Severe tachycardia disease hypothyroidism treatment. Thyroid gland and dangerous effects on the heart

The attending physician individually determines how to take Eutirox for hypothyroidism, taking into account the age, characteristics of the patient, in accordance with the duration and nature of the disease.

Thyroid gland and its hormones

The thyroid gland, called the thyroid gland in the 17th century, is located in the anterior part of the neck, next to it are the parathyroid glands. This small organ is a vulnerable place from the point of view of causing any injury or infection. The two lobes are connected by an isthmus, shaped like a shield. The gland, with its main endocrine function, is a participant in various processes of the body. Without the work of an organ, it is impossible to imagine the growth and development of any organism.

The main role of the thyroid gland, as it is popularly called, is the production of hormones:

• thyroxine;
• tyrosine;
• Iodine tyranine.

Thyroxine stimulates the growth of the body as a whole, increasing resistance to high temperatures. It is produced from the intrauterine stage of human development. Without it, growth in height, development of mental abilities, and stabilization of the immune system do not occur. Under the influence of hormones, protection is enhanced - cells are more easily freed from foreign elements.

The production of hormones is regulated by higher glands - the hypothalamus and pituitary gland. The pituitary gland produces thyroid-stimulating hormone, which causes the thyroid gland to increase not only the production of iodothyranine and thyroxine, but also activates the growth of the gland itself. The hypothalamus is the control center where nerve impulses arrive. It produces hormones that regulate the activity of the pituitary gland.

Thus, under the guidance of the hypothalamus, throughout the day, the thyroid gland produces up to 300 micrograms of thyroid hormones, which ensure the development and construction of the nervous system. When the amount of hormones is excessive or insufficient, the nervous system responds with excitability or depression.

Eutirox for hypothyroidism

Hypothyroidism is characterized by a decrease in the concentration of the hormone in the blood. Often, hormonal deficiency is not detected for a long time, since the symptoms develop slowly and do not affect the general health, but occur under the masks of other diseases. With a chronic lack of thyroid hormones in a person, metabolic processes slow down, resulting in a decrease in the production of energy and heat. The initial or obvious symptoms of hypothyroidism include:

• chilliness;
• loss of appetite with weight gain;
• drowsiness;
• dryness of the epidermis;
• poor concentration, lethargy;
• dizziness;
• depression;
• constipation;
• cardiovascular disorders.

For deficient thyroid function, so-called hypothyroidism, Eutirox, a synthetic analogue of thyroxine, is primarily indicated. This drug is used for replacement purposes. The drug belongs to the category of iodine regulators in the body.

Clinical experience and recommendations show that the use of Eutirox for long-term replacement therapy is safe. The severity of situations varies. Sometimes the depth of the patient's experiences does not correspond to the severity of the problem that befell him. An exception to the rule is old age and concomitant pathologies:

• adrenal insufficiency;
• inflammation of the heart muscle;
• acute myocardial infarction;
• acute inflammation of the membranes of the heart;
• atherosclerosis.

If you follow the recommendations in these cases, a dose adjustment of the drug is required. Eutirox is prescribed at 50 micrograms with further increases. Thyroxine is a hormone, and taking an artificial hormone, like taking any drug, is accompanied by side effects.

Effects of Eutirox

Eutirox is a hormonal tablet preparation that is chemically and molecularly identical to the human hormone. In case of hypothyroidism, which is accompanied by weight gain, the use of the drug leads to the fact that the function of the endocrine gland is normalized, and with good thyroxine levels, the weight is equalized. When taking a pharmaceutical product, allergic reactions are possible, which are detected in the initial stages of administration.

As for hair loss, when taking the drug, there is an improvement in hair quality, as opposed to the effects when hair loss is a symptom of insufficient function of the endocrine gland. When the state transitions to euthyroidism, hair will stop falling out, fragility and fragility will disappear.

With an excess dose of the drug, signs of thyrotoxicosis appear, a reverse condition characterized by hyperfunction of the thyroid gland. The most common ones are:

• arrhythmia;
• high blood pressure;
• insomnia;
• irritability, short temper;
• weight loss;
• hyperhidrosis;
• menstrual irregularities in women.

When the drug substance accumulates in the tissues of the body, changes in the functioning of the digestive system and allergic reactions also occur.

Taking and stopping Eutirox

To avoid side effects, Eutirox must be taken correctly:

• early in the morning, usually half an hour before breakfast;
• with a small portion of plain water.

It is advisable not to skip taking the drug, but to take it constantly, at the same time, throughout the entire period indicated by the doctor. Fluctuations in hormone levels are undesirable for the thyroid gland if the drug is missed. This can lead to the growth of gland nodes. You should not take the drug in a double dose to replace the missed one - this will cause a sharp jump in function. It is advisable to take the missed dose in the morning on the same day, at lunch or in the evening.

After removal of the thyroid gland, the prescription depends on the amount of tissue removed. If part of the gland has been resected or 50% of the tissue has been removed, the need to prescribe Eutirox is determined by the tests performed. This category of patients needs to check the level of thyroxine in the blood and determine the level of thyroid-stimulating hormone. If they are within normal limits, then the use of the drug is not mandatory. If decreased gland function is diagnosed - low levels of thyroxine or, conversely, an increase in thyroid-stimulating hormone, then replacement therapy is necessary.

If the thyroid gland is completely removed, the course of treatment covers the rest of your life. When prescribing Eutirox for the purpose of blocking the production of hormones by the thyroid gland itself, as a rule, the treatment course is determined for a specific period of 1–2 months.

When planning pregnancy, it is advisable to use the Eutirox hormone in the following cases:

• if a woman has had a thyroid disease;
• if you have undergone surgery on the gland and are prescribed replacement therapy.

With hypothyroidism, pregnancy is almost impossible. Carrying out adequate therapy with the prescription of hormonal drugs is the success of the development of pregnancy. During the period of gestation, taking a hormonal drug is mandatory for those for whom it is indicated. A pregnant woman with hypothyroidism who does not take replacement medications runs the risk of giving birth to a child with signs of thyroid deficiency and mental retardation.

There are cases when it is necessary to increase the dose of Eutirox. Then the observation of such a pregnancy falls within the competence of not only the gynecologist, but also the endocrinologist. Children suffering from hormonal deficiency due to hypothyroidism also need to take this drug in the dosage and course as prescribed by a specialist. The portioned dose depends on the child’s body weight and age.

Self-discontinuation of the drug will lead to a new development of symptoms of hypothyroidism, when the production of thyroxine is impossible naturally. Cancellation of Eutirox while blocking hormonal production will not lead to pronounced changes.

Drug overdose

Taking Eutirox will bring hormone levels back to normal only in situations where it is justifiably prescribed. There is no need to be afraid of taking hormones. You need to be wary of a lack of hormones. The drug Eutirox is inexpensive, accessible and effective.

Secret area

There is only one point to pay attention to. A normal person without signs of hypothyroidism is able to work for 3 days in a row and then recover quietly for 2 days. A person who takes the artificial hormone levothyroxine has a hard time tolerating this condition. With an active lifestyle, with increased physical and emotional stress, a large dose of the hormone is required. In case of an overdose of Eutirox in case of hypothyroidism, problems with the functioning of the heart arise during the recovery period after workload:

• increased heart rate;
• tachycardia;
• arrhythmia;
• pain in the heart.

The effect that a hormone similar in its chemical properties has in tablets to “native” thyroxine in a state of excitement remains unknown and is being studied by medicine, as well as pharmacology. Opinions tend to favor the effect of the body processing the artificial analogue. Nevertheless, the drug fully performs its function, and the most important tasks remain nuances. People taking Eutirox work and rest safely, reproduce and raise healthy offspring.

Combination with other dosage forms

An overdose of thyroxine or an increase in the effect of the drug can occur when using certain products and dosage forms. If the dose was exceeded when taking Eutirox, the following symptoms appear:

• chest discomfort;
• dyspnea;
• convulsions;
• loss of appetite;
• disruptions in the menstrual cycle;
• sleep disturbance;
• fever and excessive sweating;
• diarrhea;
• vomit;
• rash;
• irritability.

Taking herbal decoctions and vitamin complexes is carried out after consultation with an endocrinologist.

The medicine becomes poison for the body when acute signs of overdose are observed, appearing within 24 hours:

• Thyrotoxic crisis, in which an increase in all signs of hyperthyroidism (thyrotoxicosis) is obvious.
• Mental disorders - convulsive seizures, delirium and semi-fainting states, leading to the development of coma.
• A sharp decrease in urine output (anuria).
• Liver atrophy.

Despite the fact that Eutirox is a drug that regulates iodine in the body, you can take iodine-containing synthetic (Iodomarin) or natural (kelp) forms. Iodomarin contains inorganic iodine, which is not produced in the body, so it must come from outside. This is especially important for pregnant women and people suffering from insufficiency of the endocrine gland.

Structural analogues

Trade analogues of the drug are represented by the names L-Thyroxin, Bagotirox, Tireotom and Novotiral. Despite the fact that all these pharmacological products share one active ingredient - levothyraxine, there are differences in their action. Eutirox, when taken as prescribed, unlike other structural analogues, does not have (or in rare cases has) side effects. Indicated for the treatment of childhood deficiency conditions.

Combining with other drugs, prescribing or changing the dose on your own is strictly not recommended. Only a doctor, based on the physiological characteristics and individual health indicators of the patient, selects the drug, dosage and course of treatment.

First aid for overdose

When you feel the first signs of illness, you need to see a doctor or call a specialist to your home. You should not delay calling an ambulance if your condition worsens, or in the following cases:

• if an overdose occurs in a child, pregnant woman, or elderly person;
• severe heart rhythm disturbances and chest pain;
• diarrhea with bloody discharge;
• high blood pressure;
• pathologies of a neurological nature - seizures, paralysis, paresis;
• disturbances of consciousness.

Depending on the severity of intoxication, drug therapy is carried out using symptomatic drugs, blood purification procedures for unconscious patients.

Drugs for replacement and symptomatic therapy for thyroid hypothyroidism

Taking Iodomarin for reduced thyroid function

What is the latent form of hypothyroidism characterized by and can it be cured?

The drug Endorm for autoimmune thyroiditis

Features of the development and treatment of cordarone-induced thyrotoxicosis

Thyroid gland: symptoms of the disease in women and principles of treatment

Unfortunately, women often encounter diseases of the thyroid gland: according to statistics, every fifth representative of the fair sex has clinically pronounced manifestations of hypothyroidism, and hyperthyroidism develops in 4-6% of the world's population. There are many causes of hormonal disorders, but each of them affects the thyroid gland: we will consider the symptoms of the disease in women + treatment of the pathology in more detail in our review and video in this article.

Clinical manifestations

All endocrine diseases of the thyroid gland are divided into two large groups:

• occurring with hypofunction (failure);
• occurring with hyperfunction (excess production of hormones).

Symptoms of thyroid disease in women can be directly opposite and depend precisely on what hormonal changes occur in the body.

With a lack of thyroid hormones, all vital processes in the body slow down.

The main symptoms of hypothyroidism include:

• bradycardia - a decrease in heart rate to 60 beats per minute or lower;
• fragility, loss of hair shafts;
• dry skin;
• constant feeling of chilliness;
• gaining excess weight with a normal diet and even decreased appetite;
• disruption of the gastrointestinal tract (nausea, belching, flatulence and bloating, constipation);
• increased cholesterol levels;
• fatigue, decreased performance, weakness;
• depressed mood, depression;
• menstrual irregularities, reversible infertility;
• swelling of the face and limbs;
• decreased memory, attention, and thinking abilities.

With long-term hypothyroidism, goiter may develop - an increase in the size of the thyroid gland. At the same time, the following symptoms of thyroid disease in women are added to the classic signs of hormonal imbalance: cough, difficulty breathing, shortness of breath, change or complete loss of voice caused by compression of the respiratory tract.

Pay attention! Hypothyroidism is often diagnosed already in an advanced stage, with the development of severe multiple organ disorders. This happens because many sick people attribute the first signs of the disease to fatigue, poor health, and seasonal blues. Therefore, doctors recommend that all healthy people undergo a thyroid examination regularly (at least once every 5 years).

