Hypothyroidism

Hypothyroidism is a condition in which the thyroid gland does not make enough thyroid hormone or Hypothyroidism is a deficiency of thyroid hormone in humans. Iodine deficiency is the most common cause of hypothyroidism but it can be caused by other causes such as several conditions of the thyroid gland, or less commonly, the pituitary gland or hypothalamus.

Signs and symptoms

            Hypothyroidism can be associated with the following symptoms:

Early

• Poor muscle tone
• Fatigue
• Any form of menstrual irregularity and fertility
• Hyperprolactinemia and galactorrhea
• Elevated serum cholesterol
• Cold intolerance, increased sensitivity to cold
• Constipation
• Depression
• Muscle cramps and joint pain
• Thin, brittle fingernails
• Coarse hair
• Dry, itchy skin
• Weight gain and water retention
• Bradycardia

Late

• Goiter.
• Dry puffy skin, especially on the face
• Thinning of the outer third of the eyebrows
• Abnormal menstrual cycles
• Low basal body temperature Decreased taste and smell
• Hoarseness
• Slow speeh
• Thickening of the skin

Uncommon

• Impaired memory
• Impaired cognitive function (brain fog) and inattentiveness.
• A slow heart rate with ECG changes including low voltage signals. Diminished cardiac output and decreased contractility
• Hair loss
• Anemia
• Shortness of breath with a shallow and slow respiratory pattern
• Increased need for sleep
• Irritability and mood instability

Cause

The most common cause of hypothyroid is iodine deficiency.                                           Hypothyroidism is often classified by association with the indicated organ dysfunction.

 

Type	Origin	Description
Primary	Thyroid gland	The most common forms include Hashimoto's thyroiditis and radioiodine therapy for hyperthyroidism.
Secondary	Pituitary gland	Occurs if the pituitary gland does not create enough thyroid-stimulating hormone (TSH) to induce the thyroid gland to produce enough thyroxine and triiodothyronine.
Tertiary	Hypothalamus	When the hypothalamus fails to produce sufficient thyrotropin-releasing hormone (TRH). TRH prompts the pituitary gland to produce thyroid-stimulating hormone (TSH). Hence may also be termed hypothalamic-pituitary-axis hypothyroidism.

Diagnosis Signs and tests

·         Increased liver enzymes

·         Increased prolactin

·         Low sodium

·         Free triiodothyronine (fT₃)

·         Free levothyroxine (fT₄)

·         Total T₃

·         Total T₄

Additionally, the following measurements may be needed:

• 24-Hour urine-free T₃
• Antithyroid antibodies — for evidence of autoimmune diseases that may be damaging the thyroid gland
• Serum cholesterol — which may be elevated in hypothyroidism
• Prolactin — as a widely available test of pituitary function
• Testing for anemia, including ferritin
• Basal body temperature

      A physical examination may reveal a smaller than normal thyroid gland, although sometimes the gland is normal size or even enlarged (goiter). The examination may also reveal:

·         Brittle nails

·         Coarse facial features

·         Pale or dry skin, which may be cool to the touch

·         Swelling of the arms and legs

·         Thin and brittle hair

      A chest x-ray may show an enlarged heart.

Case

          Mrs. P.P. came to see me for hypothyroidism. It was a diagnosed case of hypothyroidism. Her TSH was 6.88 uIU/ ml.

On 29/01/2010 following medicines was prescribed. SPONGIA, IODIUM, KALI.CARB,ADEL-6 for two months.

On 02/04/2010 she was came with her TFT report.  Report was normal. The report was T3-0.91, T4-7.20, TSH-4.50.TFTwas normal. She was prescribed P. L. doses for two months.

She was come back on 29/06/10 with swelling, irregular menses. She was advised for TFT.

T3-68.8, T4-5.56, TSH-14.88. Again prescribed following medicines for three months. SPONGIA, IODIUM, KALI. CARB, ADEL-6

She came on 08/10/2010 with report of TFT which was normal.

T3-105, T4-5.61, TSH-2.61

We prescribed same medicines for three months

On 25/02/2011she came with no swelling, no palpitation, menses are regular and her TFT was normal. TSH 2.25uUI/ml.

P.L. doses prescribed

cured.

Dr. G. S. Bhatnagar

D.H.M.S.  B.H.M.S.

Research officer

Sewa Mandir

Mobile 9829978284

E-Mail: sewamandir@usa.net, drgsbhatnagar@gmail.com