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Hypothyroidism

Hypothyroidism is the disease state caused by insufficient production of thyroid hormone by the thyroid gland. There are several distinct causes for chronic hypothyroidism, the most common being Hashimoto's thyroiditis and hypothyroidism following radioiodine therapy for hyperthyroidism. more...

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The severity of hypothyroidism varies widely. Patients are classified as "subclinical hypothyroid" if diagnostic findings show thyroid hormone abnormalities, but they do not exhibit any symptoms. Others have moderate symptoms that can be mistaken for other diseases and states. Advanced hypothyroidism may cause severe complications, the most serious one of which is myxedema.

Signs and symptoms

Adults

  • Slowed speech and a hoarse, breaking voice
  • Impaired memory
  • Increased sensitivity to heat and cold
  • A slow heart rate and sluggish reflexes
  • Dry puffy skin, especially on the face, and hair loss, especially thinning of the outer 1/3 of the eyebrows
  • Depression (especially in the elderly)
  • Weight gain and obesity
  • Anemia
  • Slowed metabolism
  • Constipation
  • Fatigue
  • Choking sensation or difficulty swallowing
  • Shortness of breath
  • Increased need for sleep
  • Muscle cramps and joint pain
  • Decreased sex drive
  • Brittle fingernails
  • Paleness
  • Irritability
  • Abnormal menstrual cycles
  • Thin, fragile or absent cuticles
  • Infertility or difficulty becoming pregnant
  • Elevated serum cholesterol

Children

Very Early Infancy

  • Feeding problems
  • Constipation
  • Hoarseness
  • Excessive sleepiness

Later Infancy/Toddlerhood

  • Protruding abdomen
  • Rough, dry skin
  • Delayed teething

After Toddlerhood

  • Lack of normal growth
  • Abnormally short for age on height/weight charts
  • Puffy, bloated appearance
  • Below-normal intelligence for age

Causes

Neonatal hypothyroidism

Thyroid hormone is very important to neural development in the neonatal period. A deficiency of thyroid hormones can lead to cretinism. For this reason it is important to detect and treat thyroid deficiency early. In Australia, the Netherlands, and many other countries this is done by testing for TSH on the routine neonatal heel pricks performed by law on all newborn babies.

Hashimoto's thyroiditis

Sometimes called Hashimoto's Disease, this is part of the spectrum of autoimmune diseases and is related to Graves' disease, lymphocytic thyroiditis, and other organ-related autoimmune conditions such as Addison's disease, diabetes, premature menopause and vitiligo. Hashimoto's is a lymphocytic and plasmacytic thyroid inflammation that eventually destroys the thyroid. Patients require permanent thyroid hormone replacement.

Read more at Wikipedia.org


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Retrospective study shows hypothyroidism tied to lower breast Ca risk
From OB/GYN News, 4/15/05 by Christine Kilgore

Women treated for hypothyroidism were less likely to develop primary breast carcinoma--and more likely to have more indolent disease when they did develop cancer--than women with normal thyroid function in a retrospective, case-control study.

The findings "strengthen the possibility of a significant role of thyroid hormones on breast cancer biology," said Massimo Cristofanilli, M.D, and his associates at the University of Texas M.D. Anderson Cancer Center, Houston.

The investigators compared the medical records from 1,136 women with primary breast carcinoma with those of 1,088 healthy women who visited their breast cancer--screening clinic. Approximately 240 women reported having symptomatic primary hypothyroidism and thyroid supplementation before they were diagnosed with breast cancer or before their screening.

The prevalence of reported hypothyroidism was significantly greater in the control group, compared with the breast cancer group (15% vs. 7%).

Women with primary hypothyroidism had a 61% lower risk of developing invasive breast cancer, and women with breast cancer were 57% less likely to have hypothyroidism, compared with healthy women (Cancer 2005;103:1122-8).

After adjustment for confounders of breast cancer risk such as family history of breast carcinoma, the association between breast cancer and hypothyroidism "essentially was unchanged and [treated hypothyroidism] remained a strong protective factor against a diagnosis of invasive breast carcinoma," they said.

Among women with invasive breast cancer, patients with hypothyroidism were older at the time of diagnosis (59 vs. 51 years) and were more likely to be postmenopausal (82% vs. 64%) than patients with normal thyroid function.

Among white women specifically, those with invasive cancer who had been treated for hypothyroidism were more likely to be diagnosed with early-stage disease (95% vs. 86%) and disease without pathologic lymph node involvement (64% vs. 56%).

They also had smaller pathologic tumor size than women with invasive cancer but normal thyroid function.

COPYRIGHT 2005 International Medical News Group
COPYRIGHT 2005 Gale Group

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