The thyroid gland is an important organ of internal secretion. Its main function is the production of specific hormones (triiodothyronine, thyroxine), which control the metabolism in the human body and affect all body systems. In this article, we will consider a disease such as myxedema. Causes and symptoms will also be described.
What is myxedema?
Diseases of the thyroid gland cause the development of two syndromes. The production of hormones may increase - this is hyperthyroidism syndrome. However, the decrease in thyroid hormones, which is called hypothyroidism, is of greatest importance.
Myxedema is an extreme degree of hypothyroidism. This condition is characterized by mucous tissue edema. Due to the lack of thyroid hormones, polysaccharide residues accumulate in the tissues, which attract water to themselves. Tissues are excessively filled with water, and mucous edema develops.
What is the cause of myxedema?
Myxedema can occur at any age. Women suffer from this disease more often than men, the occurrence of myxedema in them often accompanies the menopause. Of particular importance is hypothyroidism in infants and young children. Due to a slowdown in metabolism, the physical development and psyche of the child are disturbed. If hypothyroidism is congenital (with aplasia or gland hypoplasia) and has not been treated, cretinism occurs - a special form of mental retardation in children.
In adults, myxedema causes damage to the tissue of the thyroid gland - hypothyroidism is called primary. However, the pituitary gland controls the work of the gland through TSH, a thyroid-stimulating hormone. Therefore, if the pituitary gland is disturbed (a tumor, a violation of the blood supply, trauma, congenital pathology), secondary hypothyroidism occurs . Very rarely there is tertiary hypothyroidism caused by a malfunction of the hypothalamus.
With the disease "myxedema" causes and symptoms are interrelated.
Thus, the main causes of myxedema are as follows:
- atrophic processes in the thyroid gland;
- inflammation of the gland (thyroiditis);
- tumors;
- injuries
- removal of gland tissue (surgery in the treatment of hyperthyroidism);
- radiation exposure;
- treatment with iodine radionuclides;
- lack of iodine from food;
- taking certain drugs (amiodarone, corticosteroids, thyreostatics);
- infectious diseases (especially in a pregnant woman);
- injuries and diseases of the brain, etc.
As a result, myxedema may develop. Causes and symptoms are important when choosing a treatment.
What symptoms accompany myxedema?
Since thyroid hormones affect all body systems, the manifestations of myxedema will be diverse.
In severe thyroid hormone deficiency, a person acquires a characteristic appearance - a “myxedematous face” is formed. The face is swollen, edema is most pronounced on the eyelids, lips. The skin is pale, has a jaundice, cold to the touch, peels off, loss of eyebrows, eyelashes and hair on the head is noted. The work of the facial muscles is impaired - the face is inactive, has an indifferent appearance.
The defeat of the nervous system is expressed in a change in the psyche. Movements become uncoordinated, sluggish. Depression is observed. Information from the outside is poorly perceived, the reaction to events is mild or indifferent. Drowsiness is noted, memory and attention are reduced. Speech is slurred and inhibited.
There are fluctuations in blood pressure, often downward. The work of the heart muscle is disrupted, the heart rate decreases - a "myxedematous heart" is formed. The digestive system is also affected - there are chronic constipation, impaired motor activity of the biliary tract.
Mucous edema develops.
The respiratory capacity of the lungs decreases, as a result of which periods of respiratory arrest in sleep occur. In addition, fluid often accumulates around the lungs, which also disrupts breathing. This phenomenon is called "myxedema polyserositis."
Despite a decreased appetite, a patient with myxedema develops obesity, and elevated blood cholesterol is determined. Hearing decreases, voice hoarseness occurs, nasal breathing is disturbed. Anemia often develops due to a deficiency of iron or folic acid. Here you need a good endocrinologist.
In women, the menstrual cycle is often disturbed, fertility and libido are reduced. Arthritis occurs, bone tissue is depleted in calcium, so fractures are easily formed. Children have a lag in growth and development compared with peers.
What research is carried out additionally?
A good endocrinologist can already diagnose myxedema by the appearance of the patient. However, to clarify the causes of the disease, as well as determine the tactics of treatment, a number of studies are necessary. Diagnosis of myxedema as a whole is not particularly difficult.
