What is hypothyroidism?
Hypothyroidism is the most common thyroid disease that manifests itself for a reduced production of the two hormones secreted by this gland, FT3 and FT4, which leads to aneasing of the physiological processes of the organism.
What are the causes of hypothyroidism?
The causes of hypothyroidism are different. The most common is chronic autoimmune or Hashimoto thyroiditis: the immune system attacks thyroid cells through the production of autoantibodies (AbTG and AbTPO) and destroys them by progressively reducing the production capacity of hormones.
Hypothyroidism can also be caused by the total or partial removal of the thyroid (as a result of benign or malignant nodules), by radioactive treatments, by congenital pathologies with the presence of the disease from birth and, more rarely, by diseases of the pituitary gland with reduced production of TSH (hormone that stimulatesthe thyroid gland).
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What are the symptoms of hypothyroidism?
The most frequent symptoms ofhypothyroidism are fatigue and muscle weakness, intolerance to cold, moderate weight gain, drowsiness and depression, lowering of the voice, bradicardia.
Hypothyroidism is clinically manifested in 1.7-3% of the population (especially in older women)and in the subclinical form in 8-17% of the population (and up to 20% over the age of 55-60 years). It also has a familiar prevalence.
How can Hypothyroidism be identified?
In the presence of suggestive symptoms, the diagnosis of hypothyroidism is based mainly on an accurate family and pathological history of the patient that can be conducted by the general practitioner who can request the advice of the endocrinologist specialist,in order to subject the patient to a rational diagnostic procedure.
The path consists of a visit with collection of previous data (family and personal history) and programming of hematochemical, hormonal, instrumental, radiological, and medical-nuclear examinations to arrive, in a short time, to a correct diagnostic definition and an appropriate therapeutic prescription.
In the context of radiological diagnosis,particular importance is now covered by the ultrasound of the thyroid,the most suitable examination to detect the presence of nodules, define its morphology, size, structure and evaluate further alterations at the expense of the gland.
The most important test to be carried out is the determination of TSH (TSH reflex): this is the most sensitive test since the TSH increases even in the presence of small defects of the thyroid function. Free thyroxine dosage (FT4) which is the main hormone produced by the thyroidcan also be carried out. In the presence of hypothyroidism, high levels of TSH and low levels of FT4 are observed, setting up the framework of primitive hypothyroidism. In the rare case of a pituitary defect, low levels of both FT4 and TSH (secondary hypothyroidism) will be present.
In Hashimoto’s disease hypothyroidism, there is an increase in anti-thyroid antibodies (AbTPO) alongside high levels of TSH and reduced levels of FT4.
How can hypothyroidism be cured?
Hypothyroidism is well controlled with the use of drugs that contain levothyroxine alone or in association with triiodothyronine. The disease is chronic and therefore the patient will have to take specific drugs throughout life.
Thyroid hormone replacement therapy (L-TIROXINA) orally consists of tablets to be taken fasting in the morning, at least 20 minutes before breakfast. The dosage of the drug is strictly individual and requires a thorough specialist evaluation.
Particular attention should be given to the treatment of hypothyroidism in pregnant or pregnant women: in these cases higher doses of the hormone are required, which will need to be reduced again, once the woman has given birth.
Hypothyroidism can increase the risk of complications related to surgical interventions, such as delayed functional intestinal recovery or failure to respond feverishly in the course of infection.
It is therefore necessary to achieve a normalization of thyroid function before any non-urgent surgery.
Hypothyroidism entitles you to the exemption from the shareholding in the cost of health benefits (ticket exemption) which must be certified by the endocrinologist specialist.