Treatment of chronic thyroiditis. Causes of acute thyroiditis. Thyroiditis is a chronic disease with a history going back centuries.

Thyroiditis is an inflammatory disease of the thyroid gland. The pathology can occur in several clinical forms and with a large number of symptoms.

Causes

For each form of thyroiditis, there are main reasons that lead to the development of the inflammatory process.

For acute forms this may be:

• past acute or chronic infectious diseases. These most often include processes such as tonsillitis, pneumonia or sepsis. The pathogen is introduced into the gland tissue mainly due to the hematogenous reflux of contents from the source of inflammation. In addition, it can be chronic sluggish inflammatory diseases, for example caries, sinusitis or sinusitis;
• in non-purulent form acute thyroiditis inflammation can develop against the background of:
  • traumatic effects;
  • radiation injuries;
  • taking potent medications;
  • spontaneous hemorrhage into tissue;
• The cause of subacute thyroiditis is predominantly viral in nature. The following can be identified as a pathogen:
  • adenoviruses;
  • measles rubella virus;
  • chicken pox;
  • mumps;
  • viruses that cause influenza.

In addition, risk factors should be taken into account, the presence of which increases the likelihood of thyroiditis. These include:

• female gender and age from 20 to 50 years. Those. this is a reproductive group active women those whose hormonal levels change depending on the day of the cycle;
• reversible, transient dysfunction of gland tissue;
• an autoimmune factor, which is most characteristic of subacute thyroiditis;
• heredity;
• chronic inflammatory process in the body, leading to depression immune system.

The exact cause for the development of fibrous thyroiditis has not been identified. The role of an infectious factor and autoimmune lesion cannot be ruled out.

Predisposing factors for the development of the fibrotic variant include:

• a previous case of thyrotoxicosis;
• surgical intervention on gland tissue;
• the presence of endemic goiter;
• genetic predisposition;
• the presence of autoimmune and allergic diseases;
• in the anamnesis.

There are no reasons for the development of autoimmune thyroiditis. Most experts are inclined to think of a genetic tissue defect or hyperreactivity of the immune system. To activate these processes, there are predisposing factors, including:

• a history of severe viral diseases;
• exposure to unfavorable environmental factors, such as excess chlorine, iodine, fluorine in incoming food or external conditions;
• long-term use of drugs containing iodine or hormones;
• exposure to radiation or prolonged insolation;
• suffered an acute psychotraumatic situation associated with loss loved one, job loss, etc.

Also, postpartum thyroiditis develops with poor functional activity of the thyroid gland against the background of natural hormonal processes that inhibit its activity after the birth of a child.

Symptoms of thyroiditis depending on the form

Acute inflammation of the thyroid gland (acute thyroiditis).

Shown in the photo appearance neck with acute thyroiditis

For acute form characteristic:

• the appearance of compaction in the gland tissue, the formation of a focus with clear boundaries is possible;
• the patient feels unwell, weak, and has an increase in body temperature to febrile (increase in body temperature for a long time within the range of 37.1-38.0 °C);
• there is an increase in heart rate, the appearance severe pain in the area of ​​the gland.

The pain can be stabbing or sharp, in some cases it radiates to the area of ​​the lower jaw, the back of the head, the earlobes and the tip of the tongue. Increased pain is associated with swallowing or coughing. In addition to general intoxication, if left untreated, muscle, joint and headache pain occurs.

When palpated, one can detect either diffusely enlarged gland tissue, upon touching which the patient experiences unbearable pain, or it is a clearly localized focus. As the abscess (local accumulation of pus) melts, it turns from a dense consistency into a soft one. On the part of the skin on the neck, pronounced redness and hyperthermia can be noted.

The cervical lymph nodes enlarge and become painful on palpation.

Non-purulent or subacute thyroiditis.

They have similar clinical manifestations. This is largely due to general character pathological process. The inflammation is infiltrative in nature. That is why the body temperature reaches high. The patient cannot name the exact beginning of the inflammation. There is a feeling of weakness, malaise, loss of appetite. Pain in the area of ​​the gland is slightly expressed, slight soreness of its tissue, swelling and hyperemia of the skin appear.

Chronic thyroiditis

A patient with this form of inflammatory process in the gland tissue is concerned about:

• difficulty swallowing;
• constant sensation of a foreign body in the throat;
• as the process progresses, changes in voice and breathing may occur;
• patients experience discomfort while eating;
• appears periodically headache, dizziness, visual impairment, tinnitus, etc.

