Causes, Diagnosis and Management of Hypothyroidism

Background: Among hormone deficiency, hypothyroidism is considered to be the most common disease, and is subdivided into congenital or acquired, based on the onset. The exact site of dysfunction can further classify the disease into primary and secondary. It is crucial to determine the level of severity of the disease as severe cases may end up in a coma. On the other hand, mild cases may be asymptomatic. Diagnosis is mainly based on serum thyroid hormones levels, and the treatment depends on thyroxine administration with an excellent prognosis. Aim of this review: was to explore the types of hypothyroidism, its diagnosis, and study the best course of management that must be followed. Methodology: We conducted this review using a comprehensive search of MEDLINE, PubMed, and EMBASE, January 1985, through February 2017. The following search terms were used: hypothyroidism, myxedema, classification of thyroid diseases, investigation of hypothyroidism, management of hypothyroidism. Conclusion: Hypothyroidism is a common disease that usually affects females more than males. Populations at higher risk include, old women, pregnant women, dyslipidemic patients, and patients with a history of radiation exposure. Diagnosis is based on measurement of TSH along with the thyroid hormone levels. Management includes administration of thyroxine and must be done early.

[1]  C. Fekete,et al.  Central regulation of hypothalamic-pituitary-thyroid axis under physiological and pathophysiological conditions. , 2014, Endocrine reviews.

[2]  M. Haymart,et al.  Approach to and treatment of thyroid disorders in the elderly. , 2012, The Medical clinics of North America.

[3]  S. Mukhopadhyay,et al.  Myxedema Coma: A New Look into an Old Crisis , 2011, Journal of thyroid research.

[4]  I. Kostoglou-Athanassiou,et al.  Hypothyroidism - new aspects of an old disease. , 2010, Hippokratia.

[5]  Y. Tomer,et al.  The etiology of autoimmune thyroid disease: a story of genes and environment. , 2009, Journal of autoimmunity.

[6]  E. Schoenau,et al.  Association of parvovirus B19 infection and Hashimoto's thyroiditis in children. , 2008, Viral immunology.

[7]  M. Vetter,et al.  Tyrosine kinase inhibitors and the thyroid as both an unintended and an intended target. , 2008, Endocrine practice : official journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists.

[8]  Feneli Karachaliou,et al.  Herpes virus antibodies seroprevalence in children with autoimmune thyroid disease , 2008, Endocrine.

[9]  M. Secic,et al.  Hypothyroidism: a frequent event after radiotherapy and after radiotherapy with chemotherapy for patients with head and neck carcinoma. , 2001, Cancer.

[10]  K. Usadel,et al.  CTLA-4 promoter variants in patients with Graves' disease and Hashimoto's thyroiditis. , 1998, Tissue antigens.

[11]  M. Alevizaki,et al.  High serum cholesterol levels in persons with 'high-normal' TSH levels: should one extend the definition of subclinical hypothyroidism? , 1998, European journal of endocrinology.

[12]  A. Miserez,et al.  Estimation of tissue hypothyroidism by a new clinical score: evaluation of patients with various grades of hypothyroidism and controls. , 1997, The Journal of clinical endocrinology and metabolism.

[13]  W. Futterweit,et al.  Micronodulation: ultrasonographic sign of Hashimoto thyroiditis. , 1996, Journal of ultrasound in medicine : official journal of the American Institute of Ultrasound in Medicine.

[14]  P. Ladenson,et al.  Treatment guidelines for patients with hyperthyroidism and hypothyroidism. Standards of Care Committee, American Thyroid Association. , 1995, JAMA.

[15]  American Association of Clinical Endocrinologists releases clinical guidelines for thyroid disease. , 1995, American family physician.

[16]  A. Cooke,et al.  Identification of a thyroxine-containing self-epitope of thyroglobulin which triggers thyroid autoreactive T cells , 1991, The Journal of experimental medicine.

[17]  M. P. König.  [Hypothyroidism in clinical practice]. , 1988, Schweizerische Rundschau fur Medizin Praxis = Revue suisse de medecine Praxis.

[18]  S. Refetoff,et al.  Measurement of circulating thyroid microsomal antibodies by the tanned red cell haemagglutination technique: its usefulness in the diagnosis of autoimmune thyroid diseases. , 1976, Clinical endocrinology.