I. What is hypothyroidism? What are its causes? A: The full name of hypothyroidism is hypothyroidism, which refers to the inability of the thyroid gland to produce enough thyroid hormone to meet the normal needs of the body due to various reasons. The clinical manifestations of hypothyroidism often include fear of cold, reduced sweating, dry skin, delayed expression, slowed heart rate, loss of appetite, dry stools and fatigue. The prevalence of clinical hypothyroidism is about 1%, more common in women than in men, and the prevalence increases with age. Hypofunction begins in the fetus or newborn and is referred to as cretinism; in children before the onset of pro-spring development, it is called juvenile hypothyroidism; in adults, it is called adult hypothyroidism. In severe cases, it can cause mucinous edema, and in more severe cases, it can cause mucinous edema coma. What exactly are the causes of hypothyroidism? 1, due to surgical removal of part of the thyroid gland, causing hypothyroidism; 2, due to isotope treatment, destroying part of the thyroid tissue, causing hypothyroidism; 3, subacute thyroiditis, due to viral invasion, directly destroying part of the thyroid tissue; 4, Hashimoto’s thyroiditis: the increase of thyroid antibodies in the patient’s body, damaging part of the thyroid tissue, causing hypothyroidism; 5, due to factors such as pituitary tumor surgery Damage to the pituitary control center (command) of the thyroid gland, resulting in hypothyroidism; 6, drugs, such as anti-thyroid drugs; 7, other causes, such as thyroid hormone resistance. Second, what is the danger of hypothyroidism and its symptoms? Hypothyroidism starts in the embryonic or neonatal period is called cretinism, also known as “cretinism”, it will significantly hinder the growth and development process of infants and children, especially the skeletal system and the nervous system; childhood onset is called juvenile hypothyroidism, early childhood hypothyroidism patients show growth retardation, mental retardation, after 2 years of age onset of IQ impact degree The most serious cases will affect the respiratory center, causing sleep apnea, even respiratory failure, and even death. If you have 5 or more of the following symptoms, it is recommended to go to the hospital and have your nail function checked: easy to get sleepy, low physical strength and energy; slow thinking, hard to concentrate, memory loss; weight gain; dry skin, nails become brittle, gray, easy to break; often feel cold; easily depressed and depressed; easy to urinate; feel stiff and painful muscles and bones, numbness in hands, increased blood pressure or slower heartbeat; higher cholesterol level. How is hypothyroidism diagnosed? Diagnosis of diseases requires a combination of clinical symptoms, signs and laboratory tests, and hypothyroidism is no exception. When patients experience weakness, drowsiness, memory loss, coldness, swelling and other discomforts, they need to seek medical attention and undergo laboratory tests to diagnose hypothyroidism. The indicators that need to be tested include thyroid function, thyroid autoantibodies and other specific indicators. Fourth, the treatment of hypothyroidism? As a general principle, hypothyroidism is treated with replacement therapy. The amount of substitution needs to be individualized according to the degree of hypothyroidism and the patient’s own situation. For mild hypothyroidism, no special treatment is generally needed, and dietary therapy can be used to supplement iodine, the raw material for thyroid hormone production, by eating appropriate seafood; while for moderate and severe hypothyroidism, thyroid hormone replacement therapy must be used. Of course, the specific dosage needs to vary from person to person, and young patients should review their thyroid function regularly and adjust the medication according to the index, and it is generally recommended to control TSH below 2 or 5 IU/ml, with an optimal range of 1-2. Elderly patients do not require too much supplementation, as long as TSH is controlled within the normal level. Hypothyroidism is generally irreversible and requires lifelong replacement therapy. V. Can hypothyroidism be completely cured? Can it heal itself? The thyroid follicular cells are the factory floor for the production and storage of thyroid hormones. The destruction of the thyroid gland due to various reasons, such as post-surgical hypothyroidism (surgical removal of part of the thyroid tissue), post-isotope hypothyroidism (radioactive destruction of part of the thyroid tissue, surgery without incision), Hashimoto’s thyroiditis (destruction of part of the thyroid tissue by antibodies), and subthyroiditis (destruction of part of the thyroid tissue by viruses), all lead to the reduction of the factory floor for the production of thyroid hormones. fewer factory shops for thyroid hormones. The destroyed thyroid follicles are irreversible and can only be compensated by what remains. If there is little destruction, the remaining thyroid cells can compensate and the thyroid function can still be normal. If there is more destruction, even if it is compensated, the remaining thyroid gland will not be able to produce enough to replace it, and the thyroid function will show hypothyroidism, and it will need external help to replace the thyroid hormone for life. Overdose of anti-thyroid medication for hyperthyroidism leads to pharmacological hypothyroidism, which is restored by drug reduction. Because the drug does not destroy the thyroid cells (factory floor), but only inhibits the synthesis of thyroid hormone (makes the machine turn slower and produce less), the drug is reduced and production resumes, so drug hypothyroidism is reversible. VI. Can I eat seafood when I have hypothyroidism? Iodine is an important raw material necessary for thyroid hormone synthesis, and seafood is rich in iodine. However, the intake of seafood in hypothyroidism needs to be identified. For hypothyroidism caused by surgery such as thyroid nodules, you can eat more seafood to supplement the raw materials necessary for the synthesis of