Hypothyroidism is the condition of reduced thyroid activity: how to recognize it and the treatments available
Hypothyroidism is a condition of reduced thyroid activity that induces a reduction in the production of thyroid hormones and a generalized slowdown of all metabolic processes. It is a frequent clinical condition especially in women and the elderly but it can also affect the infant-youth age.
Causes and symptoms
Hypothyroidism can be caused by a disorder of the thyroid gland or of the pituitary gland, the director of all the glands. The most frequent cause of primary thyroid damage is autoimmune: that is, our body produces antibodies that instead of defending us attack us and in this case gradually destroy the thyroid (Hashimoto's thyroiditis). Other causes are represented by surgical removal of the gland, irradiation of the head and neck, severe iodine deficiency. In rare cases hypothyroidism is caused by impaired hypothalamic-pituitary function as a result of which the stimulation of the thyroid function is lacking.
The symptoms of thyroid hormone deficiency develop slowly and often in a subtle way: the most striking picture is the hoarse voice, the swelling of the eyes and face, hair loss, sad face expression, dry and yellowish skin. Many patients gain weight, become constipated, intolerant to cold. The elderly may be more confused or show signs of dementia. Changes in the menstrual cycle can occur in women. In many cases, however, even a serious deficiency of thyroid hormones can be associated with an almost silent clinical picture.
Diagnosis and treatments
So how do you diagnose hypothyroidism and its severity? Usually a simple blood test is sufficient: the dosage of TSH (pituitary hormone that governs thyroid function). If the thyroid is hypoactive, the TSH level is elevated. If this hormone is elevated, the main hormone produced by thyroxine will also be dosed, which will be reduced or almost reduced. To complete the diagnosis, an evaluation of the glandular morphology is indicated by means of an ultrasound examination. These tests must be evaluated by the endocrinologist specialist who is responsible for assessing the need and extent of the treatment.
The treatment of hypothyroidism is based on the administration of the deficient hormone or thyroxine. This hormone has been available for almost a century in identical form to the endogenous hormone and thanks to its administration, the thyroid hormone balance is restored. Today the thyroxine replacement big man is available in tablets, in liquid formulation and in soft capsules.
It is good that thyroxine preparations are taken in the morning on an empty stomach to minimize the absorption interference given by food, coffee and concomitant therapies. The half-life of thyroxine is one week, therefore, if you forget a few tablets, there are no clinical repercussions. The dosage varies according to age groups, sex, weight. The specialist must identify the appropriate dosage for each patient, that is, the one that normalizes the levels of TSH and thyroxine and the clinical condition. Subsequently, the control over time includes periodic monitoring (once or twice a year) of TSH levels.
The changes in TSH during replacement therapy based on the seasons is still a matter of study as the data are not unambiguous; transient fluctuations in TSH levels related to the seasons have been described but that therapy should be modulated according to climate change is not currently recommended.
in collaboration with Dr. Ruth Rossetto Giaccherino