The gland can be visible to the naked eye (see photo above); uneven dense areas appear above the surface of the skin that do not move upon palpation. Increased pulsation can be seen on the cervical vessels.

Autoimmune thyroiditis

Symptoms of autoimmune thyroiditis

This clinical form can occur for a long time without the presence of any symptoms, while functional state gland remains undisturbed. Symptoms and complications can be subtle and disguised as pathology of other organs and systems. Among them it should be noted:

• decreased mood, tendency to depression;
• memory impairment, decreased concentration;
• constant feeling of drowsiness, fatigue;
• increase in body weight against the background of decreased appetite;
• decrease in heart rate;
• decreased response to external stimuli;
• hair becomes dull and brittle, skin becomes drier;
• there is a tendency to constipation;
• sexual desire is reduced or completely absent;
• the menstrual cycle changes, there is a tendency to delays, followed by intermenstrual bleeding, subsequently menstruation may stop completely;
• the appearance of swelling and slight yellowness can be detected on the face.

Classification of thyroiditis

All thyroiditis can be divided into several types. This:

• acute form of the process;
• subacute form;
• chronic form;
• autoimmune form.

Acute form divided according to the localization of the process, it can be:

• diffuse form;
• focal.

By type of inflammatory process acute thyroiditis can be divided into:

• purulent inflammation;
• non-purulent.

Subacute thyroiditis is divided into:

• granulomatous;
• Pneumocystis;
• lymphocytic.

Chronic thyroiditis The thyroid gland is in turn divided into the following types:

• hypertrophic variant or chronic Hashimoto's thyroiditis;
• juvenile lymphocytic thyroidopathy;
• postpartum form;
• idiopathic;
• fibrous form.

Chronic thyroiditis has certain patterns in its course, therefore there are several main stages:

• early thyrotoxicosis;
• euthyroidism;
• transient hypothyroidism;
• recovery.

Hypertrophic form can be divided into several subspecies:

• diffuse goiter;
• diffuse nodular goiter;
• nodular goiter

Diagnostics

For any form of thyroiditis, the diagnosis is similar. Among them, a large role is played by a conversation with the patient, clarification of the main complaints, and possible clarification of symptoms characteristic of any form of the disease. It is important for the doctor to find out the possible provoking factors that contributed to the development of inflammation.

Held visual inspection, with assessment of skin, hair, etc.

A mandatory element in the diagnosis of thyroiditis is a local examination of the thyroid gland, assessing its size, structure, pain and the presence of pathological formations.

To confirm inflammation of the thyroid gland, laboratory and instrumental methods are used. Among which:

• general blood analysis. Among the signs of the inflammatory reaction, a leukocyte shift to the left, signs of leukocytosis due to the neutrophil component, and an increase in ESR are determined;
• hormonal study. The exception is the acute phase of the inflammatory process, since at this time the disease has a blurred picture. Subacute thyroiditis manifests itself in that there may be an initial increase in the amount of hormones followed by a decrease. With an autoimmune process, there is an increase in the content of thyroid-stimulating hormone with a low content of T3 and T4;
• among instrumental methods is very popular ultrasonography . It is characterized by non-invasiveness and high accuracy of the results obtained. Not only the structure of the gland with its size is assessed, but also the presence of formations and the degree;
• scintigraphy method clarifies the size and nature of pathological foci. With a decrease in function, a decrease in absorbed isotopes will be observed; with increased absorption, the picture takes on the opposite character. Against the background of the fibrotic process, irregular sizes with unclear contours and changes in the shape of the organ will be detected.

Treatment

Treatment of acute thyroiditis

In acute thyroiditis it is required immediate treatment, which will be aimed at eliminating the pathogen.

• The basis is antibacterial agents, exhibiting their effect against a wide range of bacteria. Among them, the most common are groups of penicillins and cephalosporins. It is better to carry out therapy in severe conditions based on sensitivity to antibiotics, this will reduce the percentage of complications and maintain the functional activity of the gland.
• Antihistamine drugs are also used; they help reduce the severity of swelling and tissue inflammation. These include Suprastin, Diazolin.
• Among the means aimed at detoxification they use Hemodez, Saline solutions, Reopoliglyukin.

Surgical treatment is indicated if a limited purulent focus is detected. For therapeutic purposes, the abscess is opened and drains are installed.

