Overview of Hypothyroidism
Hypothyroidism (hypothyroidism) is a disease in which the body’s metabolism is lowered due to a decrease in the synthesis and secretion of thyroid hormones or a deficiency in their physiologic effects. According to its cause, it is divided into three categories: primary hypothyroidism, secondary hypothyroidism and peripheral hypothyroidism.
Questions you may be concerned about
What is the difference between hyperthyroidism and hypothyroidism?
Hyperthyroidism and hypothyroidism are both thyroid disorders, but they differ significantly in their etiology, clinical symptoms, and treatment options. Hyperthyroidism is characterized by an increase in thyroid hormones and hypermetabolism, and is treated with antithyroid drugs. Hypothyroidism is characterized by a decrease in thyroid hormones and slow metabolism, and requires thyroid hormone supplementation.
1. Etiology: hyperthyroidism is a clinical syndrome caused by excessive secretion of thyroid hormone, which may be related to genetics, environmental factors, infection, stress or trauma, and immune dysfunction; hypothyroidism is caused by insufficient function of the thyroid gland and insufficient secretion of thyroid hormone.
2. Clinical manifestations: hyperthyroidism manifests hypermetabolism, such as easy to hunger and overeating, weight loss, irritability, nervousness, tachycardia, proptosis, tremor, hyperthyroidism crisis, etc. Hypothyroidism often manifests slow metabolism, such as lethargy, fatigue and weakness, slow movement, slow thinking, bradycardia, etc.
3. Treatment: Hyperthyroidism is treated with anti-thyroid drugs (methimazole, propylthiouracil), radioactive iodine therapy and surgery. Treatment of hypothyroidism is mainly to supplement thyroxine (levothyroxine sodium tablets).
Hyperthyroidism and hypothyroidism should go to regular hospitals, under the guidance of specialists, standardized treatment, not unauthorized use of medication, so as not to delay the condition.
Causes
The etiology is complex, with primary ones being the most common, followed by pituitary ones, while others are rare.
Symptoms
1. Pale face, swollen eyelids and cheeks, indifferent expression, dementia, dry, thickened, rough and flaky skin all over the body, non-sunken edema, hair loss, yellowish palms of hands and feet, weight gain, thick and brittle nails in a few patients.
2. Neuropsychiatric system: memory loss, mental retardation, drowsiness, slow reaction, anxiety, dizziness, headache, tinnitus, deafness, nystagmus, ataxia, tendon reflexes, prolongation of the relaxation period of Achilles tendon reflexes, and in severe cases, dementia, stiffness, and even lethargy may occur.
3. Cardiovascular system: bradycardia, decreased cardiac output, low blood pressure, muffled heart sounds, heart enlargement, can be complicated by coronary artery disease, but generally do not occur angina pectoris and heart failure, sometimes accompanied by pericardial effusion and pleural effusion. Sometimes, it can be accompanied by pericardial effusion and pleural effusion. In severe cases, mucous edema cardiomyopathy occurs.
4. Digestive system: anorexia, abdominal distension, constipation. In severe cases, paralytic intestinal obstruction may occur. Gallbladder contraction is weakened and distended. Half of the patients have gastric acid deficiency, leading to pernicious anemia and iron deficiency anemia.
5. Motor system: muscle weakness, pain, ankylosis, may be accompanied by joint lesions such as chronic arthritis.
6. Endocrine system: excessive menstruation, amenorrhea and infertility in women; impotence and loss of libido in men. A few patients have lactation and secondary pituitary enlargement.
7. When the condition is serious, due to cold, infection, surgery, anesthesia or sedative application of inappropriate stress can be induced mucous edema coma or “hypothyroidism crisis”. The manifestation of low body temperature (T < 35 ℃), respiratory slowing, bradycardia, blood pressure drops, limb muscle relaxation, reflexes weakened or disappeared, and even coma, shock, cardiac and renal failure.
8. Hypothyroidism: dull expression, hoarse pronunciation, pale face, periorbital swelling, widening of the distance between the eyes, nose flattening, thick salivation of the lips, tongue large and outstretched limbs, short and thick, duck step.
