Therapy
Hypothyroidism is an incurable disease. The treatment of hypothyroidism should be started as early as possible to avoid permanent damage in the later stages. The aim of the therapy of hypothyroidism is to correct the TSH level to within the normal range and to contain the symptoms.
The hormone deficiency is compensated by taking thyroid hormones in the form of tablets. These are synthetically produced thyroxine, which must be taken by those affected, usually for life and without interruption. The drug is administered in ascending doses to determine the individual target dose on the one hand and to avoid the symptoms of hyperthyroidism if the dosage is too fast.
If the medication is taken correctly, the affected persons can lead a completely normal life. At the beginning of the treatment, the thyroid gland values are determined monthly by a blood sample. If the hypothyroidism is well adjusted, the annual blood test is sufficient.
A combination therapy of both thyroid hormones, i.e. T3 and T4, is rarely used if certain synthesis functions in the patient are disturbed, which prevents the hormones from converting.If a medication for the treatment of hyperthyroidism is the trigger for hypothyroidism, the dose should be changed in consultation with your doctor or the medication should be discontinued if necessary. A lifelong replacement (=substitution) of thyroxine (=T4) with L-thyroxine is necessary to prevent the consequences of hypothyroidism. It should be started as early as possible, since brain damage, once it has occurred, is irreversible. The dosage of the hormone is gradual, i.e. a slow increase in dosage is made up to a certain hormone concentration, which is finally kept constant. The aims of the therapy are to relieve the patient’s symptoms and to normalize the TSH level in the blood.
Complications
A complication of an untreated hypothyroidism that has become very rare nowadays is the so-called myxoedema coma. The metabolism of those affected is reduced to a life-threatening level. Possible symptoms are a drop in body temperature, a slowing of the heartbeat, a drop in blood pressure, and a dangerous slowing and flattening of breathing.
In some cases, myxedema may also occur. As a result, doughy swelling of various parts of the body, especially the face and limbs, may occur. My oedema coma in the context of hypothyroidism should be treated at an early stage with the administration of high doses of thyroid hormones. Balancing the electrolyte and water balance and the administration of cortisone also plays a life-saving role.
