expressions
- Macroglossia
- Bradycardia
- Pericardial effusion
- Prolonged ankle reflex relaxation time
Complications:
Severe hypothyroidism, which can manifest as myxedema coma, is an endocrine emergency. Prompt identification and treatment in the intensive care unit (ICU) are critical.
In cases of encephalopathy, hypothermia, seizures, hyponatremia, hypoglycemia, arrhythmias, cardiogenic shock, respiratory failure, and fluid retention, myxedema crisis should be suspected. Inadequate thyroid hormone doses, interruptions in treatment, undetected hypothyroidism, or the presence of acute disease such as sepsis are all risk factors for myxedema crises.
Treatment:
Thyroid replacement therapy consists of intravenous hydrocortisone at stress dosages, followed by intravenous levothyroxine, and finally oral levothyroxine after clinical improvement. The reason for using steroids is that these patients may develop adrenal insufficiency, which can progress to an Addisonian crisis if the thyroid shortage is not addressed. It is advised to screen for Adrenal insufficiency but to wait for the results before beginning treatment with steroids. If the treatment is effective, it should improve cardiopulmonary and cognitive function.
Conclusion:
Sudden weight changes are alarming. Have you ever thought why you are feeling lethargic without any reason? The reason may be a thyroid disorder. Thyroids maintain many functions in our body that aim to give us a healthy life. Hypothyroidism might disturb your life and make you sick. Low metabolism is the cause of hypothyroidism, which will make you obese because your metabolic rate is slower than that of a normal human being. Hormonal change makes people stuck in many diseases, and one of them is hypothyroidism. Thyroid stimulating hormone is the investigation test to check the level of the thyroid in the blood. If the level is lower than the normal range, you need to take advice from the doctor, who will prescribe you medications to maintain your thyroid levels. Sudden fluctuations in the hormonal range can cause chaos in the body because hormones maintain everything in the body, from emotions to metabolic rate.