9. Juvenile hypothyroidism: short stature, low intelligence, delayed sexual development.
Examination
1. Thyroid function test
Serum TT4, TT3, FT4, FT3 are lower than normal.
2.Serum TSH value
(1) Primary hypothyroidism: TSH is markedly elevated and accompanied by a decrease in free T4. In subclinical hypothyroidism, serum TT4 and TT3 values may be normal, while serum TSH is mildly elevated, and serum TSH level is higher than normal after TRH stimulant test.
(2) Pituitary hypothyroidism Low or normal or higher than normal serum TSH levels with no response to TRH excitation test. Serum TT4 level is elevated after application of TSH.
(3) Hypothalamic hypothyroidism Low or normal serum TSH level, responds well to TRH excitation test.
(4) Peripheral hypothyroidism (thyroid hormone resistance syndrome) Elevated TSH in those with central resistance, low TSH in those with peripheral tissue resistance, and different TSH manifestations in those with systemic resistance.
3. X-ray examination
The heart is enlarged, the heart beat is slowed down, pericardial effusion, and the pterygoid saddle may be enlarged on flat film of the skull.
4. Electrocardiography
Echocardiography shows low voltage, prolonged Q-T interval and ST-T abnormality. Echocardiography shows myocardial thickening and pericardial effusion.
5. Lipids, increased creatine phosphokinase activity, low glucose tolerance curve.
Diagnosis
Diagnosis can be made on the basis of etiology, clinical manifestations and laboratory tests.
Questions you may be concerned about
What are the criteria for determining permanent hypothyroidism?
Whether or not the hypothyroidism is permanent can generally be determined based on the cause of the hypothyroidism. If the hypothyroidism is after thyroidectomy, it is usually permanent and requires thyroid hormone supplementation therapy.
If the hypothyroidism is caused by subacute thyroiditis, it is usually curable because subacute thyroiditis is a self-limiting disease and will resolve on its own when it reaches a certain level. In addition, most of the hypothyroidism caused by medication can be recovered after stopping the medication.
If the hypothyroidism is caused by autoimmune thyroiditis or thyroidectomy, it is usually difficult to be cured and is a permanent hypothyroidism, which requires lifelong treatment with levothyroxine sodium tablets to keep the thyroid hormone within a reasonable range.
Patients diagnosed with hypothyroidism should actively cooperate with their doctors for treatment.
Differential diagnosis
It should be differentiated from renal edema, anemia, congestive heart failure and so on. According to rT3 and the patient’s primary manifestations, it should be differentiated from low T3 syndrome, and the symptoms of hypothyroidism and breast overflow should be differentiated from prolactinoma.
Treatment
1. Lifelong replacement therapy with thyroid preparation
Oral thyroid tablets or levothyroxine are the mainstay in early light cases. Thyroid function should be tested and TSH should be maintained at normal value.
2. Symptomatic treatment
In addition to oral thyroid tablets or levothyroxine, symptomatic treatment such as oxygen administration, fluid infusion, infection control, and control of heart failure are needed in middle and late severe cases.
Questions you may be concerned about
What is the nemesis of hypothyroidism?
There is no such thing as a “nemesis” of hypothyroidism, hypothyroidism can be categorized as “deficiency”, “galls” and “edema”. “The actual fact is that it’s not a good idea to have a good deal of time to get a good deal of time. Clinical should be based on the specific type of evidence to choose the appropriate proprietary Chinese medicine treatment, such as kidney yang deficiency can be used Jin Gui Kidney Qi Pills.
1.Tonifying the center and benefiting qi pill: composed of roasted astragalus, codonopsis, roasted licorice and so on. It has the effect of tonifying the middle and benefiting the qi, elevating the yang and lifting the sunken organs (elevating the yang qi of the body to lift the sunken organs). It is used for diarrhea, prolapse of the anus, yin ting (prolapse of the uterus or even out of the vaginal opening in women) caused by weakness of the spleen and stomach, and sinking of the middle qi (deficiency of the spleen and stomach qi, which results in the falling of the internal organs).
