Hypothyroidism (underactive thyroid) is a condition in which your thyroid gland doesn't produce enough of certain crucial hormones.
Hypothyroidism may not cause noticeable symptoms in the early stages. Over time, untreated hypothyroidism can cause a number of health problems, such as obesity, joint pain, infertility and heart disease.
CAUSES :-
1.Autoimmune disease:- The most common cause of hypothyroidism is an autoimmune disorder known as Hashimoto's thyroiditis.
2. Autoimmune disorders occur when your immune system produces antibodies that attack your own tissues. Sometimes this process involves your thyroid gland.Scientists aren't sure why this happens, but it's likely a combination of factors, such as your genes and an environmental trigger. However it happens, these antibodies affect the thyroid's ability to produce hormones.
3.Over-response to hyperthyroidism treatment:-People who produce too much thyroid hormone (hyperthyroidism) are often treated with radioactive iodine or anti-thyroid medications. The goal of these treatments is to get thyroid function back to normal. But sometimes, correcting hyperthyroidism can end up lowering thyroid hormone production too much, resulting in permanent hypothyroidism.
4.Thyroid surgery:-Removing all or a large portion of your thyroid gland can diminish or halt hormone production. In that case, you'll need to take thyroid hormone for life.
5.Radiation therapy:- Radiation used to treat cancers of the head and neck can affect your thyroid gland and may lead to hypothyroidism.
6.Medications:- A number of medications can contribute to hypothyroidism. One such medication is lithium, which is used to treat certain psychiatric disorders. If you're taking medication, ask your doctor about its effect on your thyroid gland.
7.Congenital disease :- Some babies are born with a defective thyroid gland or no thyroid gland. In most cases, the thyroid gland didn't develop normally for unknown reasons, but some children have an inherited form of the disorder. Often, infants with congenital hypothyroidism appear normal at birth. That's one reason why most states now require newborn thyroid screening.
8.Pituitary disorder:-A relatively rare cause of hypothyroidism is the failure of the pituitary gland to produce enough thyroid-stimulating hormone (TSH) — usually because of a benign tumor of the pituitary gland.
9.Pregnancy:-Some women develop hypothyroidism during or after pregnancy (postpartum hypothyroidism), often because they produce antibodies to their own thyroid gland. Left untreated, hypothyroidism increases the risk of miscarriage, premature delivery and preeclampsia — a condition that causes a significant rise in a woman's blood pressure during the last three months of pregnancy. It can also seriously affect the developing fetus.
10.Iodine deficiency:-The trace mineral iodine — found primarily in seafood, seaweed, plants grown in iodine-rich soil and iodized salt — is essential for the production of thyroid hormones. Too little iodine can lead to hypothyroidism, and too much iodine can worsen hypothyroidism in people who already have the condition.
SIGNS AND SYMPTOMS
Hypothyroidism signs and symptoms may include:
1.Fatigue
2.Increased sensitivity to cold
3.Constipation
4.Dry skin
5.Weight gain
6.Puffy face
7.Hoarseness
8.Muscle weakness
9.Elevated blood cholesterol level
10.Muscle aches
11.tenderness and Pain, stiffness or swelling in your joints
12.Heavier than normal or irregular menstrual periods
13.Thinning hair
14.Slowed heart rate
15.Depression
16.Impaired memory
17.Enlarged thyroid gland (goiter)
PATHOPHYSIOLOGY :-
DIAGNOSIS :-
1.History collection
2.Physical examination
3.To check low T3 and T4 level
4.Elevated TSH levels in primary hypothyroidism
5.Elevation of serum cholesterol
6.ABG analysis
MANAGEMENT
1.T4 levotgyroxine ,T3 Liothyroxine ,T3 and T4 thyroglobulin liotrix are used to treat hypothyroidism and suppress non toxic goitre.
2. Sodium Levothyroxine is administered parentally to restore T4 level.
3. Replacement therapy is used to myxedema disappear and Normal metabolic activity.
4. Fluids are administered cautionsly because of the danger of water intoxification.
COMPLICATIONS :-
1.Heart failure
2.Myxedema Coma
3.Infection
4.Megacolon
5.Organic Psychosis
6.Infertility
NURSING MANAGEMENT :-
Careful assessment may reveal early and subtle changes .
Educating the patient to proper intake of thyroid drugs .
Educating the patient family and patient to identify the early signs of hypothyroidism and serve from of hypothyroid
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