Hypothyroidism

Hypothyroidism is the most common disorder of thyroid function. It is usually due to some disorder of the thyroid gland, which results in reduced production & secretion of thyroid hormones resulting in reduced supply of active thyroid hormones to peripheral tissues. It is accompanied by increased TSH amounts (primary hypothyroidism) by the known mechanism of retrograde regulation.

Much less often, hypothyroidism results from reduced secretion of TSH and thus reduced stimulation of the thyroid to produce and secrete thyroid hormones (secondary or central hypothyroidism). Secondary hypothyroidism can be due to either a pituitary or hypothalamic disorder. In the latter there is reduced TRH secretion. Usually the value of TSH is low or "unsuitably" normal for the corresponding low values of thyroid hormones.

Etiology of hypothyroidism
Primary hypothyroidism
Destruction of thyroid tissue
Chronic autoimmune thyroiditis – (atrophic form or with goitre)
  131I (treatment of hyperthyroidism)
Ext. Cervical radiation (lymphoma, etc.)
Subtotal or total thyroidectomy
Iodine deficiency
Antithyroid drugs (lithium, amiodarone iodine)
Secondary hypothyroidism
Hypothalamus – pituitary diseases
Transient primary hypothyroidism
Silent thyroiditis
Post partum thyroiditis
Subacute thyroiditis
Symptoms and clinical findings of hypothyroidism
SymptomsClinical findings
FatigueSlow movements
LethargySticky speech
DrowsinessHoarseness
DepressionDry skin
Mental impairmentBradycardia
Cold intoleranceSlow reflexes
Dry skinMyxedema
Hoarseness
Weight gain
Decreased appetite
Constipation
Menstrual disorders
Arthralgias
Hallucinations

GRADUATE COURSES IN ENDOCRINOLOGY AND DIABETES- DEPARTMENT OF ENDOCRINOLOGY DIABETES AND METABOLISM OF EVANGELISMOS GENERAL HOSPITAL OF ATHENS- 2004

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