Hypothyroidism is an interdisciplinary problem

Abstract

Hypothyroidism is one of the most prevalent endocrine disorders, second only to diabetes. Hypothyroidism diagnosis can be difficult in view of its varied and non-specific symptoms. The reason is that thyroid hormones affect virtually every organ system in the body. At the same time, the severity of thyroid hormone deficiency may vary and does not always correlate with the changes in laboratory testing results. Clinical presentation of patients with hypothyroidism may include multiple symptoms and, as a result, it can be difficult to diagnose this disorder, especially in elderly and polymorbid individuals. In some patients, the prevailing symptoms indicate that only a particular system is affected. Thus, there are diseases known as the "masks" of hypothyroidism, and this review is focused on their clinical manifestations. Conditions that may be running under the "mask" of hypothyroidism include diastolic hypertension, dyslipidemia, hydropericardium, chronic constipation, biliary lithiasis, polyarthritis, alopecia, onycholysis, depression, dysfunctional uterine bleeding, infertility, anemia, etc. Due to a variety of clinical signs and symptoms, a patient with hypothyroidism may get an appointment with any medical specialist or receive a follow-up care provided in parallel by multiple specialists. Physicians should be aware of potential hypothyroidism and specific effects of the underactive thyroid on patient’s organs and systems. It is necessary to obtain a thorough medical history about comorbidities which would help to figure out that hypothyroidism is the cause of co-occurring conditions. KEYWORDS: autoimmune thyroiditis, hypothyroidism, subclinical hypothyroidism, euthyroidism, dyslipidemia, cardiovascular diseases, arterial hypertension FOR CITATION: Verbovoy A.F., Dolgikh Yu.A., Verbovaya N.I. Hypothyroidism is an interdisciplinary problem. Russian Medical Inquiry. 2022;6(9):509–515 (in Russ.). DOI: 10.32364/2587-6821-2022-6-9-509-515.

Prevalence of Hypoteriosis Prognosis and Prevention

“…Therefore, thyroid deficiency manifests itself in a wide variety of nonspecific symptoms. A thorough, detailed history will help identify combinations of various diseases, which will help to suspect hypothyroidism as the cause of multimorbidity and examine the patient to confirm this preliminary diagnosis [2,8]. With timely detection and proper treatment, hypothyroidism has a favorable prognosis.…”

“…hypothyroidism is diagnosed equally often in both men and women; its prevalence in the population, according to various sources, varies from 1: 16,000 to 1: 100,000 population, depending on age and etiology [1,2]. There are congenital and acquired forms of secondary hypothyroidism [3].…”

Histopathological Changes in the Nucleus and Contractile Apparatus of Cardiomyocytes in Overt Acquired Primary Hypothyroidism: Experimental Study

“…Hypothyroidism is manifested by pronounced morphological and clinical changes affecting almost all organs and tissues, due to the presence of multiple targets for thyroid hormones and their multifaceted and multifunctional role in the body of mammals [1][2][3]. In a significant number of patients, hypothyroidism is mild, manifesting itself only with nonspecific subclinical signs that may not bother patients for a long time, but can induce a number of irreversible changes and complications, up to death [1].…”

“…So, overt or clinically apparent primary hypothyroidism is diagnosed if the concentration of thyroid-stimulating hormone of the adenohypophysis (TSH) is above the reference range, and the concentration of free thyroxine is below the reference range. Mild or subclinical hypothyroidism, which is usually considered as a sign of early thyroid insufficiency, and is diagnosed if the concentration of TSH is above the reference range, and the concentration of thyroxine and triiodothyronine is within the normal range [1,3]. Thus, the most reliable and optimal method for diagnosing hypothyroidism is clinical and laboratory diagnostics based on determining the concentration of thyroid hormones and adenohypophysis in the blood serum of patients.…”

“…Thus, the most reliable and optimal method for diagnosing hypothyroidism is clinical and laboratory diagnostics based on determining the concentration of thyroid hormones and adenohypophysis in the blood serum of patients. The classification of hypothyroidism is based on three main principles: the time of development, the cause of occurrence and the severity [1][2][3] (Table 1).…”