A diagnosis of hypothyroidism can be suspected in patients with fatigue, intolerance to cold, constipation, and dry, flaky skin. A blood test is needed to confirm the diagnosis. When hypothyroidism is present, blood levels of thyroid hormones can be measured directly and is usually reduced. However, in early hypothyroidism, the level of thyroid hormones (T3 and T4) may be normal. Therefore, the main tool for the detection of hypothyroidism is the measurement of TSH, thyroid stimulating hormone (thyroid stimulating hormone). As mentioned earlier, TSH is released by the pituitary gland. If a decrease in thyroid hormone occurs, the pituitary gland reacts by producing more TSH and the blood TSH level increases in an effort to advance the production of thyroid hormones. Increased TSH can actually precede the decline of thyroid hormones for months or years (see section below subclinical hypothyroidism). Thus, measurement of TSH should be increased in cases of hypothyroidism.
However, there is one exception of Hypothyroidism treatment. If the decrease in thyroid hormone is actually caused by the destruction of the pituitary or hypothalamus, the low levels of abnormal TSH. As noted above, the kinds of thyroid disease hypothyroidism are known as “secondary” or “tertiary”. A special test, known as the TRH test, can help determine whether the disease is caused by damage in the pituitary or hypothalamus. This test requires an injection of TRH hormone and is performed by an endocrinologist (hormone specialist).
Blood work mentioned above confirms the diagnosis and Hypothyroidism treatment, but does not point to an underlying cause. A combination of the patient’s clinical history, antibody screening (as mentioned above), and a thyroid scan can help diagnose the underlying thyroid problem more clearly appropriate. If the cause of the pituitary or hypothalamus is suspected, an MRI of the brain and other studies may be warranted. These investigations should be made on a case-by-case basis.
With the exception of certain conditions, hypothyroidism treatment requires lifelong treatment. Before synthetic levothyroxine (T4) is available, the tablets used dried thyroid. Dried thyroid derived from animal thyroid glands, a potential lack of consistency from batch to batch. Today, a pure synthetic T4 is widely available. Therefore, there is no reason to use the dried thyroid extract for hypothyroidism treatment.
As described above, the most active thyroid hormone is actually T3. T3 [liothyronine sodium (Cytomel)] are available and there are certain indications for its use. However, for the majority of patients, a form of T4 [levothyroxine sodium (Levoxyl, Synthroid)] is the preferred treatment. It is a more stable form of the thyroid hormone and requires only one dose per day, where T3 is shorter works and needs to be taken several times per day. In the vast majority of patients, synthetic T4 is naturally ready and steadily converted into T3 in the bloodstream, and these changes are adequately regulated by the body’s tissues and helps for hypothyroidism treatment.
The average dose of T4 replacement in adults is approximately 1.6 micrograms per kilogram per day. This translates into approximately 100 to 150 micrograms per day. Children need doses greater.
In patients who are young and healthy, the full amount of the hormone T4 replacement may begin at the beginning. In patients with heart disease who have been there before, the method of replacement hormones may exacerbate underlying heart condition in approximately 20% of cases. In patients older without known heart disease, starting with a full dose of thyroid replacement may result in the discovery / unloading of heart disease, resulting in pain / chest pain or a heart attack. For this reason, patients with a history of heart disease or those who are suspected of being at high risk starts with 25 micrograms or less of hormone replacement, with an increase in dosage gradually at interval of 6 weeks. This doses is highly recommended for the hypothyroidism treatment.
Ideally, synthetic T4 replacement should be consumed in the morning, 30 minutes before eating. Other medications containing iron-antacids or antacids should be avoided, because they interfere with absorption. Hypothyroidism therapy monitored in approximately six weeks intervals until stable. During these visits, a blood sample is checked TSH her adequate amount of thyroid replacement was given. The goal is to maintain TSH within normal limits. Depending on the laboratory used, the absolute values may vary, but in general, the limits of normal TSH is between 0.5 to 5.0uIU/ml. Once stabilized, TSH can be checked once a year. Hypothyroidism with thyroid medication excessive overload is potentially dangerous and can cause problems with heart palpitations and blood pressure control and also may contribute to osteoporosis. Every effort should be made to maintain TSH in the normal range.