Hypothyroidism in adults



Hypothyroidism in adults





Hypothyroidism, a state of low serum thyroid hormone, results from hypothalamic, pituitary, or thyroid insufficiency. The disorder can progress to life-threatening myxedema coma. Hypothyroidism is more prevalent in women than in men; in the United States, incidence is rising significantly in people ages 40 to 50.


Causes

Hypothyroidism results from inadequate production of thyroid hormone, usually because of dysfunction of the thyroid gland due to surgery (thyroidectomy), radiation therapy (particularly with 131I), inflammation, chronic autoimmune thyroiditis (Hashimoto’s disease) or, rarely, conditions such as amyloidosis and sarcoidosis. It may also result from pituitary failure to produce thyroid-stimulating hormone (TSH), hypothalamic failure to produce thyrotropin-releasing hormone, inborn errors of thyroid hormone synthesis, inability to synthesize thyroid hormone because of iodine deficiency (usually dietary), or the use of antithyroid medications such as propylthiouracil.

In patients with hypothyroidism, infection, exposure to cold, and sedatives may precipitate myxedema coma.


Signs and symptoms

Typically, the early clinical features of hypothyroidism are vague and may include fatigue, forgetfulness, sensitivity to cold, unexplained weight gain, and constipation. As the disorder progresses, characteristic myxedematous signs and symptoms appear, such as decreasing mental stability; dry, flaky, inelastic skin; puffy face, hands, and feet; hoarseness; periorbital edema; upper
eyelid droop; dry, sparse hair; and thick, brittle nails.

Cardiovascular involvement leads to decreased cardiac output, slow pulse rate, signs of poor peripheral circulation and, occasionally, an enlarged heart. Other common effects include anorexia, abdominal distention, menorrhagia, decreased libido, infertility, ataxia, and nystagmus. Reflexes show delayed relaxation time (especially in the Achilles tendon).

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Jun 16, 2016 | Posted by in GENERAL & FAMILY MEDICINE | Comments Off on Hypothyroidism in adults
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