June 22, 2024

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The doctor may not tell you these knowledges of hypothyroidism

The doctor may not tell you these knowledges of hypothyroidism


The doctor may not tell you these knowledges of hypothyroidism. Hypothyroidism is a systemic hypometabolic syndrome caused by hypothyroidism or thyroid hormone resistance. It is more common in women, and the ratio of male to female incidence is 1:4 to 6.

The doctor may not tell you these knowledges of hypothyroidism

The early symptoms of hypothyroidism lack specificity, the onset is hidden, and the course of the disease is long. Therefore, hypothyroidism is also the most misdiagnosed thyroid disease. The thyroid is the largest endocrine system of the human body. Whether it is hyperthyroidism, hypothyroidism, or thyroid nodules, it will have a certain impact on the human body, so this issue will take you to understand hypothyroidism (hereinafter collectively referred to as “hypothyroidism”).



Hypothyroidism category

1. Primary hypothyroidism

It is mainly caused by autoimmunity, thyroid surgery and hyperthyroidism iodine 131 treatment. As the name suggests, this type of hypothyroidism is caused by the pathological changes of the thyroid gland itself, accounting for more than 95% of all hypothyroidism

2. Central hypothyroidism

Caused by hypothalamus and pituitary disease caused by thyroid-stimulating hormone releasing hormone or decreased production and secretion of thyroid-stimulating hormone. Such common causes are external pituitary irradiation, pituitary macroadenoma, craniopharyngioma, and postpartum hemorrhage. In some of the cases we shared before, we found the symptoms of hypothyroidism, and we also need to do brain CT and other examinations to rule out the diagnosis of hypothyroidism caused by hypothalamic or pituitary lesions.

3. Thyroid hormone resistance syndrome

A syndrome caused by thyroid hormone’s biological effect disorder in peripheral tissues.

Vulnerable population

1. Autoimmune damage: such as atrophic thyroiditis, postpartum thyroiditis, etc.

2. Those with a history of thyroid surgery or abnormal thyroid function, the cumulative incidence of hypothyroidism within 10 years after subtotal thyroidectomy was 40%.

3. Women planning pregnancy and early pregnancy (<8 weeks), infertile women

4. Pericardial effusion or dyslipidemia, BMI>40 kg/m2

5. People with a history of iodine-containing drugs such as amiodarone, among them, taking iodine-containing drug amiodarone can cause iodine overdose, and the incidence of hypothyroidism is 5%~22%.

6. Those who take antithyroid drugs such as lithium salt, thiourea, imidazole, etc.

10 typical clinical manifestations of hypothyroidism

1. chills

Hypothyroidism slows down the body’s metabolism, so some patients with hypothyroidism often have cold hands and feet, feel that the whole body is cold, or have a low tolerance to cold

2. Fatigue, joint pain, swelling of hands and feet

Patients with hypothyroidism may have muscle damage, and may have clinical symptoms such as obvious quadricus weakness, fatigue, myalgia, or muscle stiffness, and delayed Achilles reflexes, especially after exercise and in cold environments. There will be swelling in the hands and feet, and a few cases will have mucinous edema of the anterior tibia of both lower limbs.

3. Drowsiness

Fatigue and lethargy are one of the most common symptoms of hypothyroidism. This is the reduction of thyroid hormones in the blood and cells caused by hypothyroidism, and then the excitability of the brain is reduced, which ultimately results in the muscles being unable to continuously obtain stimulation signals. Many patients with hypothyroidism say that they always feel very tired in their lives and want to sleep, even if they can’t recover their spirits even if they take several sleep breaks throughout the day.

4. Memory loss

Elderly hypothyroidism can easily be misdiagnosed as Alzheimer’s. In fact, this is also the reason that hypothyroidism reduces the excitability of the sympathetic nervous system. For young people’s hypothyroidism, it will affect people’s cognitive ability, making people slow to react, slow in action, slow in speech and even forgetfulness.

