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Hypothyroidism _short for hypothyroidism_ hypothyroidism_ _86345

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									?Hypothyroidism (short for
hypothyroidism, hypothyroidism)

?Hypothyroidism (short for hypothyroidism, hypothyroidism) is due to
thyroid hormone synthesis and secretion decreases or organizations
use insufficient body metabolism reduced syndrome. If hypothyroidism
began in fetus or newborn stage, called cretinism; began in sexual
development of preschool children called juvenile-hypothyroidism;
began in adults that adult-hypothyroidism.

According to the classification part of the neuropathy: ٠because
thyroid gland itself lesion-induced hypothyroidism called primary
hypothyroidism. Accounting for hypothyroidism of 95%. The cause of
primary hypothyroidism in Autoimmunity, 131I thyroid surgery and
hyperthyroidism treatment for three main reasons accounted for more
than 90%; ‫ڠ‬as the hypothalamus and pituitary lesions induced
thyrotropin-releasing hormone (TRH) or thyroid-stimulating hormone
(TSH) produces a decrease in the and secretion of hypothyroidism
called central hypothyroidism. Pituitary radiotherapy, pituitary
macroadenoma, craniopharyngiomas and postpartum hemorrhage is the
more common reasons; because thyroid hormone in peripheral tissues
for the biological effects of obstacles caused by syndrome known as
thyroid hormone resistance syndrome. Beijing China-Japan friendship
hospital Knight into nuclear medicine Department

According to the degree of hypothyroidism: the clinical
hypothyroidism and subclinical hypothyroidism.

Clinical manifestations: symptoms mainly to metabolic rate reduction
and sympathetic nerve excitability decline primarily, illness light
early patients can have no symptoms. The typical patient chills,
malaise, hand and foot swelling, sleepiness, impaired memory, less
Khan, joint pain, weight gain, constipation, menstrual disorder, or
menorrhagia, infertility.

Physical examination: typical patients can have a look sluggish and
unresponsive, facial and eyelid edema, or lips thick tongue, dry,
rough skin, skin temperature is low, edema, hands palm skin is ginger,
drying of hair thinning, Achilles tendon reflex time stretch, pulse
rate and slow. A small number of cases of anterior tibial Mucinous
edema. Hashimoto's disease involving the heart can appear pericardial
effusion and heart failure. Severe patients can occur Mucinous edema
coma.

Laboratory diagnosis: primary hypothyroidism, elevated serum TSH and
FT4 will reduce TT4. TSH, TT4 and FT4 reduce levels of severity.
Serum TT3, normal, advanced FT3. Subclinical hypothyroidism only TSH,
TT4 and FT4 properly.

Thyroid peroxidase antibodies (TPOAb), thyroglobulin antibodies (TgAb)
is the diagnosis of autoimmune thyroiditis (including atrophy of
Hashimoto's Thyroiditis, thyroiditis) of main index. If TPOAb
positive with elevated serum TSH level, injury of thyroid cells have
already occurred. When you first visit TPOAb 50IU/ml and TgAb 40IU/ml,
clinical hypothyroidism and subclinical hypothyroidism rates increase
significantly.

Treatment: levothyroxine (L-T4, u of music) is the primary
replacement for the treatment of the disease. Generally require
lifelong replacement. But also Hashimoto's Thyroiditis-induced
hypothyroidism spontaneous remission of the report. The treatment
goal is to make clinical hypothyroidism and symptoms disappear, TSH,
TT4, FT4 values are maintained in the normal range. Secondary to the
hypothalamus and pituitary of hypothyroidism, can't get treatment
targets, TSH as rather serum TT4, FT4 reaches the normal range as
treatment goals.

Treatment of dose depends on the patient's condition, age, weight,
and individual differences. Adult patients L-T4 alternative dosage of
50-200 g/day, an average of 125 g/day. According to the weight
calculation of the dose is 1.6-1.8 g/k g/day, children need a higher
dose of approximately 2.0 g/k g/day; elderly patients you need a
lower dose, about ձ.0 g g/k/day; alternative dosage pregnancy needs
to increase by 30-50%; thyroid cancer patients need large doses of
alternative, approximately 2.2 g/k g/day, control of TSH in
preventing recurrence needs level.

General from 25 a 50 g/day, 1 time per day, each one a oral 2 week
increase 25 g until reaching the treatment goals. Suffering from
ischemic heart disease by starting dose adjusted-dose should be small,
should be slow, prevent evoked and increase heart disease. Ideal L a
T4 medication at meals, because some drugs and food affect the
absorption and metabolism of it, and other drug use interval should
4h above. The half-life of T4 is 7 days, so you can take time every
morning. Thyroid tablets is an animal of the thyroid, dry preparation
for thyroid hormone in unstable and T3 content too high is rarely
used.
Re-establish the hypothalamic-pituitary-thyroid axis balancing
general need 4-6 weeks, so the treatment period, every interval of 4-
6 weeks for the determination of hormones in the index. Then check
the results adjusted L-T4 dose, until you reach treatment goals.
Treatment compliance, the necessary every 6-12 months to review the
indicators of a hormone.
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