Manifestations Of Hypothyroidism Research Articles

Comparative analysis of the levels of thyroid-stimulating hormone, glycated hemoglobin and indicators of lipid metabolism in women of Lviv and Kyiv regions

Background. The prevalence of thyroid diseases, including endemic goiter and autoimmune disorders, has been consi­dered by scientists for more than a century as a cause for reducing the working capacity of the population and also affects the cognitive ability of future generations. Geographically, Lviv region is in an endemic iodine deficiency zone, while Kyiv region suffered negative radiation exposure as a result of the accident at the Chernobyl Nuclear Power Plant. Since both factors affect the state of the thyroid system, the study on the levels of thyroid hormones among women in the specified areas makes it possible to identify the risks of thyroid pathologies and to develop a strategy for their prevention. The purpose of the study: to find out and analyze the levels of thyroid-stimulating hormone (TSH), glycated hemoglobin and indicators of lipid metabolism in women of Lviv and Kyiv regions. Materials and methods. One hundred and fifty women were examined, their average age was 48 ± 7 years. The criterion for inclusion in the study were: absence of diabetes or treatment for thyroid pathologies, as well as other serious diseases. The survey was conducted once, in July-August 2022. The level of pituitary TSH, antibodies to thyroid peroxidase (TPO-Ab), glycated hemoglobin, total cholesterol, low-density lipoprotein was evaluated. Results. In examined women of the Kyiv region, the average TSH was 2.21 ± 0.30 mIU/l, while in those from the Lviv region it was within 2.42 ± 0.17 mIU/l (p > 0.05). A significant difference was found between the average values of TPO-Ab, some women had high levels of antibodies without manifestations of hypothyroidism and clinical complaints. The average value of TPO-Ab in patients from the Kyiv region was 81.21 ± 19.41 IU/ml and in women from the Lviv region it was 38.41 ± 5.97 IU/ml (р < 0,05). When analyzing carbohydrate metabolism, no significant changes were found between the levels of glycated hemoglobin in the examined women of Kyiv and Lviv regions, 5.81 ± 0.09 % and 5.66 ± 0.04 %, respectively (р > 0.05). Some women showed a slight increase in glycated hemoglobin over 5.6 %, which did not reach the level of 6.5 %. This group of examinees were at risk of developing type 2 diabetes and is characterized by the term “prediabetes”. Regarding lipid metabolism, we found no significant changes in the level of total cholesterol and low-density lipoprotein. Conclusions. The conducted observation revealed differences in TSH, TPO-Ab indicators in healthy women living in Lviv and Kyiv regions. We can assume that the obtained results of Lviv region reflect the problems of the endemic zone of the Western regions of Ukraine. In turn, significantly higher levels of TPO-Ab among residents of Kyiv region are most likely a consequence of the accident at the Chernobyl Nuclear Power Plant, which can still affect the health of the population of this region.

Case study of thyroid dysfunction associated with polycystic ovarian syndrome (PCOS)

Background: In recent times, there's a noticeable rise in endocrine dysfunctions, with increasing clinical resemblance between PCOS and autoimmune thyroid disease. The exact cause of this association remains uncertain, but these conditions share a reciprocal relationship. While they exhibit common clinical features, risk factors, and pathophysiological abnormalities, the root causes differ. Polycystic ovaries can be a manifestation of hypothyroidism, making it necessary to rule out hypothyroidism before diagnosing PCOS. Common factors like increased adipose tissue, insulin resistance, high leptin, and abnormal autoimmunity play a vital role in linking these conditions. These shared signs and symptoms emphasize the association between PCOS and hypothyroidism, though the etiopathological basis of this complex relationship is not fully established. Methodology: Cross-Sectional study of 200 patients involved after history, examination. Statistical analysis by SPSS v.22. Result: In this study, we aimed to evaluate thyroid function in PCOS patients using serum TSH levels and estimate the prevalence of hypothyroidism. We also examined prolactin levels in diagnosed PCOS patients, considering criteria like age distribution, BMI, clinical manifestations, fertility status, and thyroid status. Conclusion: Our findings suggest that PCOS is more prevalent in patients with thyroid disorders such as autoimmune thyroiditis and subclinical hypothyroidism compared to the general population. Additionally, PCOS increases the risk of cardiovascular diseases like hypertension and dyslipidemia. Subclinical hypothyroidism with PCOS further elevates the risk of hypertension compared to euthyroid PCOS patients. The study reveals that thyroid dysfunction occurs in 29.0% of PCOS patients, emphasizing importance of screening for thyroid abnormalities in PCOS patients.