Allocate the main and auxiliary diagnostic methods. The main methods allow detecting myxedema, and auxiliary methods are used to find the cause and clarify the form of the disease.
For examination, you can contact the address: Moscow, Dmitry Ulyanov Street, 11. The Institute of Endocrinology conducts the following diagnostic procedures:
1. Basic:
- clinical examination by an endocrinologist;
- blood test for TSH and free thyroxine.
2. Auxiliary:
- Ultrasound of the thyroid gland;
- scintigraphy with radioisotopes;
- thyroid tissue biopsy;
- detection of specific antibodies to thyroid cells.
What does each study mean?
Admission by an endocrinologist is inexpensive.
The doctor examines, palpates and listens to internal organs (heart, lungs). The symptoms described above can greatly help the doctor in a diagnostic search.
In the blood test, a decrease in the content of free thyroxine is detected, however, the detection of elevated TSH is most significant. Subclinical hypothyroidism is distinguished, which is not accompanied by any symptoms and is more often detected by chance. It is the elevated TSH level that is the first “wake-up call” regarding the development of hypothyroidism and myxedema in particular.
Ultrasound scan
Ultrasound of the thyroid gland allows you to visualize various formations in the gland tissue (nodes, tumors, calcifications). This method is considered easy to implement and relatively inexpensive when it is sufficiently informative. If myxedema is detected, treatment should be immediate.
Scintigraphy
The essence of radioisotope scintigraphy is the introduction of radioactive isotopes of iodine intravenously and the assessment of its accumulation in the thyroid gland tissue, the features of its distribution in it and excretion. If with an ultrasound the doctor can only evaluate the structure of the gland, then with scintigraphy its function is evaluated. If there is a disease of "myxedema", then a person often has a reduced accumulation of iodine preparations of a local or diffuse nature. In addition to the function, using this method, the ongoing treatment of various diseases of the gland is evaluated.
Biopsy
Thyroid biopsy involves the collection of a piece of tissue with special needles for biopsy. Subsequently, it is subjected to microscopic and histochemical studies. This allows you to identify various diseases at the cellular level and in time to recognize the tumor process.
Determination of antibodies to thyroid tissue becomes important in the absence of visible causes of myxedema. It is important to know that normally the thyroid gland does not cause the formation of protective proteins, because it is limited by a layer of connective tissue. But with some diseases, this capsule becomes thinner, and the gland tissue comes into contact with immune cells. As a result, antibodies to the cells of the gland are formed, which inhibit its function, without changing the structure.
What is the treatment of myxedema?
An endocrinologist is required before starting therapy.
The treatment of myxedema is not difficult and is a hormone replacement therapy. However, it should be remembered that it is often not possible to restore the function of the gland itself, so taking medications becomes mandatory and lifelong. Improvement in the condition is observed after 2-3 weeks of using special tools.
For the relief of symptoms, L-thyroxine preparations (Levothyroxine, Eutirox) and their analogues are used. These drugs are synthetic substitutes for natural thyroid hormones. The dose of the drug is selected by the doctor individually in each case.
It should be noted that an overdose of the drug can lead to a reverse myxedema state - hyperthyroidism, and an insufficient dose will not have an effect at all. Taking other drugs can also interfere with absorption or accelerate the metabolism of L-thyroxine, therefore, consultation with other specialists on the combination of treatment is necessary.
Where can I go for help?
The therapist may suspect the disease during a physical examination. However, the treatment of myxedema is carried out by an endocrinologist in specialized hospitals. These may be endocrinology departments of city or regional hospitals. For complex examination methods, patients are often referred to research centers in large cities. One of such objects is the “Endocrinological Research Center” (Moscow, ul. Dmitry Ulyanov, 11). The Institute of Endocrinology is known for its help in the treatment of myxedema and other diseases by competent specialists, and the most complex diagnostic and therapeutic procedures.
What is the prognosis of the disease?
In general, myxedema (the causes and symptoms are described) is a completely correctable condition. Taking medications completely eliminates the above symptoms. However, untimely access to a doctor and non-compliance with recommendations can lead to disastrous consequences.