Hyperthyroidism

Symptoms of thyroid disease in women + treatment of the pathology are directly opposite for hypothyroidism.

Characteristic signs of the disease:

• tachycardia – increased heart rate and pulse;
• arrhythmia;
• increased systolic pressure;
• thinning of skin and nails;
• heat intolerance, excessive sweating;
• weight loss despite good appetite;
• loose stools, vomiting;
• eye problems: ophthalmopathy, bulging eyes, dry cornea;
• trembling fingertips;
• insomnia, nightmares, disturbing dreams;
• nervousness and increased irritability;
• menstrual irregularities, reversible infertility.

Pay attention! Any hormonal problems of the thyroid gland can lead to reproductive disorders in women. However, they are temporary, and after a course of treatment, menstruation is restored.

Diagnostic principles

An experienced doctor can assume a thyroid disease based on complaints and a clinical examination of the patient.

To confirm the diagnosis, the following examination must be performed:

• biochemical studies of the hormonal composition of the blood (TSH, T3, T4);
• general clinical blood and urine tests;
• determination of antibodies to TSH and TPO receptors;
• scintaging—determining the functional activity of an organ;
• according to indications - puncture biopsy.

Treatment

Treatment of the thyroid gland - we discussed the symptoms of the disease in women above - depends on the degree of hormonal disorders. The principles of modern therapy are presented in the table below.

Table: Instructions for the treatment of endocrine pathologies in women:

Treatment Goals	Thyroid diseases with hypothyroidism	Thyroid diseases with hyperthyroidism
Diet	Limiting high-calorie fatty foods, soy products, and alcohol. The basis of the diet should be fruits and vegetables, seafood and lean meat	Limiting foods that stimulate the central nervous system: coffee and tea, strong rich broths, alcohol. Therapeutic nutrition should be balanced and high-calorie, as the patient quickly loses body weight.
Correction of hormonal imbalance	Synthetic analogues of thyroid hormones - Eutirox or L-thyroxine	Drugs that reduce thyroid activity - Mercazolil, Tyrosol, Metizol
Radical therapy (if drug treatment is ineffective)	An operation to remove an endocrine organ is used when there is a significant increase in its size and the formation of a grade 4-5 goiter.	Surgical removal of the organ. “Switching off” the thyroid gland from working using radioactive isotopes of iodine.

Do-it-yourself folk methods for the treatment of thyroid pathology (vegetable juices, products based on white cinquefoil, European grasshopper, gorse, etc.) only briefly eliminate the symptoms of hormonal disorders, but do not combat their causes.

Pay attention! Patients who have undergone surgery to remove the thyroid gland are forced to take hormonal medications throughout their lives.

The earlier endocrine pathology is diagnosed, the more effective its therapy will be. It is important to begin treatment for thyroid disease as early as possible: symptoms in women, although they develop slowly, are quite typical and are not difficult to diagnose.

Complications of hypothyroidism and hypothyroid coma

Hypothyroidism is a dysfunction of organs and systems caused by low functionality of the thyroid gland. Reduced synthesis of gland hormones causes various symptoms and disruption of internal organs.

The disorder often occurs in middle-aged women, but can also develop in men who have had an endocrine gland removed.

After prescribing replacement therapy, the patient has the opportunity to live a full life; the prognosis in this case is favorable, life expectancy is quite high.

Complications of hypothyroidism occur in the absence of treatment, the quality of life drops sharply, this is especially true for older people. They often die from cardiac and respiratory failure. In some cases, it is not possible to save lives even with timely and correct therapy, even for people under 30 years of age.

• Clinical picture of hypothyroidism
• Diagnostic measures when examining patients with hypothyroidism
• Hypothyroid coma
• Emergency care for hypothyroid coma and subsequent treatment of complications
• Nuances of emergency care for severe consequences of hypothyroidism
• Treatment of complications of hypothyroidism in children

Clinical picture of hypothyroidism

Can hypothyroidism be cured and how long will it take for symptoms to subside? It all depends on the age of the patient, the cause of the disorder and its severity. Treatment may take several years, and in some cases treatment will take a lifetime.

The severity of symptoms increases gradually; at the very beginning, health problems do not bother patients. Most often, this picture occurs in patients after removal of part of the gland. The resulting condition is called postoperative primary hypothyroidism.

Symptoms of thyroid hypothyroidism:

• chilliness;
• depression;
• unreasonable weight gain;
• constant fatigue;
• problems with the cardiovascular system;
• baldness;
• pale skin;
• insomnia;
• elevated cholesterol levels;
• disturbance of attention and thinking.

Diagnostic measures when examining patients with hypothyroidism

If hypothyroidism is suspected, the patient is asked to undergo laboratory tests for thyroid hormones. The TSH level is indicative; its normal level excludes hypothyroidism.

Mistakes can occur in diagnosing hypothyroidism, as its symptoms can be disguised as other diseases.

A decrease in thyroid function in patients over 50 years of age is considered a sign of aging, since the following symptoms: dementia, general weakness, poor appetite, dry skin, high cholesterol are typical for older people. In children, decreased functionality of the gland may be congenital and may not appear during the first years of life.

The set of diagnostic measures includes:

• external examination;
• palpation of the thyroid gland;
• gland biopsy;
• laboratory tests.

Hypothyroid coma

Hypothyroid coma affects people after surgery on the gland, injuries, overdose of narcotic and sedative drugs, hypothermia.

GC are characterized by:

• hypoxia of internal organs;
• hypoventilation of the lungs;
• bradycardia;
• low body temperature;
• hypoglycemia;
• high cholesterol.

Lack of adequate medical care leads to death.

Symptoms of GC:

• drowsiness;
• severe depression;
• body temperature up to 35°;
• skin is cold;
• suppression of reflexes;
• low blood pressure;
• disruption of the central nervous system.

Tachycardia in hypothyroidism increases with the onset of coma and is the cause of death of the patient.

Arrhythmia is caused by a decrease in the number of β-adrenergic receptors, while norepinephrine is produced intensively, which causes spasm of the coronary arteries and heart failure.

Emergency care for hypothyroid coma and subsequent treatment of complications

• With immediate medical attention, the prognosis for GC will be positive, especially for patients under 30 years of age. The patient is administered hydrocortisone, the daily dose of the drug should not exceed 200 mg, as well as thyroxine drip, the daily dose of thyroxine is up to 500 mg.
• In especially severe cases, blood transfusions and artificial ventilation of the lungs are performed, after which glucocorticoids are administered.
• To prevent infectious complications, antibiotic therapy is carried out.
• For bladder atony, a urinary catheter is inserted.

After emergency treatment, treatment with special drugs begins. Hypothyroidism can be treated with an individually adjusted dose of the synthetic hormone thyroxine.

The use of thyroxine improves the patient’s quality of life and promotes its duration.

For the treatment of thyroid hypothyroidism, Eutirox is prescribed once a day, before breakfast. It is recommended to drink the drug with clean boiled water. The initial dose is 50 mcg, gradually increased to 200 mcg.

The dosage is increased every three weeks until the patient reaches a euthyroid state of the gland. If there is no effect from treatment, malabsorption or improper administration of the drug may be suspected.

An adequate dose allows you to get rid of symptoms and improve your quality of life within two months.

Basics The main criteria that determine treatment tactics are the duration of thyroid dysfunction and the severity of symptoms. The effectiveness of therapy is proven by the disappearance of clinical symptoms and clinical diagnosis. The longer the duration of uncompensated disruption of the gland, the less time the patient has to live, even after starting therapy.

In order to avoid the serious consequences of endocrine gland disease, people over 30 years of age are recommended to undergo preventive examinations at least once a year. This will allow you to live, maintaining health and activity for a long time, since in many ways these factors largely depend on the synthesis of thyroid hormones.

Nuances of emergency care for severe consequences of hypothyroidism

All measures to provide assistance to patients with hypothyroid coma are carried out in the intensive care unit. During therapy, it is necessary to increase the level of hormones of the endocrine gland, eliminate hypothermia, problems with the heart and blood vessels, and normalize the nervous system.

To do this, levothyroxine is administered by drip; it can also be administered intramuscularly.

For people over 30 years of age, the rate of levothyroxine required to achieve optimal thyroid condition is 1.9 mcg/kg per kilogram of body weight. For older people, the dose of the synthetic hormone is slightly less, up to 1 mcg/kg.

How much levothyroxine can pregnant women take to relieve severe conditions? In such cases, the dosage is prescribed individually and adjusted depending on the trimester of pregnancy.

Hypothyroidism after menopause in women is corrected with increased doses of hormones, laboratory tests are carried out every two months, especially for women who have had part of the thyroid gland removed.

Basic manipulations aimed at eliminating HA and its consequences:

Treatment of complications of hypothyroidism in children

Complications of hypothyroidism in children occur in rare cases when treatment after removal of part of the gland or in the case of congenital hypothyroidism is carried out incorrectly or not at all. In especially severe cases, irreversible changes called cretinism develop, as well as dwarfism, delayed physical development, and partial damage to the central nervous system.

Congenital thyroid deficiency in children or acquired as a result of surgery is corrected with synthetic hormones, but in some cases the symptoms (poor memory, high cholesterol, chilliness, decreased cognitive abilities, poor bowel function, depression) persist. This happens if the dose is small or the drug is poorly absorbed by the intestines. The effectiveness of thyroxine is also reduced by drugs such as ferrous sulfate and calcium; in such cases, the dosage of hormones is increased.

22.02.2016, 18:18

Hello. Can anyone explain to me why tachycardia occurs with hypothyroidism? Of the detected only TSH 10, hemoglobin 180, platelets at the lower limit of normal. Body type: asthenic, height 187, weight 62 (decrease by 4 kg over 3 years). In the thyroid gland there is a hypoechoic formation 6X4 mm (it used to be isoechoic, but it became hypoechoic half a year ago). Tachycardia 110-130 beats at rest.

22.02.2016, 18:20

Lack of air, inability to work. I am 22 years old. Gender: male. Tachycardia 3 and a half years after physical overexertion.

22.02.2016, 18:23

Every third person with hypothyroidism has tachycardia - reactive activation of the symptatoadrenal system, compensatory. There are other reasons - anemia, myxedematous heart

22.02.2016, 18:37

I was prescribed to take iodine for 6 months, then monitor my TSH. Taking thyroxine did not give any results, only subjectively it became a little worse. I would like to come up with something so that I feel normal while I only take a beta blocker. Is the cause of tachycardia a node? And why did it become hypoechoic? Is it worth paying attention to?

22.02.2016, 18:41

What does iodine have to do with it? In the Russian Federation, iodine deficiency is mild to moderate and it cannot be the cause of hyperthyroidism. Thyroxine that did not give an effect - how is that? What effect were you hoping for?
The node never caused and does not cause tachycardia... but you don’t even have a node. woe from mind

22.02.2016, 23:26

The endocrinologist prescribed iodine after he prescribed thyroxine at a dose of 50 mcg, which I did not drink completely because my general condition with tachycardia became worse. The doctor said that my high TSH of 9-10 could be normal for me, since the thyroid hormones are not outside the normal range and there are no serious abnormalities on the ultrasound.
My goal is to get rid of tachycardia only, since it interferes with my normal life. Abnormalities in the thyroid gland are the only thing that was found (+ high hemoglobin), and I took many different tests (metanephrines in the urine, MRI of the head, CBC, OAM, ultrasound of the liver, spleen, Holter).
The question, in general, is how to treat this hypothyroidism if it causes tachycardia?
It got to the point that I was prescribed sedative pills (teraligen), although I myself am calm. I drank it - no effect, just like being drunk.

23.02.2016, 08:28

23.02.2016, 09:08

Thanks for the clarification. And what measures could you recommend for further investigation of the causes (the heart itself seems to be healthy according to the examination)?
Another doctor told me something else: “Perhaps tachycardia is an individual reaction of your body to hypothyroidism.” According to science there should be bradycardia.

23.02.2016, 11:48

How did you understand this phrase? Every third person with hypothyroidism has tachycardia - reactive activation of the sympathoadrenal system, compensatory.