БОЛЬШОЙ ПЕРИКАРДИАЛЬНЫЙ ВЫПОТ У ГРУДНОГО РЕБЕНКА С АУТОИММУННЫМ ТИРЕОИДИТОМ В ФАЗЕ ГИПОТИРЕОЗА И СИНДРОМОМ ДАУНА: КЛИНИЧЕСКОЕ НАБЛЮДЕНИЕ

The article describes the difficulties in diagnosing and treating a large pericardial effusion caused by the autoimmune atrophic thyroiditis with a debut in the form of a myxedema coma in a 7 months old child with Down syndrome. The clinical, laboratory and instrumental picture of a rare complication of a hypothyroidism - a hypothyroid (myxedematous) coma, the epidemiology and comorbidity of Down syndrome, autoimmune thyroiditis and hypothyroidism, manifestation of hypothyroidism with pericardial effusion prevailing in the pathological symptom complex are discussed in the article.

HYPOTHYROIDISM IN THE PRACTICE OF A GENERAL PRACTITIONER

Thyroid pathology is widespread and is detected in almost half of the population of the Chuvash Republic. The thyroid gland plays an important role in the functioning of many organs and systems in the human body. Thyroid hormones are vital for humans; they regulate water-electrolyte, protein, fat, carbohydrate and energy metabolism, normal functioning of organs and systems, including the central nervous system. One of thyroid gland pathologies associated with a deficiency of its hormones is hypothyroidism. Primary, secondary and tertiary hypothyroidisms are distinguished. Clinical manifestations of hypothyroidism are nonspecific, mostly they depend on the patient's age, duration and severity of hormone deficiency. Hypothyroidism is suspected if patients have the following symptoms: hypothermia, myxedemas due to accumulation of hyaluronic acid and mucin in the tissues, bradyphrenia, myopathy, anemia. Determining the level of TSH and free T4 in the serum helps to confirm it, and a thyrotrophin-releasing hormone test is used to diagnose secondary and tertiary hypothyroidism. The present article discusses a clinical case of hypothyroidism onset and the difficulties in diagnosing this pathology.

Abstract 27: Neuropathy in primary hypothyroidism and response to thyroxine replacement

Background: Entrapment neuropathy and sensorimotor polyneuropathy has been described as a manifestation of hypothyroidism in many studies. Only few studies are available in Indian population to know the extent of neuropathies in hypothyroid patient and effect of thyroxine replacement on these abnormalities.Aims and Objectives: To study the extent and pattern of peripheral nerve involvement in hypothyroid (subclinical and overt) patients and the response to optimal thyroid hormone replacement in them.Methods: Consecutive patients with primary hypothyroidism were clinically and electrophysiologically evaluated for peripheral nerve dysfunction at baseline and after achieving euthyroid status.Results: A total of 61 patients, were studied (Mean age 39.2 yrs, Range 19 - 55 yrs, Mean TSH 22.32 ±15.6 IU/ml). Baseline clinical examination was abnormal in 13 (21.3%) and electrophysiology was abnormal in 21 (34.4%). Among these, 6 (29%) had demyelination, 8 (38%) axonal neuropathy and 07 (33%) entrapment neuropathy. After optimal thyroxine replacement, 14 (67%) showed complete recovery. While 8 (72.7%) out of 11 with sensory axonal neuropathy showed significant improvement, all 04 patients with motor neuropathy showed significant improvement. One patient with demyelinating neuropathy did not show any improvement. Out of 7 patients with CTS, 5 (71.4%) showed improvement after thyroxine replacementConclusion: Subclinical peripheral nerve involvement is frequent in primary hypothyroidism and most cases responds well to optimum thyroxine replacement.