2. Jin Gui Kidney Qi Pill: It is composed of yam, zedoary, epiphyllum, etc. It has the efficacy of warming and tonifying the kidney yang, transforming qi to move water (to promote the operation of gas, thus promoting the operation of water and liquid). It is suitable for kidney deficiency and edema, soreness and weakness of waist and knees, dysuria (unsmooth urination), coldness and cold limbs. Note: Caution should be taken when there is deficiency of Yin and internal heat.
3. Radix Rehmanniae Pill: composed of Radix Rehmanniae, Radix et Rhizoma Ginseng, Rhizoma Atractylodis Macrocephalae, Radix et Rhizoma Glycyrrhizae, Radix et Rhizoma Glycyrrhizae, with the effect of warming the middle Jiao and strengthening spleen. It is used in treating coldness in the spleen and stomach, cold pain in the epigastrium (cold pain in the epigastrium and abdomen), vomiting and diarrhea, and lack of warmth in the hands and feet. This medicine should not be taken when one has a cold.
It is recommended to use it under the guidance of a Chinese medicine practitioner for unauthorized use of the medicine may result in adverse consequences.
How to get rid of hypothyroid edema?
When edema occurs in patients with hypothyroidism, the main treatment is to supplement the thyroid hormone, and the diet needs to limit the intake of sodium.
1. medication: hypothyroidism patients edema, because the accumulation of glycoproteins in the subcutaneous, mucous edema, need to follow the doctor’s instructions to start using a small dose of levothyroxine, and gradually control the level of thyroid hormone in a reasonable range, edema will be relieved.
2. Dietary adjustments: hypothyroidism patients need to pay attention to the daily life of less salt and low-fat diet, can also play a role in relieving edema.
Hypothyroid patients with edema are advised to go to the hospital for medical treatment.
Which acupuncture points are used to treat hypothyroidism?
Hypothyroidism belongs to the category of “deficiency labor” in Chinese medicine, and acupuncture is based on Renying, Kidney Yu, Spleen Yu, Vitality, and Foot Sanli points.
1. Renying: located next to the laryngeal node, the anterior edge of the sternocleidomastoid muscle, the common carotid artery, avoiding the artery straight 0.3 to 0.5 inches, the line of ordinary acupuncture, flat tonic and flat diarrhea, stay in the needle for 15 minutes, the main role in regulating the qi and tonifying qi.
2. Kidney Yu: located in the 2nd lumbar vertebrae, 1.5 inches away from the spinous process, straight 0.5 ~ 1 inch, warm acupuncture, stay for 15 minutes, mainly to tonify the kidney to help the role of Yang.
3. Spleen Yu: located in the 11th thoracic vertebra under the spinous process, 1.5 inches aside, oblique stabbing 0.5 ~ 0.8 inches, forbidding deep stabbing, to prevent pneumothorax and injuries to the internal organs, warm acupuncture and moxibustion, stay in the needle for 15 minutes, the main role of the spleen and qi and the center (regulating the qi of the spleen and stomach, so that the function of the spleen and stomach is smooth), benefit qi and nourish the role of blood.
4. Vital Gate: located between the spinous processes of the 2nd and 3rd lumbar vertebrae, 0.5-1 inches straight, warm acupuncture and moxibustion, leave the needle for 15 minutes, mainly to tonify the kidney and strengthen the essence, strengthen the muscles and bones.
5. Foot Sanli: located on the lateral side of the lower leg, 3 inches below the eye of the knee, 1~1.5 inches straight, warm moxibustion, leave the needle for 15 minutes, mainly to regulate the spleen and stomach, replenish the middle qi, and strengthen the role of.
Acupuncture treatment of hypothyroidism can only play a role in stimulating positive qi and improving body functions, clinical systematic treatment is often needed to better control the condition, it is recommended to seek medical treatment in a timely manner in order to avoid delays in the condition.