23.02.2016, 14:28

And nothing prevents you from calming down this very reaction - 2.5 or 5 mg of bisoprolol is quite appropriate

26.02.2016, 18:13

I took thyroxine 50 mcg per day for 1.5 months (my weight is 62 kg). As I already wrote, I quit due to deterioration in health due to tachycardia. I have been taking iodine 200 mcg per day for 3 months now. I will take it for another 3 months as the doctor said to control TSH.
"How did you understand the phrase?:<<У каждого третьего человека с гипотирозом тахикардия - реактивная активация симпатоадреналовой системы, компенсаторная.>>" - I realized that more adrenaline began to be produced due to stress (subclinical hypothyroidism). Adrenaline causes tachycardia. Beta blockers block the receptors that perceive adrenaline, so the heart does not beat as often.
I would like to get rid of hypothyroidism, and not take all sorts of pills that eliminate the symptoms. I only drink Betaloc to give my heart a rest.

27.02.2016, 00:48

It is impossible to get rid of manifest hypothyroidism, unless this is the hypothyroid phase of destructive thyroiditis - George W. Bush Sr. and fifty other presidents and prime ministers quietly receive thyroxtn

27.02.2016, 09:08

Please tell me, am I subclinical or manifest? TSH ranged from 5.25 to 10.25.

27.02.2016, 12:50

With normal light, T4 is subclinical, but you are asking the wrong thing and do not understand the answers, multiplying entities unnecessarily

27.02.2016, 22:45

Explain what I don't understand.
With hypothyroidism, I have symptoms of thyrotoxicosis: heat intolerance, heat throughout the body with tachycardia. Sometimes I go out into the cold in a T-shirt and everything becomes easier.

28.02.2016, 21:50

It's strange, all doctors speak differently. Some people told me that “with hypothyroidism there can be no tachycardia.”

29.02.2016, 09:24

Some could have had a C in their endocrinology test and never learned what we were not too lazy to write to you.
I understand that the main thing is a discussion in the kitchen about the meaning of life and it’s difficult to make any decisions - but, really, that’s enough
There is nothing stopping you from continuing to receive information from “some” doctors - but we will decide that you tell some what is known to the normal world - but do not burden us with a story about “some”

04.03.2016, 19:00

Please answer another question: why am I thin with hypothyroidism? Height 188, weight 61-62. 3-4 years ago, when I was still healthy, I always weighed 64-66. After the failure occurred, I gained up to 72 and then began to lose weight. Usually they say that with hypothyroidism, on the contrary, they get better.

04.03.2016, 19:08

You still have subclinical hypothyroidism - and everything related to manifest hypothyroidism has nothing to do with you

You do not have a ticket for one disease - but there is undoubtedly a pronounced desire to multiply entities unnecessarily

You have a strange habit of asking questions, not caring about the answers - what does this give you?
Perhaps you have a combination of several problems - what force is preventing the doctor from looking at you?
It may turn out that you have signs of adrenal insufficiency or evidence of celiac disease

04.03.2016, 19:09

Let's try again: You misunderstood what the doctor said. Or rather, what the doctor should have said. And he should have said the following:
Outside of a planned pregnancy, it is not necessary to treat subclinical hypothyroidism
With subclinical hypothyroidism, there may be tachycardia, but this does not mean that it is CAUSED BY IT
Correction of tachycardia (as well as additional clarification of its causes) is carried out regardless of the fact of hypothyroidism.
Even if you bring a carload of bricks (yoda), the house will not build itself

What was wrong with that answer?

04.03.2016, 19:42

I read your answers carefully, thank you. I’m not multiplying entities, I’m just interested. I've already been to the doctor. I took many different tests. I already wrote about tests outside the norm. I’m just in a bad condition, so I want to cure myself, not just trust doctors, who, moreover, according to you and the words of some other doctors, are not always knowledgeable professionals. The Internet is the only source of information for me, a guide.
I googled a lot of different things on the treatment of the thyroid gland, in particular on reflexology, effects on acupuncture points, methods of inhibition and excitation, warming up the soles of the feet, etc. I will practice, there is no choice. What do you think about this? [Only registered and activated users can see links]

04.03.2016, 19:48

I think that further conversation is futile - you can’t hear your interlocutor

09.03.2016, 00:14

Please answer. How effective do you think is the treatment of thyroid diseases, especially subclinical forms, using reflexology methods: heat, cold, effects on acupuncture points of the whole body, the auricle, massage, laser, light with a certain wavelength, etc.?

09.03.2016, 11:03

What you have listed has nothing to do with the treatment of thyroid diseases. As well as to the treatment of anything other than your wallet from excess fullness.

29.03.2016, 11:13

“With subclinical hypothyroidism, there may be tachycardia, but this does not mean that it is CAUSED BY IT.
Correction of tachycardia (as well as additional clarification of its causes) is carried out regardless of the fact of hypothyroidism."
I have a question, in which direction should I dig further (which tests should I take) to further identify the causes of tachycardia?
Tachycardia is constant (standing heart rate 120, lying heart rate up to 90, pressure 135/95, lack of air), only sometimes it goes away, especially in the evening, at night (pulse drops to 80, the strength to do something does not appear for long). The topic is described in more detail here [Only registered and activated users can see links]
Does it make sense to engage in psychotherapy, incl. take antidepressants? (teraligen didn't help)
Perhaps this will be important: at the onset of the disease, within six months there were two strange attacks, which manifested themselves in a strong heartbeat (tremors), severe body tremors, a desire to hide in the dark, poor tolerance to light, inability to speak (difficulty moving the tongue). I lay there as if in delirium, trembled, and then it went away. They called an ambulance once, they gave me magnesium, the chilliness went away, I felt warm and calm.

29.03.2016, 20:32

TSH now?

29.03.2016, 20:33

How did you understand this phrase?
The first measure is to compensate for hypothyroidism. The normal effective dose of thyroxine, and not the homeopathic dose of 25 mcg. Based on approximately 1 mcg per kg of body weight. If, with a normal TSH, the tachycardia remains the same, it means that hypothyroidism has nothing to do with it and we must continue the search (iron deficiency syndrome, cardiac causes, etc.).
Reasons why you might not follow this advice

24.04.2016, 22:14

A question arose about when is the best time for me to take a TSH test.
My chronology was like this:
1) I took thyroxine 50 mcg for 3 months (my weight is now 60 kg, height 187 cm);
2) decided to go to an endocrinologist due to the lack of improvement. He stopped thyroxine and prescribed iodine 200 mcg/day;
3) I have been taking iodine in this dosage for about 4 months.

I was told that TSH control would be done in 6 months. And I had a question: if I take a TSH test now, it will show my consequences of taking thyroxine along with iodine, i.e. will the result be confusing (it will be unclear what gave what)?

Second question: I read that if you have hypothyroidism, it is not advisable to take beta-blockers because they have an antithyroid effect. Then how can I relieve tachycardia? Only betaloc helps more or less.

Third question: what drugs can distort the TSH analysis, which is not recommended to be taken in the coming days, before taking the test.

Fourth question: is it worth taking T4 and T3 together with TSH? I ask because the cost is much more expensive, but is it necessary?

Thanks in advance!
Oh, yes, and another question that seems to follow from all of these (I myself can’t figure it out): “If tachycardia is caused by hypothyroidism, then how long after taking thyroxine at a dosage of 1 mcg/1 kg of body weight does an improvement in well-being occur, i.e. e. disappearance of tachycardia? I note that I took thyroxine for about 3 months, was it worth it to continue? Only after these 3 months I didn’t do a TTG...

24.04.2016, 23:34

No, the result will not be confusing at all - it will show TSH on a “clean background” for the last 2 months without treatment. Taking iodomarin has nothing to do with TSH levels and is not a treatment.
Beta blockers can, and often should, be taken to correct heartbeat in hypothyroidism. You shouldn't read what you don't understand.
Thyroxine and thyreostatics (tyrosol, propicil) have a significant effect on TSH levels.
You only need to take a TSH test.
If tachycardia is caused by hypothyroidism, then it disappears NOT after “N months of taking thyroxine in the nth dose” - but after correction of hypothyroidism. That is, with normal TSH. That is, after 2 months of taking thyroxine at a certain dose, it is necessary to check TSH to see whether it has returned to normal, or whether the dose of thyroxine needs to be adjusted.

25.04.2016, 00:06

FilippovaYulia, thank you, it has finally become clearer.
We talked here on this topic earlier and you gave me advice... It was written: “With subclinical hypothyroidism, tachycardia may occur, but this does not mean that it is CAUSED BY IT.” I thought about this, searched the entire Internet and did not find any reasons why tachycardia occurs with hypothyroidism (mechanism). Nevertheless, there are such cases, although they are less common than with bradycardia.
Everything about hyperthyroidism is clear: the tone of the sympathetic nervous system, the need for oxygen, blood pressure, peripheral vascular resistance, etc. increase.
With hypothyroidism, the opposite is true, however, they write that there is an increase in systolic blood pressure (but there are probably reasons for slow metabolism - cholesterol plaques?).
From what I have read, I understand that hypothyroidism can NEVER be the cause of tachycardia. And if it is, then the reason is different: anemia, organs - which can be the consequences of hypothyroidism.
There is no information that a lack of thyroid hormones and/or high TSH can cause tachycardia.
***
I thought I had tachycardia due to nervousness. Taking benzodiazepines showed that even against the background of absolute calm, tachycardia does not decrease. The neuroleptic didn't help either.

25.04.2016, 08:29

I wrote - reactive activation of the sympathetic system

26.04.2016, 18:37

Hello. I passed the TSH test.
TSH 4.52 µIU/ml. Reference interval 0.35-4.94. I was glad that I even got back to normal. It turns out that iodine helped...
What can you advise me next?
And another question: could it be that TSH is high one day and less the next, or does it change for a long time, i.e. 2 months as they wrote here? I just read that stress can affect TSH...

26.04.2016, 19:27

Once again, iodine intake has nothing to do with TSH levels; you are monitoring the natural fluctuations of TSH in subclinical hypothyroidism.
Stress has no effect.
Then you can continue to monitor your TSH levels annually or if your health worsens.

26.04.2016, 20:14

I'm not worried about the TSH values, just the tachycardia. Does it make sense for me to take L-thyroxine? Is it taken for subclinical hypothyroidism?
I want to find such a “line” so that the thyroid gland does not become lazy from taking thyroxine, and on the other hand, so that it does not overexert itself (if thyroxine is not taken).

26.04.2016, 20:55

It must be taken by pregnant women and women wishing to become pregnant - in other cases, the pros and cons of treatment are discussed with a face-to-face physician. Haven’t we already written to you?

26.04.2016, 20:56

Let's try again: You misunderstood what the doctor said. Or rather, what the doctor should have said. And he should have said the following:
Outside of a planned pregnancy, it is not necessary to treat subclinical hypothyroidism
With subclinical hypothyroidism, there may be tachycardia, but this does not mean that it is CAUSED BY IT
Correction of tachycardia (as well as additional clarification of its causes) is carried out regardless of the fact of hypothyroidism.
Even if you bring a carload of bricks (yoda), the house will not build itself
Well, it seems like we’ve already told you

27.04.2016, 22:29

Discussed, thank you. However, the full-time doctor also does not insist on taking thyroxine (since I took it for 2 months, my health did not improve).
Can you give me any assessment or advice on what tests I still need to take or anything else to do?
I am 22 years old, male. height 187. My weight before this failure was 66 kg, I was engaged in physical education, skiing. After another ride I felt bad.
2013 The temperature remained at 37.2 for more than 1 year. Shortness of breath, dizziness, mild tachycardia. Body weight 72 kg (about half a year). Then my body weight decreased, now I weigh even less than 5 years ago - 60 kg in total.
I wrote more about the medical history and tests [Only registered and activated users can see links]

28.04.2016, 09:03

But you are not a pregnant woman - what and why should the doctor insist on?

28.04.2016, 11:05

I don't know. I come with a problem - the endocrinologist is not sure. He told me to see a psychoanalyst. I still stutter. This is probably why everyone sends me to him. If I send my photos, could you give me advice as a full-time doctor?

