Swelling of the feet with hypothyroidism
Home ?? Library ?? Diseases of the thyroid gland ?? Weakness, facial swelling, hair loss, headache and other symptoms of hypothyroidism
Clinical manifestations of hypothyroidism are diverse,progress gradually. Patients complain of general weakness, fatigue, a sharp decline in performance, lethargy, chilliness, decreased memory, interest in the environment, drowsiness, increased irritability, dry skin, brittle and hair loss, the appearance of swelling in the face, limbs, headache, constipation.
Skin pale with a yellowish tinge due toCarotene deposits (sometimes there is a blush in the cheek area), dry, flaky, thickened due to the accumulation of mucopolysaccharides and swelling in it. Edema is not collected in the crease and does not leave a depression with pressure.
When hypothyroidism appears a kind of edemavarious tissues and organs, the so-called mucous edema. It develops as a result of extracellular accumulation in various organs and tissues of mucopolysaccharides, which increase the hydrophilicity of tissues. The development of mucous edema caused the name of myxedema hypothyroidism.
Dryness of the skin is caused by a decrease in the secretoryfunction of sweat glands. To the touch, the skin is cold, rough due to hyperkeratosis, especially pronounced in the palm, soles. The hair on the head is dry, brittle, sparse. There is a loss of eyelashes, hair in the outer third of the eyebrows, on the pubis, in the armpits. Nails grow slowly and become brittle. The face is puffy, masklike. With severe form of the disease due to the edema of the eyelids, the eye slits are narrowed, the lips are protruded. The limbs are thickened. The fingers are thick and give the impression of being short. Supraclavicular fossae are made. Because of the swelling and thickening of the vocal cords, the voice is low, rough, hoarse. There may be a decrease in hearing due to middle ear edema.
For patients with hypothyroidism, changes in the central nervous system are characteristic. Observed general mental fatigue, lack of interest, slowed down mental reactions to external stimuli.
There are drowsiness, memory loss,intelligence; mimic reactions and speech are slow. Along with this, patients can be irritable, restless, excitable, they are disturbed by night sleep. With severe hypothyroidism, there can be severe changes in the psyche right up to psychoses. There is persistent headache, dizziness, tinnitus.
Changes in the peripheral nervous systemare manifested by pain in the limbs, paresthesia, convulsions and proceed in the form of radiculitis, polyneuritis. Tendon reflexes are slow. This is the basis for the diagnostic sign of hypothyroidism - lengthening the time of contraction and relaxation of the muscles when triggering a reflex from the Achilles tendon.
There is a violation of smell and taste. Due to the swelling of the nasal mucosa, nasal breathing is difficult, and chronic inflammatory diseases of the nose often occur. Breathing is difficult. Patients are prone to respiratory diseases, pneumonia. Pneumonia occurs without a temperature reaction and lasts for a long time. Due to the weakness of the intercostal muscles or the inhibition of the respiratory center, the vital capacity of the lungs is reduced.
In patients with hypothyroidism, the tongue is thickened withdents from the teeth along the edges of it, coated with a grayish coating. Taste and appetite are reduced. There may be nausea, vomiting. The secretory and excretory function of the stomach is reduced, the suction function is slow. The motional function of the intestines is disrupted, which leads to the development of atonic constipation, characterized by flatulence. Sometimes there is a clinical picture of the dynamic obstruction of the intestines.
Reduced the neutralizing-synthetic functionliver. Often, dyskinesia of the biliary tract is hypotonic. There is a decrease in the filtration capacity of the glomeruli and the secretory capacity of the tubules. Occasionally, moderate proteinuria is detected. Sluggish infections of the urinary tract are often observed.
Women have a violationovarian-menstrual cycle, menorrhagia, metrorrhagia, less often amenorrhea. The ability to conceive is preserved, but there may be infertility. There are frequent complications of pregnancy, toxicosis, miscarriages at different times, premature birth; in men - decreased sexual desire and potency.
Body temperature in patients with hypothyroidism is reduced. Infectious diseases and inflammatory processes can occur in them without a pronounced temperature response. There is an increase in body weight associated with fluid retention in the body.
With hypothyroidism much sufferingthe cardiovascular system. Patients complain of shortness of breath during physical exertion, pain in the region of the heart of a different nature, increasing with exercise. Heart sounds are auscultatory, deaf, heart borders are widened. The heart is enlarged in size due to the accumulation of a mucinous substance in the myocardium, sometimes a pericardial effusion containing a large amount of protein and cholesterol is detected. The number of heartbeats is reduced, but in some cases, bradycardia may not be, or it is replaced by tachycardia (with heart failure, anemia, and operated with thyrotoxicosis).
Shock and minute volume of blood are lowered, blood flowslowed down, the mass of the circulating blood decreases. The permeability of capillaries increases. In the myocardium the level of metabolic processes is reduced, oxygen uptake is reduced. In the electrocardiogram, in addition to sinus bradycardia, low voltage, prolongation of PQ and ST intervals, decrease in T wave (often negative) are determined. Although patients with hypothyroidism, especially young age, rarely develop heart failure, myocardial infarction, changes in electrocardiograms of a metabolic nature can resemble a picture of ischemic disease. Against the background of substitution therapy with thyroid hormones, these changes disappear. The contractile function of the myocardium in hypothyroidism is reduced, and cardiac output is also reduced.
Arterial pressure in patients with hypothyroidismcan be normal, reduced and often elevated. Factors contributing to increased blood pressure are the increased peripheral resistance found in this pathology and increased rigidity of the arteries. In the origin of hypertension, the role of hormonal factors can not be ruled out. In hypothyroidism, increased vasopressin excretion normalized after treatment with thyroid hormones, an increase in norepinephrine concentration at a normal adrenaline level, a change in renin activity in plasma.
More than half of the patients develop anemia,sometimes it is detected before the appearance of clinical signs of hypothyroidism. Thyroid hormones stimulate erythropoiesis, possibly by activating erythropoietins and increasing oxygen uptake in tissues. With hypothyroidism, the half-life of erythrocytes is reduced. Anemia can also develop due to reduced absorption of iron in the intestine. Due to reduced absorption of vitamin cyanocobalamin, the development of megaloblastic anemia is possible. Combinations of primary hypothyroidism with pernicious anemia are described. In the blood, the number of leukocytosis is not changed, relative lymphocytosis, ESR is increased.
When hypothyroidism suffer protein, carbohydrate,fat metabolism. The synthesis of protein and its decay are reduced. With prolonged course of severe hypothyroidism, moderate osteoporosis may develop, probably as a result of insufficient protein synthesis. In the blood with spontaneous hypothyroidism, the content of globulins increases. The blood sugar level is normal. The glycemic curve after loading by glucose is flattened due to delayed absorption and a decrease in the rate of glucose metabolism.
Changes in lipid metabolism are characterized byan increase in the content of total lipids, total cholesterol and its fractions, triglycerides, the total content of prebeta and beta-lipoproteins, a decrease in the concentration of non-esterified fatty acids (NEFC) and alpha-lipoproteins.
It is believed that the listed disorders of lipidmetabolism in hypothyroidism affect the tone, permeability of the vascular wall and lead to the development of vascular arteriosclerosis. However, there is another opinion, which is based on clinical and sectional data. According to clinical data, angina pectoris, myocardial infarction, sectional infarction rarely develop in patients with hypothyroidism of the young age - no atherosclerosis of the coronary vessels is observed.
"Weakness, facial swelling, hair loss, headache and other symptoms of hypothyroidism" - an article from the section Thyroid Diseases