thyroid hormones; for hypothyroidism caused by Hashimoto’s thyroiditis, in principle, seafood is not contraindicated and can be consumed, but excessive intake is not recommended because excessive iodine intake can increase thyroid autoantibodies (TPOAb, TGAb) and thus aggravate thyroiditis; for hyperthyroidism caused by the same? hypothyroidism caused by isotope treatment of hyperthyroidism, it is still recommended to strictly avoid iodine as long as the thyroid stimulating hormone receptor antibody (TRAb) is still positive. This is because excluding the part of the thyroid follicle destroyed by the isotope, the remaining part is still taking in iodine continuously, which may lead to the recurrence of hyperthyroidism. Even if the overproduced thyroid hormone does not reach the normal level, it will affect the amount of thyroid hormone replacement, resulting in constant changes in the amount of replacement, which is not conducive to stable drug replacement in hypothyroid patients. 7. Can hypothyroidism be hereditary? Hypothyroidism is mostly an autoimmune disease. Autoantibodies are formed in the acquired environment, provided that the antigen invades. But why some people produce antibodies after bacterial and viral infections and some people do not? This means that there is a certain genetic susceptibility, that is, some people are particularly sensitive to certain antigens and will produce antibodies once they are exposed to them. This genetic susceptibility may be inherited. (Note that it is not a genetic disease, but a sensitivity to antigens). Further, hypothyroidism is a polygenic disease in which the genetic susceptibility as well as the onset of the disease is determined by a combination of multiple genetic loci, which raises the question of probability. For example, if 50 genes are associated with the susceptibility, as soon as 35 genes are passed down, the offspring develop the disease. Suppose the mother has the disease and carries 36 genes, and she passes 18 genes to half of the offspring, and the father has no disease and less than 35 genes, if 17 genes are passed down, the offspring will have 18+17=35 susceptibility genes and will be susceptible to the disease. If the father passes down 16 related genes, the offspring will have 18+16=34 susceptibility genes and will not develop the disease. Therefore, it is difficult to say whether it is hereditary or not, and the probability of heredity has yet to be further studied. VIII. Can I get pregnant with hypothyroidism? Do I need to take medication when I am pregnant? Is it possible to stop taking medication? Hypothyroidism can lead to pregnancy, but it is necessary to take the medication. Only if the thyroid gland is functioning normally can you get pregnant. Exogenous thyroid hormone supplementation is no different from the natural thyroid hormone in the body, so as long as the amount of thyroid hormone (euthyroid) is supplemented with the physiological needs, there are no side effects of the medication for the mother and the fetus. Therefore, it is important to supplement thyroid hormones during pregnancy, especially in the first trimester, because in early pregnancy, the fetal thyroid gland is not yet developed, and the fetus needs thyroid hormones for the development of the nervous system and other important organs, and the thyroid hormones needed come from the mother’s body. Therefore, pregnant women should not stop using thyroid hormone before and during pregnancy (especially in the first three months of pregnancy), and at the same time, TSH must be controlled to less than 2 or 5 IU/ml. pregnant mothers need to monitor thyroid function every month and adjust the dose of medication in time to ensure the safety of the fetus and mother. 9. Can hypothyroid patients breastfeed? Hypothyroidism patients can breastfeed and the effect on the baby is not significant. The amount of thyroid hormone passing through breast milk is very small, and the replacement of eugenol is only to the normal level of thyroid function, so it is possible to breastfeed normally after delivery. Usually hypothyroid patients take eugenol replacement when they are pregnant. During pregnancy, as the fetus grows, the amount of Ft4 needed gradually increases, reaching a peak before delivery. Once delivery occurs and the fetus, which was originally sharing Ft4 in the body, has left, maternal thyroid hormone may be increased or even overdosed. Therefore, it is recommended to review the thyroid function 48-72 hours after delivery (when the mother reaches equilibrium) and adjust the dose of Eugenol in time. If hyperthyroidism occurs during breastfeeding of hypothyroidism patients, regardless of the overdose of eugenol or the recurrence of real hyperthyroidism, the amount of T4 in breast milk will be increased, and the newborn’s own thyroid development will be affected, so we must wait until the thyroid function is normal before breastfeeding. Do I need to take medication for the rest of my life for hypothyroidism? What are the side effects of the medication? What should I pay attention to when taking the medication? Hypothyroidism is generally irreversible and requires lifelong medication for replacement therapy. However, the dosage varies from person to person, and the best dosage should be given according to the patient’s different needs. The most important medication is levothyroxine tablets (Eugenol), which is a synthetic thyroid hormone, the same as the natural thyroid hormone, so it has no side effects on the human body. However, it should be noted that if the replacement dose is too high, it may lead to drug-induced hyperthyroidism, so the dose needs to be adjusted and individualized from person to person, and the patient needs to promptly visit or consult a professional endocrinologist to determine if the drug dose needs to be adjusted. If you take Eugenol on an empty stomach, it is well absorbed, but if you take a larger dose, you can take it in divided doses, but it is not recommended to take it at night because it is an excitatory hormone and taking it at night may lead to insomnia and other conditions.