28.04.2016, 11:07

Once again - I don’t know which analyst.
1. It’s not a fact that your problems are related to subclinical hypothyroidism
2. this last one does not need to be treated
3. You are dissatisfied with the results of treatment
Therefore, look for the cause in other problems, including the analyst

29.04.2016, 19:46

Well, I understand that. It’s not entirely clear in which industries to dig further, what to explore...
I read: "The most common causes of tachycardia are disorders of the autonomic nervous system, endocrine system disorders, hemodynamic disorders and various forms of arrhythmias."
Questions:
1) Are there clear TSH numbers at which pathological activation of the sipathoadrenal system occurs? Or is it individual?
2) Is hypersymaticotonia possible when any nerve in the neck or spine is pinched?
3) Is tachycardia possible with chondrosis, scoliosis? (after all, many have it, but I think that the pinching must be very strong for there to be a tach.);
4) What blood tests for anemia make sense to do?
5) If I had a source tah. was in the heart, it would have been shown on an ECG, HolterECG (microinfarction? damage to the sinus node?)
6) How is a problem in the autonomic nervous system diagnosed? (organs can be examined by ultrasound, blood tests done, etc.)
7) Does the fact that a beta blocker helps me mean that the problem is vegetative?
8) What endocrine problem, besides the thyroid gland, can also cause tach? (I tested metanephrines in urine)
Thank you.

29.04.2016, 19:52

You are reading simplified literature adapted for understanding the patient, which we ourselves write - why are you retelling something for us?
I assure you, to people who get acquainted with scientific articles every day, you are unlikely to say anything new - and having received answers from us, you are unlikely to come up with something that we have not already told you
1. no
2. Lord, what kind of women's talk is this?
3. and there is no chondrosis in the world...
4. haven’t you tried to go to your aunt’s doctor?
5. and now to the cardiologist - if the aunt from step 4 refers
6 cm answers to p4 and 5
7 hints

29.04.2016, 19:58

I understand that you know all this. I went to the doctors, they did a holter for me and much more. The endocrinologist sent me to a psychoanalyst, as I already wrote. They themselves don't know what to do with me. The only thing I can do is read your articles and at least somehow move from the “dead point”.
I visited a cardiologist, neurologist, hematologist, endocrinologist and internist.

29.04.2016, 20:00

The hematologist actually just looked at the analysis and said that “there are no blood diseases,” he said that it was due to hypothyroidism. And the therapist says that “such growth”, they say the body has grown, but the organs have not yet.

29.04.2016, 20:03

I’m ready to conduct advanced training classes with a hematologist - but the topic is maliciously slipping into flood

30.04.2016, 16:50

I don't understand the answer to question 4. Which doctor should I contact about this issue? Aren't you a doctor?
If the tachycardia is not from hypothyroidism, then please write what specific examinations or tests I still need to undergo. Thank you.

30.04.2016, 16:58

Another question about the dose of betaloc. I have 100 mg tablets. I divide the tablet into approximately 5 parts and take 15-20 mg. It helps for about 2-5 hours, then tremors, dystonia, lack of air and tachycardia begin again. But in general I endure it for a day. Then I can’t, I feel terrible, my resting pulse is 132, I’m suffocating. Therefore, no matter without pills.
What happens if I don't take Betalok? Is it life-threatening? When I don't drink for a long time, my heart starts to ache.
The effect of betalok seemed stronger to me when I took it together with elzepam - it helps faster. Elzepam alone does not help at all

Subclinical hypothyroidism is a form of thyroid dysfunction without symptoms. The disease is detected by determining blood hormones. Older women are most susceptible to subclinical hypothyroidism.

The main sign indicating the presence of the disease is an increased amount of thyroid-stimulating hormone from the pituitary gland in the blood. The thyroid-stimulating hormone of the pituitary gland is responsible for regulating the secretion of thyroid hormones, therefore, when even a slight decrease in thyroid function occurs, an increase in the thyroid-stimulating hormone of the pituitary gland is observed, while the amount of thyroid hormones in the blood may be normal or slightly reduced.

Signs of hypothyroidism

Unfortunately, diagnosing hypothyroidism is the number one problem. Many patients suffer from hypothyroidism. however, the clinical picture of the disease is often carefully disguised, and the patient may exhibit the following symptoms?

Gastroenterology:

• Constipation
• Manifestations of cholelithiasis
• Biliary dyskinesia

Rheumatology:

• Syneviitis
• Polyarthritis
• Manifestations of progressive osteoarthritis

Gynecology:

• Infertility
• Uterine bleeding

Cardiology:

• Diastolic hypertension
• Cardiomegaly
• Bradycardia

With subclinical hypothyroidism, there are no signs of dysfunction of the thyroid gland, but deviations from the norm in metabolism may be observed. For this reason, other functions in the body may suffer. Patients often experience a decrease in mood, depression, anxiety, memory impairment, decreased concentration, weakness, and fatigue.

Fat metabolism in subclinical hypothyroidism does not go unnoticed. This manifests itself in an increase in body weight, the development of atherosclerosis, coronary heart disease, and a high risk of heart attack. Replacement therapy at the initial stage of the disease in some cases helps restore metabolic processes.

Thyroid hormones affect the circulatory system, namely the circulatory organs. The influence of hormones can change the number of heart contractions, myocardial contractility, blood pressure, blood flow speed, and blood vessel resistance. With subclinical hypothyroidism, hypertrophy of the heart muscle in the area of ​​the left ventricle may be observed, which indicates overstrain of the heart.

It is very important to identify subclinical hypothyroidism during pregnancy, since early detection of the disease makes it possible to avoid disturbances in the fetus’s body, thanks to timely treatment.

Symptoms of subclinical hypothyroidism

• Memory impairment
• Decreased concentration
• Decrease in intelligence
• Susceptibility to depression
• Increased level of endothelial dysfunction
• Rhythm disturbances
• Menstrual irregularities
• Vaginal bleeding
• Infertility
• Premature birth
• Increased intraocular pressure
• Hypochromic anemia
• Myalgia

Treatment of subclinical hypothyroidism

Replacement therapy may be prescribed. Although many doctors argue that subclinical hypothyroidism does not require treatment. But the disease is fraught with negative consequences, so after comparing the symptoms, the doctor decides on the need for treatment.

L-thyroxine (levothyroxine) is often used in the treatment of subclinical hypothyroidism. L-thyroxine is especially important for expectant mothers. If there is no history of thyroid surgery, doctors often delay treatment in order to monitor the patient’s condition and require repeated tests in a couple of months. If there are no changes, treatment will be prescribed.

When taking l-thyroxine, most patients notice improvements, but taking the drug can result in a lot of side effects, including weight gain, anxiety, insomnia, arrhythmia, and tachycardia.

It is very important to compare possible complications without treatment of subclinical hypothyroidism with the effectiveness of the drug, and you should not discount its side effects. The decision on the need for treatment is made by the doctor if the first two points are equivalent. However, before starting treatment, it is necessary to exclude transient hypothyroidism.

The most interesting news

Thyroid diseases - Diet

Read more about this disease in the section. THYROID GLAND

Thyroid diseases in women are 8-20 times more common than in men. And a disease such as thyroiditis occurs 15-25 times more often in women than in men. In addition, the volume and weight of the gland in women can fluctuate depending on the menstrual cycle and pregnancy. In the absence of thyroid disease in men, her weight is constant.

Diseases of this type in women and men most often occur at the age of 30-50 years. Disorders of this organ also occur in children, and they can also be congenital. Enlargement of the gland in children due to iodine deficiency in some areas reaches 60-80%. Thyroid dysfunction affects 3% of the population.

The most common thyroid diseases are: hypothyroidism, hyperthyroidism, autoimmune thyroiditis, nodular goiter, cyst, cancer.

Hypothyroidism of the thyroid gland - causes, symptoms

Hypothyroidism- decreased activity of the thyroid gland. One of the reasons is iodine deficiency, which reduces hormone synthesis. Other causes of this disease are developmental abnormalities, inflammation of the gland, congenital defects in the synthesis of hormones

Symptoms of hypothyroidism:

Fatigue and loss of strength, chilliness, weakness, drowsiness, forgetfulness, decreased memory, hearing, dry and pale skin, swelling, constipation, excess weight, the tongue thickens, impressions from the teeth are noticeable at the edges, and hair begins to fall out.

With this disease, the menstrual cycle may be disrupted in women; in men, potency is impaired and libido decreases.

The disease develops slowly, over the years, the symptoms of hypothyroidism are not noticeable for a long time

Hyperthyroidism - causes, symptoms

Hyperthyroidism (thyrotoxicosis)– increased activity of the thyroid gland. With this disease, the iron produces an excess amount of hormones, which leads to “poisoning” of the body with these hormones - thyrotoxicosis. Metabolism increases. The thyroid gland enlarges. The cause of hyperthyroidism cannot be excess iodine, since the excess is excreted by the kidneys. The causes are mental or physical stress, disease of other organs, hereditary predisposition, pituitary tumor

Symptoms of hyperthyroidism of the thyroid gland:

Weight loss, feeling hot, sweating, trembling hands, irritability, anxiety, rapid heartbeat, feeling of “sand” in the eyes, pressure behind the eyes.

Carbohydrate metabolism is disrupted, which can lead to type 2 diabetes

In women, the menstrual cycle may be disrupted, in men, potency is disrupted.

The disease develops very quickly.

Autoimmune thyroiditis, causes, symptoms

Thyroiditis– inflammation of the thyroid gland.

Autoimmune thyroiditis caused by a buildup of white blood cells (leukocytes) and fluid inside the gland. In autoimmune thyroiditis, antibodies produced by the immune system mistake the cells of one's own thyroid gland for foreign ones and damage them. There is a gradual destruction of the thyroid gland, which leads to hypothyroidism. Also, against the background of autoimmune thyroiditis, a temporary increase in hormone production is possible - hyperthyroidism

Cause of this disease- partial genetic defect of the immune system. This defect can be hereditary, or can be caused by poor ecology, pesticides, an excess of iodine in the body (long-term excess of iodine stimulates the production of antibodies to thyroid cells), radiation, infections

Symptoms— autoimmune thyroiditis:

During the first years of the disease there are no symptoms, then symptoms of hyperthyroidism may temporarily appear, and then symptoms of hypothyroidism. The main symptoms of this disease are associated with its inflammation and enlargement: difficulty swallowing, difficulty breathing, pain in the thyroid gland

Goiter - causes, symptoms

Goiter is a disease characterized by a pathological increase in the volume of the thyroid gland. Goiter occurs as a result of increased cell proliferation in order to increase the production of the missing thyroxine due to this increase. One of the reasons is iodine deficiency. Goiter can develop in both hypothyroidism and hyperthyroidism

Thyroid nodules and nodular goiter are formations that differ from the gland tissue in structure and structure. All nodular forms of thyroid diseases are divided into two groups: 1) nodular colloid goiter, which never degenerates into cancer; 2) tumors. Tumors, in turn, can be benign, in which case they are called adenomas, and malignant, in which case they are called cancer.

Thyroid cancer

easy to diagnose, often detected in the early stages using puncture biopsy of nodes. Symptoms of thyroid cancer (pain in the throat and neck, pain when swallowing and breathing) are sometimes attributed to infectious diseases, making diagnosis difficult in some cases. The chance of recovery from thyroid cancer is more than 95% if the disease is diagnosed at an early stage.

Diet for thyroid diseases

Diet for the treatment of the thyroid gland vegetarian preferably. It is necessary to include more greens, root vegetables, fruits, nuts, and vegetable proteins in your diet. They contain the necessary organic iodine.

The diet for a thyroid disease such as hypothyroidism should contain fish, seafood, and seaweed. These products have the highest iodine content - 800 - 1000 mcg/kg (daily iodine requirement - 100-200 mcg).

Here's more foods containing iodine in large quantities: beans, soybeans, green peas, carrots, tomatoes, radishes, lettuce, beets, potatoes, garlic, apple seeds, grapes, persimmons, millet, buckwheat. (40-90 mcg/kg). The iodine content in products of plant origin also depends on the soil on which these products are grown. In vegetables grown on iodine-rich and iodine-poor soils, the iodine content can differ many times.