Myxoedema ascites-Rare presentation of long standing hashimotos thyroiditis

Hypothyroidism is among the common clinical conditions which are encountered in the medicine OPD. An autoimmune disorder called Hashimoto’s thyroiditis is a common cause for hypothyroidism followed by over response to hyperthyroidism treatment, radiation therapy, medications, congenital disease etc. Patients can present with sensitivity to cold, weight gain, constipation, menstrual abnormalities, and slow mentation with irritability, dry skin, hair loss, and fatigue. Rarely, uncontrolled hypothyroidism can present as pericardial effusion, pleural effusion and ascites. Ascites as the feature of hypothyroidism is uncommon and only less than four percent of patients with hypothyroidism /develop ascites.As it is rarely presented as ascites so its diagnosis is delayed but once it is diagnosed, treatment leads to clinical improvement.: A 20-year-old female presented to medicine OPD with non- tender abdominal distension, vomiting. She was a known case of Hashimoto's thyroiditis an autoimmune disorder; however, she was not compliant to thyroid medication. All necessary investigations were carried out to rule out the cause for ascites. With all the negative reports including imaging and supportive fluid cytology we attributed the symptoms to uncontrolled hypothyroidism as the patient was non-compliant to the thyroid medications. Also the picture of macrocytic anaemia in our patient supported the diagnosis. She was started on levothyroxine and was counselled. On a follow-up visit there was dramatic improvement of all the symptoms including ascites and her TSH was normal-2.017. Ascites as a symptom of hypothyroidism is rare and its pathophysiology is not fully understood however there are few theories and studies in the past which do explain ascites as the manifestation of hypothyroidism. Severe uncontrolled hypothyroidism though uncommon but can cause ascites. Being a reversible cause of ascites, it becomes important for clinicians to take hypothyroidism as one of the differential diagnosis for ascites. Our case supports the need of taking hypothyroidism as one of the cause, as it is easily treatable and patient can show dramatic improvement.

Prevalence and Manifestations of Hypothyroidism among Population of Hyderabad, Sindh, Pakistan

Prevalence and Manifestations of Hypothyroidism among Population of Hyderabad, Sindh, Pakistan

Prevalence and Manifestations of Hypothyroidism among Population of Hyderabad, Sindh, Pakistan

Prevalence and Manifestations of Hypothyroidism among Population of Hyderabad, Sindh, Pakistan

A Case of Rhabdomyolysis in a Patient With Hashimoto’s Thyroiditis

Introduction: Hashimoto’s thyroiditis (HT) is an autoimmune disease that presents with musculoskeletal symptoms like proximal muscle weakness, stiffness, pain or cramps in the majority of patients. Rhabdomyolysis which is a breakdown of the skeletal muscles, is a rare but serious manifestation of hypothyroidism and if occurs, it is usually related to trauma, strenuous exercise or use of statins. We report a patient with unrecognized Hashimoto’s thyroiditis who presented with severe rhabdomyolysis without reported history of strenuous exercise, seizures or statin use and surprisingly, He did not have any complications from rhabdomyolysis like electrolytes abnormalities or acute kidney injury. Case Report: A 56-year-old man with no reported past medical history who presented with severe generalized weakness, bilateral leg pain, and recurrent falls for three months. He also reported constipation, fatigue and dry skin. Denied any prior personal or family history of thyroid disease, seizure disorder, statin use, trauma or tick bite. He was afebrile with a heart rate of 80 beats/minute, a blood pressure of 126/71mmHg. Initial laboratory testing showed normal metabolic panel, elevated thyroid stimulating hormone 30.6 uIU/mL (Range 0.27-4.2 uIU/mL), FT4 0.1 ng/dL (Range 0.93-1.7ng/dL), TPO Ab 300IU/mL (N<43IU/mL), Creatine Kinase (CK) level 10,000U/L (N<200U/L), ESR 27 mm/Hr (N<20mm/Hr) and Lactate Dehydrogenase 621U/L (N <225U/L). A muscle biopsy was done to rule out polymyositis as a cause of his severe muscle pain, weakness and tenderness and it was negative. Patient was diagnosed with HT with associated rhabdomyolysis after excluding other causes of rhabdomyolysis. Supportive treatment with intravenous fluids and Levothyroxine were initiated and resulted in dramatic clinical improvement. Conclusion: Rhabdomyolysis is a rare but potentially a serious complication of hypothyroidism. Screening for hypothyroidism in patients with elevated muscle enzymes should be considered, as early diagnosis and prompt treatment of hypothyroidism is essential to prevent rhabdomyolysis and its consequences like acute kidney disease and electrolytes abnormalities. Appropriate fluid resuscitation is the mainstay therapy for AKI prevention and should be initiated in a timely manner. Key Words: HT: Hashimoto’s Thyroiditis, ESR: Erythrocyte Sedimentation Rate, TPO Ab: Thyroid Peroxidase Antibody, TSH: Thyroid Stimulating Hormone, FT4: Free Thyroxine level, AKI: Acute Kidney Injury.

