Hypothyroidism - History, Anatomical, and Physiological Causes - Research Paper Example

? Hypothyroidism Hypothyroidism is a condition in which there is deficiency in thyroid hormones in the body. There are manycauses of hypothyroidism in relation to age. Hypothyroidism in children is often called cretinism and in adults is called myxoedema. Patients with hypothyroidism often exhibit signs and symptoms related to the deficiency in functioning of thyroid hormones in various systems. Hypothyroidism often affects the skeletal system, nervous system, muscular system, gastrointestinal system, urinary system, skin, respiratory system, cardiovascular system, and hematopoietic system. Hypothyroidism can be treated commonly with levothyroxine. In regard to treatment, a number of clinical trials are still underway to research more on this given condition and come up with other modes of treatment. Keywords: Hypothyroidism, treatment, myxoedema, cretinism, signs and symptoms What is the disease or disorder? Hypothyroidism remains as an endocrine disorder that results due to the thyroid gland producing low thyroid hormone. The disease often presents in both children and adults due to deficiency in thyroid hormone (Cooper, 2004). Thyroid hormone is crucial in the normal functioning of the nervous system, skeletal system, gastrointestinal system, muscular system, skin and other appendages, temperature control among others. Deficiency of thyroid hormone often leads to effects in the affected systems (Haynes, 2012). What is the history of the disease or disorder (background information)? Thyroid glands often secrete some quantities of thyroid hormones: Tetraiodothyronine (T4) and triiodothyronine (T3). These hormones are often responsible for the normal functioning of growth plus development in the human body, in addition to helping in maintaining body temperature plus energy needs. These hormones contain majorly iodine in their biochemical make up (Cooper, 2004). What are the underlying anatomical and/or physiological causes of the disease or disorder? Hypothyroidism is of two types: The childhood type called cretinism and the adult type called myxoedema (Haynes, 2012). In Cretinism, the anatomical and physiological causes of the given disease include the following: I) Developmental anomalies, for example, thyroid agenesis- one born without a thyroid, ectopic thyroid- one born with a thyroid in other places rather than its normal position in the neck and superior mediastinum (Cooper, 2004). II) Genetic defects in the given thyroid hormone synthesis might contribute to the hypothyroidism in some cases, for example, a genetic defect in the iodine trapping mechanism, genetic defect in the oxidation process, iodination process, coupling process and the thyroglobulin process (Bonaert, 2012). III) Another cause of hypothyroidism in children might result due to fetal exposure to antithyroid drugs and even iodides leading to less production of thyroid hormones. IV) Another cause of hypothyroidism in children might be endemic cretinism that results due to dietary lack of iodine in a given area. In adults, the causes of hypothyroidism constitute the following: I) The hypothyroidism could be due to ablation or resection of the thyroid gland following a surgical procedure like removing a cancerous thyroid gland. II) Another cause of hypothyroidism in adults is autoimmune reaction commonly called autoimmune thyroiditis. In this case, the body produces immune cells that identify the thyroid gland hormones or cells as foreign and attack them leading to less production of the given thyroid hormones (Haynes, 2012). This often becomes seen in a condition called Hashimoto’s thyroiditis that constitutes a major cause of hypothyroidism (Bonaert, 2012). III) Hypothyroidism in adults could also result due to dietary deficiency of iodine, commonly seen in areas with endemic or sporadic goiter (Cooper, 2004). IV) Since the thyroid gland gets controlled too by the pituitary gland, any lesion in the pituitary gland could lead to an increase or reduction in hormone production at the thyroid level. Hence less production of the thyroid stimulating hormone from the pituitary gland often leads to reduced production of thyroid hormones by the thyroid glands (Wells, 2010). V) Some form of thyroid cancers may lead to less production of thyroid hormones thus causing myxoedema. VI) Excess or prolonged administration of the given antithyroid hormones might have a negative effect on the physiological process of thyroid hormones production. This may result to less thyroid hormones production and consequently, hypothyroidism (Brenta, 2012). VII) Another cause of hypothyroidism in adults, though not quite common include mild developmental anomalies or dyshormonogenesis (Haynes, 2012). What are the most common symptoms of the disease or disorder? Hypothyroidism in children often leads to cretinism while in adults leads to myxoedema. Cretinism in children often begins few weeks after birth to