Causes of hypothyroidism in adults

The article was professionally consulted with Master, Doctor Vu Thi Duyen - Doctor of Nephrology - Endocrinology - Department of Examination & Internal Medicine, Vinmec Hai Phong International General Hospital.

Hypothyroidism in adults is a very common endocrine disease today, especially in women. Hypothyroidism in adults due to many causes with common clinical manifestations are neck goiter, dry skin, hair loss, forgetfulness, memory loss, fatigue, etc... Adults with hypothyroidism start hormone compensation is required, except for some mild cases of hypothyroidism, followed by follow-up.

Hypothyroidism also known as hypothyroidism, hypothyroidism leads to decreased hormone secretion than normal levels. When the amount of thyroid hormone produced is not enough compared to the body's needs, it will lead to metabolic disorders and damage to tissue cells and organs in the body.
Hypothyroidism in adults is common in women over the age of 65, but men are also likely to have hypothyroidism, but at a much lower rate.

Hypothyroidism in adults due to the following causes:
Primary hypothyroidism: As autoimmune or idiopathic thyroiditis. Hypothyroidism with goiter: Autoimmune diseases, Hashimoto's thyroiditis. Central or secondary hypothyroidism: Due to pituitary lesions, hypothalamic disease, deficiency or structural abnormalities of the thyroid hormone TRH (thyrotropin-releasing hormone) from the hypothalamus, or lack of thyroid hormone thyroid-stimulating hormone (TSH) from the pituitary gland. After thyroidectomy: Hypothyroidism in adults appears after the patient has received iodine radiation therapy or total or partial thyroidectomy, or may appear later (from 4 to 25 years) after thyroidectomy. with chemotherapy with antithyroid drugs such as methimazole or propylthiouracil. Silently Progressive Hypothyroidism: Adult hypothyroidism may occur in postpartum women as a result of silent thyroiditis or subacute granulomatous thyroiditis. In addition, there are other causes such as: Congenital deficiency of enzymes involved in the synthesis of thyroid hormones, iodine deficiency, environment or food containing tumour, or due to use of certain drugs or diseases. dysplasia or hypoplasia of the thyroid gland.
In addition, some of the following factors are thought to increase the risk of hypothyroidism in adults:
Older adults. Previously treated with radiation therapy for diseases in the head and neck region. Previously treated with immunomodulatory drugs, antiarrhythmic drugs containing iodine, treatment with lithium. Family or personal history of autoimmune diseases such as type 1 diabetes, Addison's disease, Graves' disease, postpartum thyroiditis.

Adults with hypothyroidism have the following clinical symptoms:
Goiter in the neck: Tumor is large or small, or there is scarring in the neck area due to previous thyroidectomy. Fatigue, memory loss, lethargy, slowness, fear of cold, weight gain. The skin is infiltrated, pigmented, dry, waxy yellow in color. Loss of hair, hair, nails. Round face, large and infiltrated tongue, hoarse voice. Prolonged constipation, digestive disorders due to decreased intestinal motility. Low blood pressure, slow heart rate.

Diagnosis of hypothyroidism in adults is based on the following tests:
Specific tests related to the thyroid gland: TSH increased or normal, FT3, FT4 decreased. Other non-specific tests: Blood count with normal or enlarged red blood cells, anemia, dyslipidemia (hypercholesterolemia, hypertriglyceridemia), electrolyte disturbances (hyponatremia). Thyroid ultrasound: Hypothyroidism in adults when ultrasound is difficult to detect thyroid parenchyma or thyroid atrophy, thyroid parenchyma has hypoechoic density, many fibrosis. Echocardiography: In some cases, pericardial effusion can be seen. Chest X-ray: Myocardial infiltrates make the heart enlarged. Electrocardiogram: The results of the electrocardiogram show sinus bradycardia, low voltage.

Treatment of hypothyroidism in adults with the goal is to return to a normal hypothyroid state and maintain this condition for a long time. Besides, it is also necessary to pay attention to monitoring and preventing and treating complications caused by the disease. out.
Principles of treating hypothyroidism in adults need to ensure correct treatment of the cause of hypothyroidism, compensate for thyroid hormone with hormone type and dose depending on the patient's condition and the degree of hypothyroidism encountered, starting with The dose is small and gradually increased to the maximum dose until the muscle reaches euthyroid state.
Note in the treatment of hypothyroidism in adults who need to predict coronary events in patients at risk, the dose should be titrated from low to high and very closely monitored such as heart rate or chest pain, if present. With adrenal insufficiency, it is necessary to give priority to compensate for adrenal hormone, pregnant women appoint a higher dose when not pregnant because when pregnant, the need for use is greater, especially in the first 3 months of pregnancy. After giving birth, the dose is gradually reduced back to the original level.
There are many causes of hypothyroidism in adults and the principle of hypothyroidism treatment is to treat the cause.
To detect the disease early, you should check your general health periodically. Currently, Vinmec International General Hospital has general health checkup packages suitable for each age, gender and individual needs of customers with a reasonable price policy, including:
Health checkup package general Vip Standard general health checkup package Patient's examination results will be returned to your home. After receiving the results of the general health examination, if you detect diseases that require intensive examination and treatment, you can use services from other specialties at the Hospital with quality treatment and services. outstanding customer service.