What are the symptoms of hypothyroidism and how can it be treated?

1. Causes

Primary (thyroid) hypothyroidism: accounts for 90% of clinical hypothyroidism. Most cases are caused by acquired factors, such as chronic lymphocytic thyroiditis, which causes hypothyroidism. Chronic lymphocytic thyroiditis (Hashimoto's disease)

2. Clinical manifestations

1. General symptoms: chills, fatigue, apathy, slow reaction (the opposite of hyperthyroidism). Remember a word here: myxedema. When this word appears, it means hypothyroidism.

Gastrointestinal manifestations: constipation;

Hypothyroidism + myxedema (or coma) - critical condition

2. Myxedema coma is often induced by cold, infection, sedatives, etc. It is more common in the elderly, and all comatose patients have brain edema. The mortality rate is extremely high.

3. Diagnosis

TT4, TT3, FT4, and FT3 are all decreased, while TSH is increased. This is the opposite of hyperthyroidism. Only high TSH is primary hypothyroidism. The increase of TSH precedes the decrease of thyroid hormones FT4 and TT4, and is the earliest manifestation of primary hypothyroidism. Therefore, TSH is used to distinguish between primary and secondary hypothyroidism. TSH is also the first abnormality to appear in hypothyroidism, and it is also the most sensitive indicator to reflect the condition.

IV. Treatment

1. Thyroid replacement therapy: We use replacement therapy for endocrine dysfunction. Give thyroid hormone at physiological doses for long-term maintenance treatment. Initial dose: 25 micrograms.

2. Treatment of mucoedema coma: Immediate emergency treatment. First, intravenous injection of L-T4 or L-T3, then give appropriate dosage, and switch to oral administration when oral administration is possible.