months from birth. Such children often present with clinical features related to failure to thrive, delayed development milestone, poor feeding, constipation, hoarse cry, bradycardia and dry scaly skin. Children affected by hypothyroidism often end up as dwarfs and mentally retarded (Cooper, 2004). In adults with myxoedema, the form of hypothyroidism often remains as severe in long standing cases. The given term myxoedema refers to a condition with the presence of non pitting oedema that commonly accumulates due to hydrophilic mucopolysaccharides presence in the ground substance of the given dermis plus other tissues (Wells, 2010). In regard to its symptoms, on set of myxoedema often remains to be slow and a fully developed clinical syndrome could develop after several years of one having hypothyroidism. Myxoedema patients strikingly have cold intolerance, physical and mental lethargy, slow speech, constipation, slow intellectuals function, loss of hair, puffiness of hair, plus altered texture of their skin (Haynes, 2012). Women having hypothyroidism may experience irregular menstrual cycles. Other symptoms observed in hypothyroidism adults entail increase in depression states, decreased libido, frequent muscles cramps and muscles aches, coarse dry hair, increase in weight or weight loss and fatigability. How does the disease or disorder affect other body systems? Thyroid hormones are responsible for maintaining optimal growth process, development process, functioning plus maintenance of all the given body tissues. In hypothyroidism, the low thyroid hormone level often results in some effects in other body systems that might be interpreted as signs and symptoms depending on the age of the patient (Mathur, 2011). First of all, thyroid hormones remain critical for skeletal, nervous, and reproductive tissues. In addition, it also has effect on the given protein synthesis plus potentiates secretion and the given action of thyroid hormone (Bonaert, 2012). Hence, in children who get deprived of thyroid hormones in early life often suffer from mental retardation and even dwarfism. This often can be seen in patients born from congenital cretinism since the process existed since utero. The secretion plus the degradation rates of most hormones get virtually influenced by thyroid hormones (Brenta, 2012). Therefore, in the absence or reduction in the thyroid hormones beyond the expected level often results in a slower metabolic process involving catecholamine, estrogens, cortisol, testosterone plus insulin that might result in other effects related to accumulation of the other hormones (Cooper, 2004). Thyroid hormones often result in changes in the levels of cyclic adenine monophosphate level that have effect on the beta receptors. Hence a reduction in the levels of thyroid hormones often results in the reduction in the levels of beta receptor levels. In relation to the nervous system hypothyroidism often results to lethargy or general slowing of the given mental process or neuropathies (Bonaert, 2012). In regard to the cardiovascular system, hypothyroidism also has effects. A reduced level of thyroid hormone often leads to increased peripheral resistance (Mathur, 2011). Increased peripheral resistance results in decreased heart rate, cardiac output, stroke volume and pulse pressure. Heart muscles often become weak in relation to reduced levels of thyroid hormones resulting in occurrence of low output cardiac failure. In an Echocardiogram, one could detect bradycardia presence and prolonged PR interval and sometimes pericardial effusion in case of a chest x-ray. In the respiratory system, hypothyroidism might result in pleural effusions, carbon dioxide retention and hypoventilation. In relation to skin and other appendages, hypothyroidism often causes it to become pale, cool, dry and brittle hair plus brittle nails (Cooper, 2004). Hypothyroidism on the eyes often results in drooping of the eyelids, some periorbital oedema, puffy and non pitting facies, sometimes and loss of the given temporal aspects of eyebrows. In other scenarios, some patients might present with large tongues commonly referred to as macroglossia (Bonaert, 2012). In regard to the gastrointestinal system, hypothyroidism often results to decreased appetite in those affected. In addition, the frequency of the given bowel movements often becomes reduced resulting in some instance to constipation. Furthermore, such individuals become also prone to developing ascites. In relation to the metabolic system, hypothyroidism often results in a decline in the body basal metabolic rate (Cooper, 2004). In addition, it often causes a slight positive nitrogen balance plus delayed insulin degradation. Furthermore, it often results in increased triglycerides and cholesterol levels. Hypothyroidism often results in decreased hormone degradation and subsequent accumulation of the same hormones (Brenta, 2012). In regard to the reproductive system, hypothyroidism also results in hyper menorrhea, decreased