EXPERIMENTAL MODELS OF THE HYPOTHYROIDISM

Hypothyroidism is a systemic chronic disease that occurs as a result of a deficiency of thyroid hormones (thyroid hormones): triiodothyronine and tetraiodothyronine (thyroxine). Targets of thyroid hormones are almost all organs and tissues of the human body, which explains the variety of clinical manifestations that occur when these hormones are deficient. Recently, basic research through the use of experimental models has become more relevant and allowed us to obtain a number of new morphological and functional changes that occur in hypothyroidism. This review discusses the main experimental models of hypothyroidism: surgical, radioactive, dietary, anti-thyroid administration and genetics’ model. The main principle of the surgical model of hypothyroidism is to remove the thyroid gland. The radioactive model is based on the introduction of a radioactive isotope of iodine to laboratory animals. The dietary model is based on the use of a special diet with a limited amount of iodine. The drug model is based on the introduction of antithyroid drugs - methylimidazole and propylthiouracil. The principle of the genetic model consists in special genetic manipulations with the genome of laboratory animals. The advantages and disadvantages of each model are discussed. The use of sophisticated equipment has brought specialists closer to a more complete and holistic understanding of the morphological and functional manifestations of hypothyroidism. Researching of experimental models is an important tool in relation to the studying of the mechanisms underlying hypothyroidism and, as a result, in improving prevention and treatment-diagnostic strategies.

Hoffmann Syndrome, Manifestation of Hypothyroidism: Case Report

Hoffmann syndrome is defined since 1897 as the combination of hypothyroidism with myopathy, mioedema, rigidity, muscle cramps, and hypertrophy. The objective of this publication is to describe a typical case of thyroid disease with clinical, hormonal, and muscular characteristics of a Hoffmann syndrome, as an exceptional manifestation of hypothyroidism. The clinical challenge consisted in linking the apparent ambiguity of the clinical symptoms such as: generalized weakness, fatigue, muscle cramps in a young patient, without personal record of previous disease, apparently healthy and well-nourished with favorable muscle development. Additionally, manifestation of pituitary gland dysfunction was found, such as headache and galactorrhea, bibliography reviewed showed mainly, male patients patter and not any comment concerning hypophysis impairment. all clinical manifestations disappeared after replacement treatment with levothyroxine, including the goiter and pituitary macroadenoma. The management of the case involved a multidisciplinary team and involved internists, cardiologist, endocrinologists, radiologist, and neurosurgeons. This form of thyroid myopathy is rare and usually accompanies adult patients with severe and long-standing hypothyroidism, is different from those that begin in early childhood and are associated with cretinism and muscle hypertrophy.

Ego-Dystonic Psychotic Symptoms as the Initial Manifestations of Hypothyroidism in an Elderly Man

Ego-Dystonic Psychotic Symptoms as the Initial Manifestations of Hypothyroidism in an Elderly Man

State of the coronary arteries and assessment of the role of hormone replacement therapy in patients with coronary heart disease against the background of primary manifest hypothyroidism