5. Loss of appetite, weight gain

The thyroid gland secretes thyroid hormones, which help regulate diet and the metabolism of fat and sugar. Hypothyroidism can lead to hormone imbalance, which can cause loss of appetite and slow metabolism. In addition, I just mentioned that hypothyroidism can cause edema, so although you may not eat much, your weight will continue to increase.

6. Constipation

Hypothyroidism can cause slow bowel movements, which can cause constipation. Friends with frequent constipation should pay attention, especially the elderly patients with hypothyroidism, who are less active, and some elderly patients are more likely to cause constipation because of long-term bed rest and reduced intake of fibrous food.

7. Menstrual disorders or heavy menstruation, infertility

Decreased thyroid hormones can cause testicular atrophy in men, ovulation disorders in women, and decreased libido in men and women.

Irregular menstruation and heavy menstruation are common in women, and serious cases may lead to amenorrhea, and the rate of miscarriage after pregnancy will increase.

8. Hypothyroidism

Hypothyroidism face is also called “mask face”, with dull expression, pale complexion, swelling of face and eyelids, thick lips and big tongue, often with tooth marks.

At the same time, hypothyroidism can also affect the excitability of the brain, and patients are prone to depression, reluctance, and even depression.

9. Dry skin and hair loss

Hypothyroidism will reduce the rate of metabolism, so that skin moisture and sweat will be reduced, and the skin is prone to dryness and peeling. At the same time, hypothyroidism can also affect hair growth, with patients experiencing hair loss, sparse eyebrows, and even sparse beards in men. (I previously shared an article about my friend’s sister’s constipation and sparse eyebrows. The final diagnosis is also hypothyroidism. Interested readers can click on the link below to read)

→ Her constipation is different, and she feels that life has no fun. The internist saw the clue at a glance!

10. Hoarseness and snoring

The lips and tongue of patients with hypothyroidism are often relatively hypertrophic, and the base of the tongue falls back, causing hoarseness and unclear speech. It also affects the breathing state during sleep and is prone to sleep snoring.



Treatment of hypothyroidism

The treatment of hypothyroidism is actually relatively simple. It is to supplement the patient with an appropriate amount of L-thyroid hormone according to the principle of “how much is lacking, and how much is supplemented” to restore and maintain normal thyroid function.

Patients with hypothyroidism are mainly treated with levothyroxine, and the initial dose of levothyroxine for primary hypothyroidism and the time required to reach a complete replacement dose are related to the degree of hypothyroidism, age, weight, and cardiac function status of the patient.

Hypothyroidism is a lifelong disease. Whether patients with hypothyroidism can discontinue the drug after taking the medication mainly depends on the cause of the hypothyroidism. Drug-induced hypothyroidism, postpartum thyroiditis, subacute thyroiditis and other causes of hypothyroidism are mostly transient (except for a few patients). In most cases, the drug can be stopped after treatment and recovery.

Hypothyroidism caused by hyperthyroidism surgery and radiotherapy is permanent and requires life-long medication; therefore, whether the medication can be discontinued, you must follow the doctor’s advice and never make your own claims.




Attention to diet in patients with hypothyroidism

1. Intake of iodine

Hypothyroidism caused by iodine deficiency alone can be supplemented with iodine under the guidance of a doctor.
If hypothyroidism is caused by Hashimoto’s thyroiditis, a low-iodine diet is required, and high-iodine foods such as kelp and seaweed should not be eaten. Because excessive iodine can induce and aggravate autoimmune thyroiditis.

2. Daily diet

In the daily diet, patients with hypothyroidism should pay attention to supplementing sufficient iron and high-quality protein to ensure the intake of eggs, milk, soy products, freshwater fish and shrimp, etc.;
At the same time, eat less high-fat and high-cholesterol foods to avoid further aggravating lipid metabolism disorders.

3. Pay attention to diet

Cruciferous vegetables such as cabbage, broccoli, broccoli, radish, and cabbage that we often eat in life contain thiocyanate, which can interfere with the synthesis of thyroid hormones and cause goiter. Patients with hypothyroidism should eat these vegetables as little as possible, especially not raw.

In addition, if you have “myxedema” in patients with hypothyroidism, pay attention to a light diet and do not eat too salty.





(source:internet, reference only)

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