When treating the thyroid gland, the diet should include foods rich in the following microelements: cobalt, copper, manganese, selenium. They contain a lot of chokeberries, rose hips, gooseberries, blueberries, strawberries, raspberries, pumpkin, eggplant, garlic, black radish, turnips, beets, and cabbage.

According to some theories, it is believed that the main cause of thyroid problems is pollution in the body. With hyperfunction of the gland, thyrotoxicosis, the lymph is so contaminated that it cannot cope with the drainage of this organ. Polluted blood constantly irritates the gland with its toxins; therefore, it is no longer able to be controlled by the pituitary gland, and malfunctions occur in its functioning. The presence of toxins in the blood that are harmful to the thyroid gland is associated with pollution, poor liver and intestinal function. In addition, it is believed that one of the causes of hypothyroidism is a violation of the absorption of iodine and other nutrients in the intestines, and the cause of hyperthyroidism can be untimely evacuation of iodine from the body. In connection with this theory, the diet should be such as to cleanse the blood, liver and intestines and improve their functioning. Therefore, it is useful to drink teas from bitter herbs (wormwood, angelica root, yarrow, St. John's wort), cleansing products (radish, garlic, horseradish, celery, parsnips, nuts)

Diet for thyroid diseases shouldn't include the following products:

1. Fatty meat, sausages.

2. Margarine; artificial fats.

3. Sugar, confectionery.

4. White bread, pastries, baked goods

5. Fried, smoked, canned foods

6. Spicy seasonings: mayonnaise, vinegar, adjika, pepper

7. Chemicals: dyes, flavors, flavor enhancers, stabilizers, preservatives

8. Avoid smoking and drinking alcohol and coffee.

The basis of nutrition There should be porridge, boiled and fresh vegetables, legumes, fruits, vegetable oil. In small quantities diet may contain: honey, butter, nuts, eggs

Diet for hypothyroidism

Do not use folk remedies without consulting your doctor! Remember that all methods may have individual contraindications.

More articles about this disease:

Hypothyroidism

Hypothyroidism is a condition that is caused by an inadequate decrease in the concentration of free thyroid hormones in the blood serum.

In our clinic, we successfully treat this disease using hirudotherapy. in a few sessions of complex therapy you will feel the disease receding. Read the article on this disease.

Because thyroid hormone receptors are present in virtually all tissues, the signs and symptoms of hypothyroidism are many and varied. The severity of clinical manifestations depends on the degree of decrease in T3 and T4 concentrations. Severe hypothyroidism is designated by the term “myxedema,” in which there is an accumulation of hydrophilic mucopolysaccharides in the basal layers of the skin and other tissues.

There are primary, secondary and tertiary hypothyroidism. Primary hypothyroidism is caused by direct damage to the thyroid gland, which results in the development of insufficiency of its function,

Secondary hypothyroidism is a consequence of hypofunction of the pituitary gland and insufficient production of thyroid-stimulating hormone (TSH), decreased TSH stimulation of thyroid function and insufficient synthesis of T4, T3.

Tertiary hypothyroidism develops as a result of pathology of the hypothalamus, a decrease in the synthesis of thyrotropin-releasing hormone (TRH) and insufficient stimulation of the pituitary thyrotrophs, a decrease in the synthesis of TSH and stimulation of TSH of the thyroid gland.

Hypothyroidism is characterized by a wide range of disorders and damage to various body systems. Their presence and severity depend on the severity of hypothyroidism. Damage to the cardiovascular system is observed in 70-80% of patients. The nature and extent of cardiac changes depend on the age of the patient, the etiology of hypothyroidism, and concomitant diseases.

The most pronounced changes in the cardiovascular system occur with severe primary hypothyroidism and are referred to as “myxedematous heart”, the first clinical description of which was given by H. Zondek in 1918, highlighting its main symptoms - cardiomegaly and bradycardia.

It has been established that T3 acts on specific myocyte genes responsible for the function of cardiomyocytes, affects myosin, Ca-activated ATPase of the sarcoplasmic reticulum, phospholamban, adrenergic receptors, adenyl cyclase and protein kinase. Both T3 stimulation and T3 deficiency affect myocardial function, including contractility, mass, and number of contractions.

With hypothyroidism, protein synthesis decreases, the concentration of sodium and water ions increases, the content of potassium ions decreases, hypo- or hyperchromic anemia develops due to a decrease in oxidative processes and protein synthesis in the bone marrow, and capillary permeability increases. An increase in capillary permeability plays a major role in the development of edema of various tissues, organs, including the myocardium, and the accumulation of fluid in the pericardium. With successful replacement therapy, capillary permeability is normalized and symptoms associated with edema are regressed.

Hypothyroidism is accompanied by hypercholesterolemia, resistant and refractory to treatment with diet, statins, and other antihyperlipoprosemic drugs, and the degree of its severity also depends on the severity of the disease. Atherogenic lipid fractions accumulate in the blood, and the level of HDL decreases, which contributes to the rapid and progressive development of atherosclerosis with multiple localizations. Lipid metabolism disorders are found not only in overt hypothyroidism, but also in its subclinical forms.

Cardiac changes are caused by the development of myocardial dystrophy due to a pronounced disturbance of metabolic processes, which progresses as the edema of the stroma and parenchyma in the myocardium increases and is accompanied by a decrease in oxidative phosphorylation, a decrease in oxygen uptake by the myocardium, a slowdown in protein synthesis, electrolyte disturbances, which leads to a decrease in the contractile function of the myocardium and an increase in heart size, development of heart failure. The size of the heart increases both due to interstitial edema and nonspecific inflammation of myofibrils, dilatation of its cavities, and due to effusion in the pericardium. With timely and adequate treatment of hypothyroidism with thyroid hormones, myocardial dystrophy undergoes reverse development with the complete disappearance of existing signs of heart damage; otherwise, cardiosclerosis develops.

Clinical manifestations of cardiovascular disorders in hypothyroidism are characterized by complaints of pain in the heart region of a polymorphic nature, shortness of breath during physical activity, arising against the background of various and nonspecific complaints (muscle weakness, decreased mental and motor activity, edema of various localizations). In hypothyroidism, there are two types of pain in the heart, clinically difficult to distinguish: truly coronarogenic (especially in elderly patients), which can become more frequent and intensify when thyroid therapy is prescribed, and metabolic, which disappears during treatment.

During the examination, bradycardia (up to 40 beats/min) or other heart rhythm disturbances are detected.

Sinus bradycardia is recorded in 50-60% of patients with hypothyroidism and is caused, according to researchers, by a decrease in the concentration of blood catecholamines and the sensitivity of adrenergic receptors to them. In 20-25% of patients with hypothyroidism, sinus tachycardia is detected, the pathogenesis of which remains controversial. Most authors explain the presence of sinus tachycardia by a complex of disorders that develop with hypothyroidism - hypothyroid myocardial diatrophy, accompanied by mucous edema of the myocardium, deficiency of macroergs and potassium ions in cardiomyocytes, increased lipid peroxidation and membrane damage, and, consequently, electrical instability of the myocardium, its pseudohypertrophy , accumulation of creatine phosphate, atherogenesis, disturbance of the rheological properties of blood and microcirculation (Tereshchenko I.V.). As a result, in patients with hypothyroidism, especially in old age, in addition to tachycardia, paroxysmal tachycardia, paroxysms of atrial fibrillation and flutter, and sick sinus syndrome may develop. It is noted that these rhythm disturbances are refractory to cordarone and β-blockers and their disappearance when thyroid hormone preparations are prescribed.

Among other rhythm disturbances, it should be noted extrasystole (ES), detected among 24% of patients (atrial - in 15%, ventricular - in 9%). ES occurs more often when hypothyroidism is combined with cardiac pathology (hypertension, coronary artery disease, heart failure, cardiomyopathy). Rhythm disturbances can occur during treatment of hypothyroidism with thyroid drugs, which may be due to increased sympathetic influences on the myocardium under the influence of TG during this period.

During percussion and auscultation of the heart, an increase in cardiac dullness, a weakening of the apical impulse and heart sounds are noted; an accent of the 2nd tone over the aorta can be heard, as a manifestation of atherosclerosis and a systolic murmur at the apex of the heart, caused by dilatation of the left ventricle. In the presence of effusion in the pericardium, heart sounds become muffled and even difficult to hear when there is a significant accumulation of effusion.

X-rays reveal an increase in the size of the heart of varying intensity, a weakening of its pulsation, expansion of the shadow of blood vessels, signs of fluid accumulation in the pericardium and pleural cavities (the heart takes the shape of a “decanter”, its pulsation is sharply weakened). Since transudate accumulates slowly and its amount is not large, cardiac tamponade is rare.

The fluid in the pericardium contains large amounts of protein, unlike the fluid in heart failure. The accumulation of transudate is due to increased capillary permeability and hypernatremia. It has been established that the transudate is transparent, brown or yellow, contains albumin, cholesterol and mucoid substance, erythrocytes, lymphocytes, monocytes, polynuclear and endothelial cells. The clinical manifestations of hydropericarditis are mild, despite the accumulation of a large amount of fluid, which, according to clinicians, may be due to its slow accumulation. A protodiastolic gallop rhythm (III sound) and, rarely, a IV sound can be heard, as confirmation of a decrease in myocardial contractile function, in the absence of other signs. A small effusion in the pericardium may not change the x-ray picture and its detection can be carried out using a more reliable research method - echocardiography

During an ECG study, various changes are observed. According to researchers, the most common and early sign is a decrease in amplitude, smoothness or inversion of T waves, mainly in leads V3.6, but can also occur in standard leads. These ECG changes occur in 65-80%, regardless of the age of patients ( even in childhood) are not associated with risk factors for clinical manifestations of atherosclerosis of the coronary arteries - hypercholesterolemia, angina pectoris and arterial hypertension. The second most common ECG sign is a low-voltage waveform, characterized by a decrease in the amplitude of the QRS complex. Its greatest decrease is recorded in the presence of effusion in the pericardial cavity. Depression of the ST segment and a decrease in the amplitude of the P wave may be observed. Intraventricular blockade and prolongation of atrioventricular conduction are diagnosed. Changes in the T wave and ST segment decrease or disappear along with clinical manifestations when adequate replacement therapy is prescribed and remain in elderly patients suffering from coronary heart disease.

An echocardiographic study in patients with hypothyroidism reveals asymmetric hypertrophy of the interventricular septum, a decrease in the rate of early diastolic closure of the anterior leaflet of the mitral valve, and an increase in end-diastolic pressure, which disappear after pathogenetic treatment.

Decreased myocardial contractile function in hypothyroidism

causes hemodynamic disturbances, which are characterized by a decrease in stroke and cardiac output, a decrease in cardiac index with a reduced volume of circulating blood, as well as an increase in total peripheral resistance in the systemic circulation and diastolic pressure, a decrease in pulse pressure and blood flow velocity in various organs. A long course of uncompensated hypothyroidism can contribute to the development of heart failure, which can be relieved by prescribing only thyroid hormones with a moderate degree of its severity. Severe stage (IIb and III) of heart failure requires additional administration of cardiac glycosides, diuretics and indicates the presence of concomitant cardiac pathologies: ischemic heart disease, cardiosclerosis, cardiomyopathy, etc.

Researchers, even in latent, subclinical forms of the disease, identify endothelial dysfunction based on a decrease in endothelial vasodilation (EV), as a marker of early atherosclerosis. When studying the relationship between EV levels and the level of thyroid-stimulating hormone (from O.4 µU/ml), the greatest decrease in vasodilation was observed in patients with TSH levels more than 10 µU/ml (Gavrilyuk V.N. Lekakise J,). Studies conducted by Japanese authors to study the thickness of the internal and middle membranes of the common carotid artery in 35 patients with hypothyroidism established its thickening compared to individuals in the control group (0.635 mm and 0.559 mm, respectively).

Cardiac disorders, which are characterized by the development of myocardial dystrophy in patients with hypothyroidism, should be differentiated, first of all, from ischemic heart disease and atherosclerotic cardiosclerosis, especially in elderly patients and the elderly, since the ECG data in them may be identical. For this purpose, it is necessary to determine the function of the thyroid gland by studying the levels of hormones in the blood - T3, T4 (preferably their free forms), TSH. Hypothyroidism is confirmed by low levels of thyroid hormones and their ratio. Differential diagnosis of these pathologies based on clinical parameters is presented in Table. 3.