Aim To study features of coronary damage and incidence of different types of acute coronary syndrome (ACS) in history associated with primary symptomatic hypothyroidism in patients with ischemic heart disease (IHD) and possible associations of replacement hormonal therapy with lipidogram indexes.Material and methods This retrospective study included 344 patients with IHD and functional class I-III stable angina (ССS, 1976). Of them 100 patients had primary symptomatic hypothyroidism and 244 had no hypothyroidism. Coronary angiography was performed for all patients included into this study. Routine laboratory, instrumental and clinical indexes were analyzed. Hypothyroidism was confirmed by levels of thyrotropic hormone, free triiodothyronine, and thyroxine. Comparative analysis was performed for the incidence of ACS types in history, types of coronary injury, and laboratory, instrumental and clinical indexes with assessment of potential interrelations. Statistically significant results were reported. Type of data distribution was evaluated with the Kolmogorov-Smirnov test. Quantitative data with normal (Gaussian) distribution were presented as mean (M) and standard deviation (SD). Data with attributes of non-normal distribution were presented as median (Me) with maximum and minimum values (min; max). Statistical significance of differences between means was assessed with the Mann-Whitney test. Logistic regression analysis was used in parallel for evaluating dependence of a quantitative variable on values of two or more quantitative or qualitative variables (factors). Significance level for testing of statistical hypotheses was р&lt;0.05.Results Incidence of ST segment elevation ACS (STEACS) was significantly higher in IHD patients with hypothyroidism than in the group without hypothyroidism (61.6 and 35.6 %, р=0.03) and also with three-vessel coronary artery disease (60.6 and 30.6 %, р=0.001). In the IHD group with hypothyroidism, levels of total cholesterol, triglycerides, and low- and very low-density lipoproteins were significantly increased compared to the respective values in patients without hypothyroidism (р&lt;0.0001). An inverse correlation was found between lipidogram indexes and L-thyroxine (р&lt;0.0001).Conclusion The incidence of STEACS associated with primary symptomatic hypothyroidism in history was significantly higher in the patient group with IHD on the background of primary symptomatic hypothyroidism compared to the comparison group. Also, the incidence of three-vessel coronary disease was significantly greater than in the IHD patient group without hypothyroidism. A significant association was found between the replacement hormonal therapy and the best lipidogram indexes. The authors suggested that the key factor for prevention of adverse cardiovascular events in IHD with hypothyroidism is achieving control of clinical manifestations of hypothyroidism with replacement hormonal therapy.

ASSESSMENT OF KNOWLEDGE, ATTITUDE, AND PRACTICE REGARDING HYPOTHYROIDISM AMONG INFERTILE WOMEN WITH HYPOTHYROIDISM

Objective: The study was designed to assess the knowledge, attitude, and practice (KAP) of hypothyroidism among infertile women with hypothyroidism.&#x0D; Methods: A cross-sectional analysis was performed in an outpatient environment of infertility centers. We used a validated questionnaire to assess hypothyroidism KAP. Using frequency counts (n) and percentages (%), discrete data were summarized. The Chi-square/Fisher test was used between groups to compare.&#x0D; Results: The mean age of participants was found to be 32±5.77 years. It was found that 72% of the subjects had poor knowledge, 44% were extremely concerned, and 81% were practicing with a moderate level of precaution. Among the consequences of hypothyroidism, 68% of the study subjects most properly-recognized menstrual disturbance, followed by 66%, 51%, and 48% of study subject properly-recognized weight gain, fatigue, and muscle aches/pain as a clinical manifestation of hypothyroidism. Most patients (98%) adhered to their medications. Nearly half of the study patients (45%) did not avoid cabbage, cauliflower, or soya.&#x0D; Conclusion: Our study highlighted the significance of investing appropriate time to provide patients with a comprehensive education to bridge the gaps in patient care. The findings also indicated that it be better for the understanding of the patients if health-care providers could provide patients with data sheets explaining the disease or having some pictorial/pamphlets about the disease’s reality and myths.

Cardiovascular manifestations of hypothyroidism

Cardiovascular manifestations of hypothyroidism

Hoffman’s syndrome presenting as sole manifestation of hypothyroidism: A rare entity

Hoffman’s syndrome presenting as sole manifestation of hypothyroidism: A rare entity

Assessment of Public Knowledge regarding the Differences between Hyperthyroidism and Hypothyroidism

