What is Hypothyroidism ?

Hypothyroidism is a condition where the thyroid gland is underactive and produces too little thyroid hormone. A very severe hypothyroidism is called miksedema.


CAUSE
The most common cause is Hashimoto's thyroiditis was found. In Hashimoto's thyroiditis, the thyroid gland is often enlarged, and hypothyroidism occurred several months later due to damage to the gland is still functioning. The second cause is the most common treatment for hyperthyroidism. Both radioactive iodine or surgery are likely to cause hypothyroidism.

Long-term iodine deficiency in the diet, causing enlargement of the thyroid gland is underactive (hypothyroidism goitrosa). Long-term iodine deficiency is the most common cause of hypothyroidism in underdeveloped countries.


SYMPTOMS
Thyroid hormone deficiency causes slowing of body functions. Symptoms are mild and occur gradually, can be misinterpreted as depression. Facial expressions become dull, the voice becomes hoarse and spoke into a slow, eyelids and eyes closed and his face became swollen. Many patients who experience weight gain, constipation and do not tolerate cold weather.

The hair becomes thin, rough and dry; skin becomes coarse, dry, scaly and thickened. Many people who have carpal tunnel syndrome. The pulse can be slowed down, palms and soles may appear slightly orange (carotenemia) and eyebrows started to fall off the side. Some people, especially the elderly, become forgetful, confused and forgetful.

If left untreated, can eventually cause anemia and heart failure. This condition can progress to stupor or coma (coma miksedema). This condition can be fatal; breathing becomes slow, patient experienced seizures and reduced blood flow to the brain.

Miksedema coma can be triggered by:
- Cold weather
- Infection
- Trauma
- Drugs (eg sedative that suppress the function of the brain).

Diagnosis
Physical examination shows delayed relaxation of muscles during reflex examination. The patient looks pale, yellow skin, a suburb of eyebrow loss, thin hair and brittle, her expression harsh, brittle nails, arms and legs to swell and reduced mental function. Vital signs showed slowing heart rate, low blood pressure and low body temperature.

Chest X-ray examination may reveal an enlarged heart. Laboratory tests to determine thyroid function usually show low levels of T4 and TSH levels are high.


TREATMENT
Hypothyroidism is treated by replacing the thyroid hormone deficiency, namely by providing a dosage per-oral (by mouth). Who much preferred the artificial thyroid hormone T4. Yanglain form is dried thyroid (thyroid glands obtained from animals).

Treatment in elderly patients starting with low doses of thyroid hormone, because the dose is too high can cause serious side effects. The dose is gradually lowered until TSH levels returned to normal. The drug is usually continued to drink throughout the person's life. In an emergency (eg coma miksedem), thyroid hormone can be given intravenously.