An additional diagnostic test in patients with hypothyroidism with nonspecific ECG changes (which manifests itself in disruption of repolarization processes - smoothed or negative T waves in most leads) is a potassium test, even with normal values ​​of potassium in the blood plasma.

Instrumental diagnostics should be aimed at assessing the functional state of the heart, identifying early signs of heart failure, and excluding the presence of exudate in the pericardial cavities and pleural cavities. For this purpose, it is necessary to conduct an ECG, daily monitoring of blood pressure and ECG, assessment of heart rate variability, X-ray examination and echocardiography.

The use of 24-hour ECG monitoring and recording of a cardiac intervalogram is of particular importance in monitoring treatment with I thyroxine and in assessing its effect on the condition of the heart, since such patients often complain of palpitations and the presence of vegetative manifestations (attacks of sweating, anxiety, trembling, etc.). These methods make it possible to verify episodes of tachycardia, identify other heart rhythm disturbances throughout the day, and check their relationship with the activation of the sympathetic division of the ANS.

Treatment of cardiac manifestations of hypothyroidism is based on the use of thyroid hormone replacement therapy (β-thyroxine, thyroidin, thyroid therapy). The most radical is the use of β-thyroxine at a dose of 1.6 mcg/kg body weight per day. For ischemic heart disease and hypertension, the initial dose should not exceed 15-25 mg with a gradual increase to the optimal dose.

Due to the long half-life of the hormone, levothyroxine is usually taken once a day. On average, 80% of the dose taken is absorbed and absorption worsens with age. The dose of the drug must be selected gradually, individually, starting with the minimum dose (0.05 mcg/day). For ischemic heart disease and arterial hypertension, the initial dose should not exceed 15-25 mcg/day. The interval between periods of increasing the drug is 2-3 weeks. Today, it is necessary to prescribe L-thyroxine in a dosage that will maintain the TSH level not only normal (0.4-4 mIU/l), but even within a lower range - 0.5-1.5 mIU/ l (Fadeev V.V.), based on the fact that in most people the TSH level is normally 0.5-1.5 mIU/l.

In patients with subclinical hypothyroidism with a TSH level greater than 10 honey/l, the administration of thyroxine preparations is also indicated (Kamenev 3.). In cases of TSH values ​​less than this value, data from multicenter studies do not provide a clear conclusion about the usefulness of this treatment.

Numerous clinical and pathological studies have proven the increased sensitivity of the myocardium to thyroid hormones. When exposed to thyroid hormones (TH), as a result of increased metabolic processes, relative coronary insufficiency can develop in the absence of atherosclerosis of the coronary arteries (Fig. 4). If you have coronary artery disease in old age, there is a risk of increased frequency of angina attacks and its transition to an unstable form. Treatment with inadequate doses of TG can lead to complications such as myocardial infarction and heart failure. Therefore, it is especially important when prescribing this type of treatment to select adequate doses of thyroid hormones with lengthening the period of adaptation of the body (increase the dose of the drug every 7-12 days) to these hormones and carry out electrocardiographic monitoring every 3-5 days to exclude signs of deterioration of coronary circulation.

The body's need for thyroid hormones decreases in the summer, which must be taken into account when treating patients. Men have a higher average need for thyroxine than women. To assess the adequacy of the replacement therapy, periodic monitoring of the level of TSH in the blood is necessary, an increase in which indicates insufficient treatment, and an increase in T3 indicates excess. In diagnosing an overdose of thyroid drugs, the clinical picture is of primary importance, and this is, first of all, tachycardia and determination of the level of thyroid hormones. In this case, the content of T4 in the blood serum, according to E. Braunwald and co-author, should be set at a level slightly higher than the upper limit of normal fluctuations. Serum T3 concentration is a more reliable indicator of metabolic status in patients receiving levothyroxine than T4 concentration.

When prescribing thyroxine, it is important to teach patients self-control - it is necessary to take into account changes in pulse, blood pressure, body weight, monitor well-being and tolerability of the drug, which will help to avoid complications of hypothyroidism and side effects of replacement therapy.

In patients with coronary heart disease, the administration of thyroid hormones must be combined with antianginal drugs: nitrosorbide, nitrong, cordiket, etc. and β-adrenergic blockers. -Adrenergic blockers reduce the increased TG demand of the myocardium for oxygen and thereby prevent the occurrence of angina attacks (Starkova N.T. Levine H.D. Leading). The use of β-blockers is recommended to be prescribed along with TG to patients with hypothyroidism in combination with arterial hypertension and tachycardia, if rhythm disturbances occur. However, it should be taken into account that β-blockers, along with rauwolfia and clonidine, as well as estrogens, reduce the function of the thyroid gland, aggravating thyroid insufficiency (Tereshchenko I.V.). When rhythm disturbances occur while taking TG, various classes of antiarrhythmic drugs are used.

It should be noted that the use of thyroid therapy alone leads to a decrease or normalization of blood pressure in patients previously unsuccessfully treated with antihypertensive drugs. The combined use of thyroid drugs together with antihypertensive drugs can significantly reduce the doses of the latter (Starkova N.T.).

Correction of thyroid insufficiency relieves patients from hypercholesterolemia without the use of any other drugs, however, it may be necessary to prescribe statins or fibrates.

Treatment of heart failure should be combined with the administration of glycosides and diuretics. Their use is recommended to be combined with the prescription of potassium supplements, given the presence of hypokalemia in patients with hypothyroidism. In the presence of effusion in the pericardium, puncture is rarely used, since the effusion accumulates in a volume of less than 500 ml and resolves when replacement therapy is prescribed (Levina L.I.).

In addition, it should be remembered that with hypothyroidism there may be phenomena of intoxication with cardiac glycosides due to a decrease in their metabolism in the liver and a decrease in hepatic blood flow.

A reduction or disappearance of cardiovascular disorders in patients with hypothyroidism has been proven when adequate hormone replacement therapy is used (Starkova N.T.). Thus, Japanese researchers studied the dynamics of the thickness of the walls of the common carotid artery a year after normalization of the level of thyroid hormones under the influence of T4 intake and found a decrease in their thickness to the values ​​of healthy individuals. A decrease in vascular wall thickness correlated with a decrease in total cholesterol and LDL cholesterol levels (Naggasaky T.).

Subclinical hypothyroidism is a form of thyroid dysfunction without symptoms. The disease is detected by determining blood hormones. Older women are most susceptible to subclinical hypothyroidism.

The main sign indicating the presence of the disease is an increased amount of thyroid-stimulating hormone from the pituitary gland in the blood. The thyroid-stimulating hormone of the pituitary gland is responsible for regulating the secretion of thyroid hormones, therefore, when even a slight decrease in thyroid function occurs, an increase in the thyroid-stimulating hormone of the pituitary gland is observed, while the amount of thyroid hormones in the blood may be normal or slightly reduced.

Signs of hypothyroidism

Unfortunately, diagnosing hypothyroidism is the number one problem. Many patients suffer from hypothyroidism. however, the clinical picture of the disease is often carefully disguised, and the patient may exhibit the following symptoms?

Gastroenterology:

• Constipation
• Manifestations of cholelithiasis
• Biliary dyskinesia

Rheumatology:

• Syneviitis
• Polyarthritis
• Manifestations of progressive osteoarthritis

Gynecology:

• Infertility
• Uterine bleeding

Cardiology:

• Diastolic hypertension
• Cardiomegaly
• Bradycardia

With subclinical hypothyroidism, there are no signs of dysfunction of the thyroid gland, but deviations from the norm in metabolism may be observed. For this reason, other functions in the body may suffer. Patients often experience a decrease in mood, depression, anxiety, memory impairment, decreased concentration, weakness, and fatigue.

Fat metabolism in subclinical hypothyroidism does not go unnoticed. This manifests itself in an increase in body weight, the development of atherosclerosis, coronary heart disease, and a high risk of heart attack. Replacement therapy at the initial stage of the disease in some cases helps restore metabolic processes.

Thyroid hormones affect the circulatory system, namely the circulatory organs. The influence of hormones can change the number of heart contractions, myocardial contractility, blood pressure, blood flow speed, and blood vessel resistance. With subclinical hypothyroidism, hypertrophy of the heart muscle in the area of ​​the left ventricle may be observed, which indicates overstrain of the heart.

It is very important to identify subclinical hypothyroidism during pregnancy, since early detection of the disease makes it possible to avoid disturbances in the fetus’s body, thanks to timely treatment.

Symptoms of subclinical hypothyroidism

• Memory impairment
• Decreased concentration
• Decrease in intelligence
• Susceptibility to depression
• Increased level of endothelial dysfunction
• Rhythm disturbances
• Menstrual irregularities
• Vaginal bleeding
• Infertility
• Premature birth
• Increased intraocular pressure
• Hypochromic anemia
• Myalgia

Treatment of subclinical hypothyroidism

Replacement therapy may be prescribed. Although many doctors argue that subclinical hypothyroidism does not require treatment. But the disease is fraught with negative consequences, so after comparing the symptoms, the doctor decides on the need for treatment.

L-thyroxine (levothyroxine) is often used in the treatment of subclinical hypothyroidism. L-thyroxine is especially important for expectant mothers. If there is no history of thyroid surgery, doctors often delay treatment in order to monitor the patient’s condition and require repeated tests in a couple of months. If there are no changes, treatment will be prescribed.

When taking l-thyroxine, most patients notice improvements, but taking the drug can result in a lot of side effects, including weight gain, anxiety, insomnia, arrhythmia, and tachycardia.

It is very important to compare possible complications without treatment of subclinical hypothyroidism with the effectiveness of the drug, and you should not discount its side effects. The decision on the need for treatment is made by the doctor if the first two points are equivalent. However, before starting treatment, it is necessary to exclude transient hypothyroidism.

The most interesting news

Thyroid diseases - Diet

Read more about this disease in the section. THYROID GLAND

Thyroid diseases in women are 8-20 times more common than in men. And a disease such as thyroiditis occurs 15-25 times more often in women than in men. In addition, the volume and weight of the gland in women can fluctuate depending on the menstrual cycle and pregnancy. In the absence of thyroid disease in men, her weight is constant.

Diseases of this type in women and men most often occur at the age of 30-50 years. Disorders of this organ also occur in children, and they can also be congenital. Enlargement of the gland in children due to iodine deficiency in some areas reaches 60-80%. Thyroid dysfunction affects 3% of the population.

The most common thyroid diseases are: hypothyroidism, hyperthyroidism, autoimmune thyroiditis, nodular goiter, cyst, cancer.

Hypothyroidism of the thyroid gland - causes, symptoms

Hypothyroidism- decreased activity of the thyroid gland. One of the reasons is iodine deficiency, which reduces hormone synthesis. Other causes of this disease are developmental abnormalities, inflammation of the gland, congenital defects in the synthesis of hormones

Symptoms of hypothyroidism:

Fatigue and loss of strength, chilliness, weakness, drowsiness, forgetfulness, decreased memory, hearing, dry and pale skin, swelling, constipation, excess weight, the tongue thickens, impressions from the teeth are noticeable at the edges, and hair begins to fall out.

With this disease, the menstrual cycle may be disrupted in women; in men, potency is impaired and libido decreases.

The disease develops slowly, over the years, the symptoms of hypothyroidism are not noticeable for a long time

Hyperthyroidism - causes, symptoms

Hyperthyroidism (thyrotoxicosis)– increased activity of the thyroid gland. With this disease, the iron produces an excess amount of hormones, which leads to “poisoning” of the body with these hormones - thyrotoxicosis. Metabolism increases. The thyroid gland enlarges. The cause of hyperthyroidism cannot be excess iodine, since the excess is excreted by the kidneys. The causes are mental or physical stress, disease of other organs, hereditary predisposition, pituitary tumor

Symptoms of hyperthyroidism of the thyroid gland:

Weight loss, feeling hot, sweating, trembling hands, irritability, anxiety, rapid heartbeat, feeling of “sand” in the eyes, pressure behind the eyes.