Background: Thyroid hormones play a pivotal role in the metabolism of human body. Changes of the thyroid gland activity manifest in nearly all body systems. Appropriate knowledge of the public about thyroid disorders and their manifestations is essential for early detection. Objective: The aim of this study was to assess public knowledge regarding the differences between hyperthyroidism and hypothyroidism in Tabuk city, Saudi Arabia. Methods: A cross sectional study was conducted on 300 randomly selected adult residents in Tabuk city. An Arabic self-administered questionnaire was filled by the participants through a link or softcopy. The questionnaire included questions about socio-demographic data of the respondents and other questions to assess knowledge about the type and functions of thyroid gland, its disorders, factors affecting thyroid disorders, and their common manifestations. Results: Respondents with good knowledge of thyroid gland and its disorders constituted 52%, while 45% had poor knowledge. Good knowledge was demonstrated in questions about the type of thyroid gland (71.4%), and the most susceptible individuals to have the disorder (90.4%). Manifestations of hypothyroidism were also recognized by most respondents, particularly weight gain (76%) as well as fatigability and sleepiness (74.9%). Inadequate and poor knowledge was found as regards the functions of thyroid gland, causes of thyroid hormonal disturbances, and symptoms of hyperthyroidism. Conclusion: The knowledge of respondents about thyroid disorders is poor. Inadequate knowledge can result in increased number of undetected cases. Health education should be launched by the health authorities and distributed through all available channels of information. Good knowledge of the general population about thyroid disorders is expected to decrease the incidence of preventable disorders and increase the detection of subtle undiagnosed cases.

Correlation between thyroid hormones and body weight in hypothyroid females in Erbil city

Hypothyroidism, also known as underactive thyroid, is a condition where the thyroid gland does not produce enough of thyroid hormone called thyroxine. Thyroid hormones regulate the way in which the body uses energy - metabolism - and without enough thyroxine, many of the body's functions slow down. Through this study we aim to define any relationship of fluctuations that might exist between serum thyroid stimulating hormone, triiodothyronine and its prohormone thyroxine with body weight in hypothyroidism under thyroxin therapy. The present cross-sectional study deals with estimation of levels of serum thyroid stimulating hormone, triiodothyronine, thyroxine, Vitamin D 3 and calcium in (100) patients with hypothyroidism, all the biochemical parameters were estimated calorimetrically. The mean ± SE concentrations of serum thyroid stimulating hormone, triiodothyronine, thyroxine, Vitamin D and Calcium were 33.6 ± 1.3 UIU/ml, 10.6 ±1.1 nmole/L, 41.1 ±1.4 nmole/L, 29.5 ± 2.3 nmole/L and 13.4 ± 2.1 mg/dl, respectively. In the existing study we found, a statistical positive correlation (r = 0.404 ) between thyroid stimulating hormone and body weight. While there were a negative correlation between triiodothyronine (r = -0,41538 ), thyroxine (r = -0,41538 ) and body weight. Our results of the present study demonstrates that weight gain and obesity are two common manifestation of hypothyroidism.

Індексна оцінка стану тканин пародонта в осіб із первинним гіпотиреозом

In recent decades, both in the world and in our country, thyroid gland diseases are not only widespread, but also have a tendency to constant growth. Currently, more attention is paid to diseases of the thyroid gland that are associated with endemic foci of iodine defi ciency in soil and water.The aim of the study – to investigate the state of periodontal tissues in individuals with primary hypothyroidism.Materials and Methods. We conducted a survey of 86 people with primary hypothyroidism, 16 of them with manifestation and 70 with subclinical forms. A comparison group was 45 people without thyroid gland diseases. Index assessment of periodontal tissues included the defi nition of a simplifi ed oral hygiene index of the oral cavity of the Green-Vermillion (Oral Hygiene Index-Simlifi ed, Green-Vermillion, 1964), the degree of gingival infl ammation was determined by Parma (C. Parma, 1960, Papillary-Marginal Alveolar Index)), the state of periodontal tissues in the complex periodontal index (KPI) (1987), destructive changes in the bone tissue of the alveolar appendix were determined by the Fux index.Results and Discussion. The article presents the results of the index estimation of periodontal tissues in individuals with primary hypothyroidism. An analysis of the conducted index evaluation found that they had a poor level of hygienic state of the oral cavity. This was manifested by the development of infl ammatory and, to a lesser extent, infl ammatory and dystrophic lesions of periodontal tissues, as evidenced by papillarymarginalalveolar (PMA) and complex periodontal indices (KPI).Conclusions. Even more signifi cant changes in these indicators were found in individuals with a manifestation of hypothyroidism. So, we can conclude that in persons with primary hypothyroidism metabolic processes ofthe organism are violated, which leads through a number of pathophysiological changes to the activity of parodontopathogenic microfl ora and the development of infl ammatory and infl ammatory and dystrophic periodontal diseases.

To Study the Cardiovascular Manifestations of Hypothyroidism

To Study the Cardiovascular Manifestations of Hypothyroidism