libido, infertility, impotence, decreased gonadal steroid metabolism and oligospermia. In relation to the hematopoietic system, this clinical disorder sometimes leads to anemia or decreased erythropoiesis. In the renal system, hypothyroidism sometimes results in impaired water excretion, decreased glomerular filtration rate and decreased renal blood flow (Brenta, 2012). In pregnancy states, hypothyroidism becomes often associated with anemia, preeclampsia, postpartum hemorrhage, spontaneous abortion, cardiac ventricular dysfunction, low birth weight, fetal mortality and impaired cognitive development. What do we not understand about the disease or disorder? What are common treatments for the disease or disorder? Hypothyroidism get commonly treated by replacement therapy of the given thyroid hormone preparations. The treatment goals for a patient with hypothyroidism entail the reversal of the given clinical progress and the correcting the metabolic derangements existing (Mathur, 2011). Thyroid hormone often becomes administered in order to supplement or replace the endogenous hormone. Therefore, hypothyroidism in general can be treated adequately with a constant plus daily dose of levothyroxine. The benefits of this treatment begin to show the effect after 3-5 days and its level may wade off after 4-6 weeks. In giving the replacement therapy, full replacement therapy can be initiated in patients that are young and healthy. Elderly patients often do not receive the full anticipated replacement dose like the young and healthy. Elderly patients and those having ischemic heart disease often get treated with a fourth to a half of the regular treatment regimen given to a normal healthy person. In pregnancy, one often anticipates increased use of thyroxine in treatment of hypothyroidism. The increase becomes more anticipated in the first and second trimester due to increased body demand by the growing fetus and the mother. Increased dosage requirements should be anticipated during pregnancy, especially in the first and second trimesters. After delivery, levothyroxine dosage often becomes reduced to its prepregnancy state while at the same time checking thyroid stimulating hormone level after 6 weeks of delivering. What is the outlook for treatment and/or cure for the disease/disorder? The outlook for treatment often is eliminating or reducing the given symptoms presented by the hypothyroidism patient and returning the patient to near or normal health state. In some cases, some patients may be given excess thyroid hormones medication resulting in the following: Heart palpitations, shaking, mood swings, forgetfulness, feeling hot plus sweating, sometimes loss of weight and menstrual irregularities (Cooper, 2004). Is there current research or clinical trials for new treatments? Currently, there is a meta-analysis of a certain randomized controlled trials on thyroxine-triiodothyronine combination therapy versus thyroxine monotherapy (T4) used in the treatment of clinical hypothyroidism (Bonaert, 2012). The trial found out that there got no difference between the effectiveness of the monotherapy versus the combined one in reducing bodily pain, fatigue levels, depression, anxiety, total cholesterol levels, quality of life and triglycerides levels. From the clinical trial conducted, it got concluded that thyroxine should remain as the treatment of choice for hypothyroidism states. In relation to autoimmune thyroid disease that lacks overt hypothyroidism, higher miscarriage rates became more associated to it. In a study conducted by Negro et al, euthyroid Caucasian women treated with positive anti-TPO antibodies plus with levothyroxine during the given first trimester got reported to have lower miscarriage rates compared to the women that remained not treated (Bonaert, 2012). In addition, the research also found out that lower incidence of the given premature deliveries remained recorded in women that received the antibodies compared to those who did not get. The study became confirmed by other similar studies and confirmed the importance of using thyroid hormones on treating euthyroid pregnant women. Another research found out that levothyroxine should never be taken with prenatal vitamin preparation which contains calcium and iron during antennal period. References Bonaert, K. (2012). Thyroid hormone in health and disease. Journal of endocrinology, 5(45), 12- 45. Brenta, G. (2012). Diabetes and thyroid disorders. The British Journal of Diabetes & Vascular Diseases, 7(30), 45-56. Cooper, D. M. M. (2004). Hypothyroidism. The Journal of Clinical Endocrinology & Metabolism, 10(22), 20-43. Haynes, E. (2012). Hypothyroidism. Health Journal, 12(23), 34-39. Mathur, R. (2011, November 6). Hypothyroidism. Retrieved May 28, 2012, from MedicineNet.com: http://www.medicinenet.com/hypothyroidism/page4.htm#toc7at Wells, C. (2010, April 6). Hypothyroidism. Retrieved May 28, 2012, from Medscape: http://emedicine.medscape.com/article/122393-treatment Read More