Tag: Reference range

Hypothyroidism,simple,  is manageable and not totally curable.

The dosage must be strictly adhered to and check up once a month is advisable.

There is no problem in getting married and getting pregnant.

http://thyroid.about.com/cs/newsinfo/l/bltest_values.htm

Hypothyroidism (pronounced /ˌhaɪpɵˈθaɪrɔɪdɪzəm/) is a deficiency of thyroid hormone in humans and other vertebrates. Iodine deficiency is the most common cause of hypothyroidism worldwide but it can be caused by any number of other causes such as several conditions of the the thyroid gland, or less commonly, the pituitary gland or hypothalamus.^[1] It can result from a lack of a thyroid gland. It can also be due to iodine-131 used to treat thyroid cancer, its surgical removal. Cretinism is a form of hypothyroidism found in infants.

Signs and symptoms

Early

• Poor muscle tone (muscle hypotonia)
• Fatigue
• Any form of menstrual irregularity and fertility problems
• Hyperprolactinemia and galactorrhea
• Elevated serum cholesterol
• Cold intolerance, increased sensitivity to cold
• Constipation
• Depression
• Muscle cramps and joint pain
• Thin, brittle fingernails
• Coarse hair
• Paleness
• Decreased sweating
• Dry, itchy skin
• Weight gain and water retention^[5][6][7]
• Bradycardia (low heart rate – fewer than sixty beats per minute)

Late

• Goiter
• Slow speech and a hoarse, breaking voice – deepening of the voice can also be noticed, caused by Reinke’s Edema.
• Dry puffy skin, especially on the face
• Thinning of the outer third of the eyebrows (sign of Hertoghe)
• Abnormal menstrual cycles
• Low basal body temperature

Uncommon

• Impaired memory^[8]
• Impaired cognitive function (brain fog) and inattentiveness.^[9]
• A slow heart rate with ECG changes including low voltage signals. Diminished cardiac output and decreased contractility
• Reactive (or post-prandial) hypoglycemia^[10]
• Sluggish reflexes
• Hair loss
• Anemia caused by impaired haemoglobin synthesis (decreased EPO levels), impaired intestinal iron and folate absorption or B₁₂deficiency^[11] from pernicious anemia
• Difficulty swallowing
• Shortness of breath with a shallow and slow respiratory pattern
• Increased need for sleep
• Irritability and mood instability
• Yellowing of the skin due to impaired conversion of beta-carotene^[12] to vitamin A (carotoderma)
• Impaired renal function with decreased glomerular filtration rate
• Acute psychosis (myxedema madness) (a rare presentation of hypothyroidism)
• Decreased libido in men^[13] due to impairment of testicular testosterone synthesis
• Decreased sense of taste and smell (anosmia)
• Puffy face, hands and feet (late, less common symptoms)
• Gynecomastia
• Deafness^[14]

Causes

About three percent of the general population has hypothyroidism.^[15]

Iodine deficiency is the most common cause of hypothyroidism worldwide.^[1] In iodine-replete individuals hypothyroidism is frequently caused by Hashimoto’s thyroiditis, or otherwise as a result of either an absent thyroid gland or a deficiency in stimulating hormones from thehypothalamus or pituitary.

Factors such as iodine deficiency or exposure to iodine-131 from nuclear fallout, which is absorbed by the thyroid gland like regular iodide and destroys its cells, can increase the risk.

Congenital hypothyroidism is very rare accounting for approximately 0.2‰ and can have several causes such as thyroid aplasia or defects in the hormone metabolism. Thyroid hormone insensitivity (most often T3 receptor defect) also falls into this category although in this condition the levels of thyroid hormones may be normal or even markedly elevated.

Hypothyroidism can result from postpartum thyroiditis, a condition that affects about 5% of all women within a year of giving birth.^{[citation needed]} The first phase is typically hyperthyroidism; the thyroid then either returns to normal, or a woman develops hypothyroidism. Of those women who experience hypothyroidism associated with postpartum thyroiditis, one in five will develop permanent hypothyroidism requiring life-long treatment.

Hypothyroidism can also result from sporadic inheritance, sometimes autosomal recessive.^{[citation needed]}

Hypothyroidism is also a relatively common disease in domestic dogs, with some specific breeds having a definite predisposition.^[16]

Temporary hypothyroidism can be due to the Wolff-Chaikoff effect. A very high intake of iodine can be used to temporarily treat hyperthyroidism, especially in an emergency situation. Although iodide is a substrate for thyroid hormones, high levels reduce iodideorganification in the thyroid gland, decreasing hormone production. The antiarrhythmic agent amiodarone can cause hyper- or hypothyroidism due to its high iodine content.

Hypothyroidism can be caused by lithium-based mood stabilizers, usually used to treat bipolar disorder (previously known as manic depression).^[1] In fact, lithium has occasionally been used to treat hyperthyroidism.^[17] Other drugs that may produce hypothyroidism includeinterferon alpha, interleukin-2, and thalidomide.^[1]

Hypothyroidism is often classified by association with the indicated organ dysfunction (see below):^[18][19]

To diagnose primary hypothyroidism, many doctors simply measure the amount of thyroid-stimulating hormone (TSH) being produced by the pituitary gland. High levels of TSH indicate that the thyroid is not producing sufficient levels of thyroid hormone (mainly as thyroxine (T₄) and smaller amounts of triiodothyronine (T₃)). However, measuring just TSH fails to diagnose secondary and tertiary hypothyroidism, thus leading to the following suggested blood testing if the TSH is normal and hypothyroidism is still suspected:

• Free triiodothyronine (fT₃)
• Free levothyroxine (fT₄)
• Total T₃
• Total T₄

Additionally, the following measurements may be needed:

• 24-Hour urine-free T₃^[21]
• Antithyroid antibodies — for evidence of autoimmune diseases that may be damaging the thyroid gland
• Serum cholesterol — which may be elevated in hypothyroidism
• Prolactin — as a widely available test of pituitary function
• Testing for anemia, including ferritin
• Basal body temperature,

Treatment

Hypothyroidism is treated with the levorotatory forms of thyroxine (levothyroxine) (L-T₄) and triiodothyronine (liothyronine) (L-T₃). Both synthetic and animal-derived thyroid tablets are available and can be prescribed for patients in need of additional thyroid hormone. Thyroid hormone is taken daily, and doctors can monitor blood levels to help assure proper dosing. Levothyroxine is best taken 30–60 minutes before breakfast, as some food can diminish absorption. Compared to water, coffee reduces absorption of levothyroxine by about 30 percent.^[22]Some patients might appear to be resistant to levothyroxine, when in fact they do not properly absorb the tablets – a problem which is solved by pulverizing the medication.^[23] There are several different treatment protocols in thyroid replacement therapy:

T₄ only

This treatment involves supplementation of levothyroxine alone, in a synthetic form. It is currently the standard treatment in mainstream medicine.^[24]

T₄ and T₃ in combination

This treatment protocol involves administering both synthetic L-T₄ and L-T₃ simultaneously in combination.^[25]

Desiccated thyroid extract

Desiccated thyroid extract is an animal based thyroid extract, most commonly from a porcine source. It is also a combination therapy, containing natural forms of L-T₄ and L-T₃.^[26

http://en.wikipedia.org/wiki/Hypothyroidism.