Carbohydrate metabolism is disrupted, which can lead to type 2 diabetes

In women, the menstrual cycle may be disrupted, in men, potency is disrupted.

The disease develops very quickly.

Autoimmune thyroiditis, causes, symptoms

Thyroiditis– inflammation of the thyroid gland.

Autoimmune thyroiditis caused by a buildup of white blood cells (leukocytes) and fluid inside the gland. In autoimmune thyroiditis, antibodies produced by the immune system mistake the cells of one's own thyroid gland for foreign ones and damage them. There is a gradual destruction of the thyroid gland, which leads to hypothyroidism. Also, against the background of autoimmune thyroiditis, a temporary increase in hormone production is possible - hyperthyroidism

Cause of this disease- partial genetic defect of the immune system. This defect can be hereditary, or can be caused by poor ecology, pesticides, an excess of iodine in the body (long-term excess of iodine stimulates the production of antibodies to thyroid cells), radiation, infections

Symptoms— autoimmune thyroiditis:

During the first years of the disease there are no symptoms, then symptoms of hyperthyroidism may temporarily appear, and then symptoms of hypothyroidism. The main symptoms of this disease are associated with its inflammation and enlargement: difficulty swallowing, difficulty breathing, pain in the thyroid gland

Goiter - causes, symptoms

Goiter is a disease characterized by a pathological increase in the volume of the thyroid gland. Goiter occurs as a result of increased cell proliferation in order to increase the production of the missing thyroxine due to this increase. One of the reasons is iodine deficiency. Goiter can develop in both hypothyroidism and hyperthyroidism

Thyroid nodules and nodular goiter are formations that differ from the gland tissue in structure and structure. All nodular forms of thyroid diseases are divided into two groups: 1) nodular colloid goiter, which never degenerates into cancer; 2) tumors. Tumors, in turn, can be benign, in which case they are called adenomas, and malignant, in which case they are called cancer.

Thyroid cancer

easy to diagnose, often detected in the early stages using puncture biopsy of nodes. Symptoms of thyroid cancer (pain in the throat and neck, pain when swallowing and breathing) are sometimes attributed to infectious diseases, making diagnosis difficult in some cases. The chance of recovery from thyroid cancer is more than 95% if the disease is diagnosed at an early stage.

Diet for thyroid diseases

Diet for the treatment of the thyroid gland vegetarian preferably. It is necessary to include more greens, root vegetables, fruits, nuts, and vegetable proteins in your diet. They contain the necessary organic iodine.

The diet for a thyroid disease such as hypothyroidism should contain fish, seafood, and seaweed. These products have the highest iodine content - 800 - 1000 mcg/kg (daily iodine requirement - 100-200 mcg).

Here's more foods containing iodine in large quantities: beans, soybeans, green peas, carrots, tomatoes, radishes, lettuce, beets, potatoes, garlic, apple seeds, grapes, persimmons, millet, buckwheat. (40-90 mcg/kg). The iodine content in products of plant origin also depends on the soil on which these products are grown. In vegetables grown on iodine-rich and iodine-poor soils, the iodine content can differ many times.

When treating the thyroid gland, the diet should include foods rich in the following microelements: cobalt, copper, manganese, selenium. They contain a lot of chokeberries, rose hips, gooseberries, blueberries, strawberries, raspberries, pumpkin, eggplant, garlic, black radish, turnips, beets, and cabbage.

According to some theories, it is believed that the main cause of thyroid problems is pollution in the body. With hyperfunction of the gland, thyrotoxicosis, the lymph is so contaminated that it cannot cope with the drainage of this organ. Polluted blood constantly irritates the gland with its toxins; therefore, it is no longer able to be controlled by the pituitary gland, and malfunctions occur in its functioning. The presence of toxins in the blood that are harmful to the thyroid gland is associated with pollution, poor liver and intestinal function. In addition, it is believed that one of the causes of hypothyroidism is a violation of the absorption of iodine and other nutrients in the intestines, and the cause of hyperthyroidism can be untimely evacuation of iodine from the body. In connection with this theory, the diet should be such as to cleanse the blood, liver and intestines and improve their functioning. Therefore, it is useful to drink teas from bitter herbs (wormwood, angelica root, yarrow, St. John's wort), cleansing products (radish, garlic, horseradish, celery, parsnips, nuts)

Diet for thyroid diseases shouldn't include the following products:

1. Fatty meat, sausages.

2. Margarine; artificial fats.

3. Sugar, confectionery.

4. White bread, pastries, baked goods

5. Fried, smoked, canned foods

6. Spicy seasonings: mayonnaise, vinegar, adjika, pepper

7. Chemicals: dyes, flavors, flavor enhancers, stabilizers, preservatives

8. Avoid smoking and drinking alcohol and coffee.

The basis of nutrition There should be porridge, boiled and fresh vegetables, legumes, fruits, vegetable oil. In small quantities diet may contain: honey, butter, nuts, eggs

Diet for hypothyroidism

Do not use folk remedies without consulting your doctor! Remember that all methods may have individual contraindications.

More articles about this disease:

Hypothyroidism

Hypothyroidism is a condition that is caused by an inadequate decrease in the concentration of free thyroid hormones in the blood serum.

In our clinic, we successfully treat this disease using hirudotherapy. in a few sessions of complex therapy you will feel the disease receding. Read the article on this disease.

Because thyroid hormone receptors are present in virtually all tissues, the signs and symptoms of hypothyroidism are many and varied. The severity of clinical manifestations depends on the degree of decrease in T3 and T4 concentrations. Severe hypothyroidism is designated by the term “myxedema,” in which there is an accumulation of hydrophilic mucopolysaccharides in the basal layers of the skin and other tissues.

There are primary, secondary and tertiary hypothyroidism. Primary hypothyroidism is caused by direct damage to the thyroid gland, which results in the development of insufficiency of its function,

Secondary hypothyroidism is a consequence of hypofunction of the pituitary gland and insufficient production of thyroid-stimulating hormone (TSH), decreased TSH stimulation of thyroid function and insufficient synthesis of T4, T3.

Tertiary hypothyroidism develops as a result of pathology of the hypothalamus, a decrease in the synthesis of thyrotropin-releasing hormone (TRH) and insufficient stimulation of the pituitary thyrotrophs, a decrease in the synthesis of TSH and stimulation of TSH of the thyroid gland.

Hypothyroidism is characterized by a wide range of disorders and damage to various body systems. Their presence and severity depend on the severity of hypothyroidism. Damage to the cardiovascular system is observed in 70-80% of patients. The nature and extent of cardiac changes depend on the age of the patient, the etiology of hypothyroidism, and concomitant diseases.

The most pronounced changes in the cardiovascular system occur with severe primary hypothyroidism and are referred to as “myxedematous heart”, the first clinical description of which was given by H. Zondek in 1918, highlighting its main symptoms - cardiomegaly and bradycardia.

It has been established that T3 acts on specific myocyte genes responsible for the function of cardiomyocytes, affects myosin, Ca-activated ATPase of the sarcoplasmic reticulum, phospholamban, adrenergic receptors, adenyl cyclase and protein kinase. Both T3 stimulation and T3 deficiency affect myocardial function, including contractility, mass, and number of contractions.

With hypothyroidism, protein synthesis decreases, the concentration of sodium and water ions increases, the content of potassium ions decreases, hypo- or hyperchromic anemia develops due to a decrease in oxidative processes and protein synthesis in the bone marrow, and capillary permeability increases. An increase in capillary permeability plays a major role in the development of edema of various tissues, organs, including the myocardium, and the accumulation of fluid in the pericardium. With successful replacement therapy, capillary permeability is normalized and symptoms associated with edema are regressed.

Hypothyroidism is accompanied by hypercholesterolemia, resistant and refractory to treatment with diet, statins, and other antihyperlipoprosemic drugs, and the degree of its severity also depends on the severity of the disease. Atherogenic lipid fractions accumulate in the blood, and the level of HDL decreases, which contributes to the rapid and progressive development of atherosclerosis with multiple localizations. Lipid metabolism disorders are found not only in overt hypothyroidism, but also in its subclinical forms.

Cardiac changes are caused by the development of myocardial dystrophy due to a pronounced disturbance of metabolic processes, which progresses as the edema of the stroma and parenchyma in the myocardium increases and is accompanied by a decrease in oxidative phosphorylation, a decrease in oxygen uptake by the myocardium, a slowdown in protein synthesis, electrolyte disturbances, which leads to a decrease in the contractile function of the myocardium and an increase in heart size, development of heart failure. The size of the heart increases both due to interstitial edema and nonspecific inflammation of myofibrils, dilatation of its cavities, and due to effusion in the pericardium. With timely and adequate treatment of hypothyroidism with thyroid hormones, myocardial dystrophy undergoes reverse development with the complete disappearance of existing signs of heart damage; otherwise, cardiosclerosis develops.

Clinical manifestations of cardiovascular disorders in hypothyroidism are characterized by complaints of pain in the heart region of a polymorphic nature, shortness of breath during physical activity, arising against the background of various and nonspecific complaints (muscle weakness, decreased mental and motor activity, edema of various localizations). In hypothyroidism, there are two types of pain in the heart, clinically difficult to distinguish: truly coronarogenic (especially in elderly patients), which can become more frequent and intensify when thyroid therapy is prescribed, and metabolic, which disappears during treatment.

During the examination, bradycardia (up to 40 beats/min) or other heart rhythm disturbances are detected.

Sinus bradycardia is recorded in 50-60% of patients with hypothyroidism and is caused, according to researchers, by a decrease in the concentration of blood catecholamines and the sensitivity of adrenergic receptors to them. In 20-25% of patients with hypothyroidism, sinus tachycardia is detected, the pathogenesis of which remains controversial. Most authors explain the presence of sinus tachycardia by a complex of disorders that develop with hypothyroidism - hypothyroid myocardial diatrophy, accompanied by mucous edema of the myocardium, deficiency of macroergs and potassium ions in cardiomyocytes, increased lipid peroxidation and membrane damage, and, consequently, electrical instability of the myocardium, its pseudohypertrophy , accumulation of creatine phosphate, atherogenesis, disturbance of the rheological properties of blood and microcirculation (Tereshchenko I.V.). As a result, in patients with hypothyroidism, especially in old age, in addition to tachycardia, paroxysmal tachycardia, paroxysms of atrial fibrillation and flutter, and sick sinus syndrome may develop. It is noted that these rhythm disturbances are refractory to cordarone and β-blockers and their disappearance when thyroid hormone preparations are prescribed.

Among other rhythm disturbances, it should be noted extrasystole (ES), detected among 24% of patients (atrial - in 15%, ventricular - in 9%). ES occurs more often when hypothyroidism is combined with cardiac pathology (hypertension, coronary artery disease, heart failure, cardiomyopathy). Rhythm disturbances can occur during treatment of hypothyroidism with thyroid drugs, which may be due to increased sympathetic influences on the myocardium under the influence of TG during this period.

During percussion and auscultation of the heart, an increase in cardiac dullness, a weakening of the apical impulse and heart sounds are noted; an accent of the 2nd tone over the aorta can be heard, as a manifestation of atherosclerosis and a systolic murmur at the apex of the heart, caused by dilatation of the left ventricle. In the presence of effusion in the pericardium, heart sounds become muffled and even difficult to hear when there is a significant accumulation of effusion.

X-rays reveal an increase in the size of the heart of varying intensity, a weakening of its pulsation, expansion of the shadow of blood vessels, signs of fluid accumulation in the pericardium and pleural cavities (the heart takes the shape of a “decanter”, its pulsation is sharply weakened). Since transudate accumulates slowly and its amount is not large, cardiac tamponade is rare.

