Thyrotoxicosis begins gradually, sometimes imperceptibly to the patient. In the blood is already changing the content of the thyroid hormones, and the patient is no change in their body does not feel. This is called subclinical hyperthyroidism. It is desirable to identify it at this stage.
As revealed subclinical hyperthyroidism
The diagnosis of subclinical hyperthyroidism is placed with a decrease in the blood levels of thyroid-stimulating hormone, pituitary gland (TSH) with normal thyroid hormones (triiodothyronine – T3 and tetraiodothyronine or thyroxine – T4). As is known, by means acts on the pituitary TSH thyroid and it regulates the secretion of hormones. If the amount of thyroid hormone increases, decreases the amount of TSH. In subclinical thyrotoxicosis pituitary first notice a tendency to increase thyroid hormone secretion in response to decreases their hormones. To catch this moment and start examining and if necessary treatment of the patient is in the subclinical stage is very important.
Such changes in the blood can be not only in thyrotoxicosis, but when taking certain medications that suppress the production of TSH (for example, when taking glucocorticoid hormones), during pregnancy and in the elderly, with severe injuries, burns, severe kidney disease.
The causes of subclinical hyperthyroidism
Subclinical hyperthyroidism is more common in older women. The cause of the disease can be both internal and external factors. Among the internal factors of primary importance is the hidden course of Graves ‘disease, the so-called early Graves’ disease. In addition, subclinical hyperthyroidism occurs in multinodular goiter, thyroid adenoma, postpartum thyroiditis and medicinal.
External factors include the effects of various drugs, for example, L-thyroxine, which is administered, for example, after removal of the thyroid gland or reducing its function. And also in the treatment of drug that can stimulate the development of inflammation of the thyroid gland – thyroiditis (eg, alpha-interferon, iodine preparations in patients with multinodular goiter).
The signs of subclinical hyperthyroidism
The signs of subclinical hyperthyroidism may be bouts of tachycardia, tremors occurring periodically, moderately excessive sweating, excessive excitability, irritability, and insomnia. But these symptoms are erased or sporadically. Dangerous is the fact that subclinical hyperthyroidism increased mortality, especially in older people, and particularly from cardiovascular disease. In subclinical hyperthyroidism occurs frequently so heavy cardiovascular disease as atrial fibrillation, thromboembolism. It was also found that the long-term course of subclinical hyperthyroidism promotes depletion of the body with minerals and the development of osteoporosis, especially in postmenopausal women, which contributes to the appearance of fractures in these patients. The decrease of TSH levels also contributes to the formation of dementia.
In the long subclinical hyperthyroidism violated metabolism, especially fat. Such changes can cause increase in body weight and the development of atherosclerosis, which in turn leads to coronary heart disease with angina attacks and myocardial infarction.
Treatment of subclinical hyperthyroidism
Based on numerous studies have shown that it is necessary to carry out the definition of TSH in the blood among groups at increased risk of morbidity subclinical hyperthyroidism. These are women who have close relatives with thyroid disease, patients with diabetes first type, and other autoimmune diseases, that is caused by an allergy to their own tissue.
In identifying the patient’s signs of subclinical hyperthyroidism, first of all, find out if he does not receive replacement therapy in the form of thyroid hormone. If received, the correct dosage of the drug (typically this is assigned to L-thyroxine).
If the patient is not receiving such drugs, it is fully examined: perform repeated blood tests for thyroid hormones and pituitary hormones (TSH, T3 and T4), thyroid ultrasound, scintigraphy (research with radioactive iodine), if necessary – a computer and magnetic resonance imaging and puncture thyroid and some other studies.
According to a survey produced by the tactics of surveillance data of patients and (if appropriate) treatment. In most cases, the detection of subclinical hyperthyroidism at a young age in the absence of severe diseases of the sick just watching. In old age, the presence of osteoporosis, and stroke is the treatment of the underlying disease that caused subclinical hyperthyroidism.