The fluid in the pericardium contains large amounts of protein, unlike the fluid in heart failure. The accumulation of transudate is due to increased capillary permeability and hypernatremia. It has been established that the transudate is transparent, brown or yellow, contains albumin, cholesterol and mucoid substance, erythrocytes, lymphocytes, monocytes, polynuclear and endothelial cells. The clinical manifestations of hydropericarditis are mild, despite the accumulation of a large amount of fluid, which, according to clinicians, may be due to its slow accumulation. A protodiastolic gallop rhythm (III sound) and, rarely, a IV sound can be heard, as confirmation of a decrease in myocardial contractile function, in the absence of other signs. A small effusion in the pericardium may not change the x-ray picture and its detection can be carried out using a more reliable research method - echocardiography

During an ECG study, various changes are observed. According to researchers, the most common and early sign is a decrease in amplitude, smoothness or inversion of T waves, mainly in leads V3.6, but can also occur in standard leads. These ECG changes occur in 65-80%, regardless of the age of patients ( even in childhood) are not associated with risk factors for clinical manifestations of atherosclerosis of the coronary arteries - hypercholesterolemia, angina pectoris and arterial hypertension. The second most common ECG sign is a low-voltage waveform, characterized by a decrease in the amplitude of the QRS complex. Its greatest decrease is recorded in the presence of effusion in the pericardial cavity. Depression of the ST segment and a decrease in the amplitude of the P wave may be observed. Intraventricular blockade and prolongation of atrioventricular conduction are diagnosed. Changes in the T wave and ST segment decrease or disappear along with clinical manifestations when adequate replacement therapy is prescribed and remain in elderly patients suffering from coronary heart disease.

An echocardiographic study in patients with hypothyroidism reveals asymmetric hypertrophy of the interventricular septum, a decrease in the rate of early diastolic closure of the anterior leaflet of the mitral valve, and an increase in end-diastolic pressure, which disappear after pathogenetic treatment.

Decreased myocardial contractile function in hypothyroidism

causes hemodynamic disturbances, which are characterized by a decrease in stroke and cardiac output, a decrease in cardiac index with a reduced volume of circulating blood, as well as an increase in total peripheral resistance in the systemic circulation and diastolic pressure, a decrease in pulse pressure and blood flow velocity in various organs. A long course of uncompensated hypothyroidism can contribute to the development of heart failure, which can be relieved by prescribing only thyroid hormones with a moderate degree of its severity. Severe stage (IIb and III) of heart failure requires additional administration of cardiac glycosides, diuretics and indicates the presence of concomitant cardiac pathologies: ischemic heart disease, cardiosclerosis, cardiomyopathy, etc.

Researchers, even in latent, subclinical forms of the disease, identify endothelial dysfunction based on a decrease in endothelial vasodilation (EV), as a marker of early atherosclerosis. When studying the relationship between EV levels and the level of thyroid-stimulating hormone (from O.4 µU/ml), the greatest decrease in vasodilation was observed in patients with TSH levels more than 10 µU/ml (Gavrilyuk V.N. Lekakise J,). Studies conducted by Japanese authors to study the thickness of the internal and middle membranes of the common carotid artery in 35 patients with hypothyroidism established its thickening compared to individuals in the control group (0.635 mm and 0.559 mm, respectively).

Cardiac disorders, which are characterized by the development of myocardial dystrophy in patients with hypothyroidism, should be differentiated, first of all, from ischemic heart disease and atherosclerotic cardiosclerosis, especially in elderly patients and the elderly, since the ECG data in them may be identical. For this purpose, it is necessary to determine the function of the thyroid gland by studying the levels of hormones in the blood - T3, T4 (preferably their free forms), TSH. Hypothyroidism is confirmed by low levels of thyroid hormones and their ratio. Differential diagnosis of these pathologies based on clinical parameters is presented in Table. 3.

An additional diagnostic test in patients with hypothyroidism with nonspecific ECG changes (which manifests itself in disruption of repolarization processes - smoothed or negative T waves in most leads) is a potassium test, even with normal values ​​of potassium in the blood plasma.

Instrumental diagnostics should be aimed at assessing the functional state of the heart, identifying early signs of heart failure, and excluding the presence of exudate in the pericardial cavities and pleural cavities. For this purpose, it is necessary to conduct an ECG, daily monitoring of blood pressure and ECG, assessment of heart rate variability, X-ray examination and echocardiography.

The use of 24-hour ECG monitoring and recording of a cardiac intervalogram is of particular importance in monitoring treatment with I thyroxine and in assessing its effect on the condition of the heart, since such patients often complain of palpitations and the presence of vegetative manifestations (attacks of sweating, anxiety, trembling, etc.). These methods make it possible to verify episodes of tachycardia, identify other heart rhythm disturbances throughout the day, and check their relationship with the activation of the sympathetic division of the ANS.

Treatment of cardiac manifestations of hypothyroidism is based on the use of thyroid hormone replacement therapy (β-thyroxine, thyroidin, thyroid therapy). The most radical is the use of β-thyroxine at a dose of 1.6 mcg/kg body weight per day. For ischemic heart disease and hypertension, the initial dose should not exceed 15-25 mg with a gradual increase to the optimal dose.

Due to the long half-life of the hormone, levothyroxine is usually taken once a day. On average, 80% of the dose taken is absorbed and absorption worsens with age. The dose of the drug must be selected gradually, individually, starting with the minimum dose (0.05 mcg/day). For ischemic heart disease and arterial hypertension, the initial dose should not exceed 15-25 mcg/day. The interval between periods of increasing the drug is 2-3 weeks. Today, it is necessary to prescribe L-thyroxine in a dosage that will maintain the TSH level not only normal (0.4-4 mIU/l), but even within a lower range - 0.5-1.5 mIU/ l (Fadeev V.V.), based on the fact that in most people the TSH level is normally 0.5-1.5 mIU/l.

In patients with subclinical hypothyroidism with a TSH level greater than 10 honey/l, the administration of thyroxine preparations is also indicated (Kamenev 3.). In cases of TSH values ​​less than this value, data from multicenter studies do not provide a clear conclusion about the usefulness of this treatment.

Numerous clinical and pathological studies have proven the increased sensitivity of the myocardium to thyroid hormones. When exposed to thyroid hormones (TH), as a result of increased metabolic processes, relative coronary insufficiency can develop in the absence of atherosclerosis of the coronary arteries (Fig. 4). If you have coronary artery disease in old age, there is a risk of increased frequency of angina attacks and its transition to an unstable form. Treatment with inadequate doses of TG can lead to complications such as myocardial infarction and heart failure. Therefore, it is especially important when prescribing this type of treatment to select adequate doses of thyroid hormones with lengthening the period of adaptation of the body (increase the dose of the drug every 7-12 days) to these hormones and carry out electrocardiographic monitoring every 3-5 days to exclude signs of deterioration of coronary circulation.

The body's need for thyroid hormones decreases in the summer, which must be taken into account when treating patients. Men have a higher average need for thyroxine than women. To assess the adequacy of the replacement therapy, periodic monitoring of the level of TSH in the blood is necessary, an increase in which indicates insufficient treatment, and an increase in T3 indicates excess. In diagnosing an overdose of thyroid drugs, the clinical picture is of primary importance, and this is, first of all, tachycardia and determination of the level of thyroid hormones. In this case, the content of T4 in the blood serum, according to E. Braunwald and co-author, should be set at a level slightly higher than the upper limit of normal fluctuations. Serum T3 concentration is a more reliable indicator of metabolic status in patients receiving levothyroxine than T4 concentration.

When prescribing thyroxine, it is important to teach patients self-control - it is necessary to take into account changes in pulse, blood pressure, body weight, monitor well-being and tolerability of the drug, which will help to avoid complications of hypothyroidism and side effects of replacement therapy.

In patients with coronary heart disease, the administration of thyroid hormones must be combined with antianginal drugs: nitrosorbide, nitrong, cordiket, etc. and β-adrenergic blockers. -Adrenergic blockers reduce the increased TG demand of the myocardium for oxygen and thereby prevent the occurrence of angina attacks (Starkova N.T. Levine H.D. Leading). The use of β-blockers is recommended to be prescribed along with TG to patients with hypothyroidism in combination with arterial hypertension and tachycardia, if rhythm disturbances occur. However, it should be taken into account that β-blockers, along with rauwolfia and clonidine, as well as estrogens, reduce the function of the thyroid gland, aggravating thyroid insufficiency (Tereshchenko I.V.). When rhythm disturbances occur while taking TG, various classes of antiarrhythmic drugs are used.

It should be noted that the use of thyroid therapy alone leads to a decrease or normalization of blood pressure in patients previously unsuccessfully treated with antihypertensive drugs. The combined use of thyroid drugs together with antihypertensive drugs can significantly reduce the doses of the latter (Starkova N.T.).

Correction of thyroid insufficiency relieves patients from hypercholesterolemia without the use of any other drugs, however, it may be necessary to prescribe statins or fibrates.

Treatment of heart failure should be combined with the administration of glycosides and diuretics. Their use is recommended to be combined with the prescription of potassium supplements, given the presence of hypokalemia in patients with hypothyroidism. In the presence of effusion in the pericardium, puncture is rarely used, since the effusion accumulates in a volume of less than 500 ml and resolves when replacement therapy is prescribed (Levina L.I.).

In addition, it should be remembered that with hypothyroidism there may be phenomena of intoxication with cardiac glycosides due to a decrease in their metabolism in the liver and a decrease in hepatic blood flow.

A reduction or disappearance of cardiovascular disorders in patients with hypothyroidism has been proven when adequate hormone replacement therapy is used (Starkova N.T.). Thus, Japanese researchers studied the dynamics of the thickness of the walls of the common carotid artery a year after normalization of the level of thyroid hormones under the influence of T4 intake and found a decrease in their thickness to the values ​​of healthy individuals. A decrease in vascular wall thickness correlated with a decrease in total cholesterol and LDL cholesterol levels (Naggasaky T.).

Hello Alice!

Damage to the organs of the cardiovascular system is a very common phenomenon accompanying hypothyroidism. It can be of a different nature and manifest itself in different ways. In many ways, the nature of heart pathology depends on the individual characteristics of the patient’s body.

What can happen with hypothyroidism

The hormonal imbalance that characterizes hypothyroidism leads in almost every case to disruption of the autonomic nervous system. Almost all patients experience an increase in the tone of the vagus nerve, which is manifested by a change in the rhythm of the heartbeat. Indeed, in most cases, bradycardia develops, that is, the heart beats slower. A decrease in heart rate can lead to the development of pathology of the heart muscle, and the heart will no longer cope with its load. In this case, pain will appear in the heart area, and the heart rate will increase significantly. A feeling of lack of air, shortness of breath and heavy breathing also indicate that the internal organs do not have enough oxygen, because the blood flows to them in insufficient quantities.

Studies show that quite often patients with hypothyroidism develop hydropericardium, that is, serous effusion accumulates in the cavity of the heart sac. The frequency of its detection reaches 80% of clinical cases. This pathology aggravates the course of hypothyroidism, increases the risk of developing heart failure and in many cases leads to tachycardia.

Pain in the heart area can be caused by concomitant myocardial dystrophy, that is, a disorder of nutrition and metabolism in the tissues of the heart muscle. The main reason for this condition is the loss of sensitivity of certain groups of nerve cells to substances responsible for transmitting nerve impulses.

Against the background of hypothyroidism, the risk of developing atherosclerosis of the vessels feeding the heart and coronary disease increases. Both of these pathologies can cause pain in the projection of the heart and an increase in the rhythm of its beating.

Also, against the background of hypothyroidism, anemia often develops, that is, the number of red blood cells in the blood that transport oxygen decreases. This condition can also manifest itself as increased heart rate and a feeling of shortness of breath.

Diagnostic methods

In order to determine the cause of your symptoms and choose the most effective treatment, you need to consult a specialist - a general practitioner or cardiologist. In most cases, they prescribe additional diagnostic procedures, the most common of which are electrocardiography (ECG) and ultrasound of the heart.

An ECG allows you to get an idea of ​​the functional capabilities of the heart muscle. A cardiac ultrasound provides information about the condition of the heart muscle, the cavity surrounding the heart, and the main blood vessels.

Indicators of a laboratory blood test are also important, in which signs of anemia, an inflammatory reaction, or specific compounds indicating the presence of heart failure may be detected.

Based on the results of the examination, the doctor will be able to select symptomatic therapy or prescribe medications that improve the condition of the heart and blood vessels.

Best wishes, Svetlana.