Treatment of chronic and autoimmune thyroiditis

Therapy consists of medications. These include:

• Thyroid drugs. Prescribed if laboratory tests reveal a decrease in function. Long-term use, in some cases lifelong, during use they compensate for the lack of their own hormones. These include drugs Thyroxine and Triiodothyronine.
• Group of glucocorticosteroids. These drugs have an anti-inflammatory mechanism. These include Prednisolone and its derivatives.
• Group of immunomodulators. These drugs help stimulate the defenses. Often the use is combined with hormonal drugs.

Surgical treatment is applicable only in cases where instrumental methods have determined an atypical picture of the pathological process. In this case, the volume of operation can be based on partial resection tissue or complete removal of the gland.

Traditional methods often use plants such as white cinquefoil. It is able to slightly compensate for hormonal deficiency.

Complications

In acute thyroiditis, the most a common complication is the generalization of the inflammatory process with transition to neighboring organs and tissues, and possible spread through the blood.

There may be purulent melting of the tissue with loss of gland function, a condition that will subsequently require replacement therapy.

Transition to adjacent tissues is possible when a purulent focus ruptures, involving organs located nearby in purulent process, such as the esophagus, trachea, vessels, etc. Also, hematogenous spread of the pathogen to all tissues and organs with the development of sepsis is possible.

Complications of chronic thyroiditis are much more terrible. One of the most common complications that manifests itself against the background of chronic thyroiditis is further progression of the pathology:

• people have disorders of the nervous system. This will be manifested by irritability, apathy, decreased interest in life, a tendency to depressive disorders. People often develop panic attacks and lose interest in life.
• Chronic thyroiditis of the thyroid gland is characterized by the fact that the cardiovascular system is affected. This shows up:
  • tachycardia;
  • bradycardia;
  • acute and chronic heart failure;
• cholesterol decreases, which is a factor in the development of cancer;
• a developing thyroid goiter significantly disrupts a person’s life. In addition to the constantly present discomfort, there is a violation of tolerance to physical activity, consumption of solid food, up to the consumption of only liquid foods and problems with breathing at rest;
• goiter cells can subsequently degenerate into malignant ones;
• in women, chronic Hashimoto's thyroiditis and autoimmune thyroiditis leads to reproductive dysfunction. This can be expressed:
  • menstrual irregularities;
  • infertility or miscarriage;
• Vision gradually deteriorates until the development of high myopia, which leads to disability.

Prevention

In order to prevent acute thyroiditis, prevention will consist of following the following rules:

1. Generalization of the island inflammatory process, as well as its transition to chronic thyroiditis of the thyroid gland, should be avoided. Therefore, at the first pathological signs even from other systems, you should contact a specialist and begin treatment.
2. Eliminate foci of chronic infection in a timely manner and prevent the development of exacerbations.
3. Take measures aimed at strengthening the immune system.
4. Avoid traumatic effects on the neck and thyroid gland, which can occur completely by accident.
5. Insolation should be carried out during periods of least solar activity, and visits to the solarium should be limited.
6. Women of reproductive age should regularly visit a gynecologist to prevent the development of dishormonal pathologies.

For chronic and autoimmune thyroiditis, preventive measures are aimed at preventing possible reasons. As a rule, there are no specific measures in this case. These include:

1. People with an existing hereditary predisposition should regularly visit an endocrinologist and undergo laboratory and instrumental diagnostics.
2. If initial changes are identified, it is necessary to begin drug treatment as early as possible; this will help to significantly compensate for the condition.
3. Prevent exposure to radiation, hypothermia, and traumatic effects.

Forecast

Thyroiditis has a relatively favorable prognosis. With timely diagnosis of the disease, compensation quickly occurs, which may not be clinically manifested. In case of complications arising from inflammation in the thyroid gland, a significant improvement in the condition can be achieved.

If left untreated, the prognosis will be relatively poor.

Videos on the topic

Various thyroid dysfunctions are one of the most common reasons for patients to turn to specialists.

IN Lately doctors often diagnose “chronic thyroiditis”, so many patients are interested in what it is, what are the clinical manifestations of the disease and whether there is an effective treatment for it.

It is worth noting that chronic thyroiditis is a collective concept.

It includes inflammatory diseases of the thyroid gland that are completely different in their etiopathogenetic mechanisms of development, characterized by a long course and requiring differentiated treatment tactics.

According to modern classification, the following types of disease are distinguished:

• postpartum;
• autoimmune (so-called Hashimoto's chronic thyroiditis);
• fibrous-invasive (Riedel's goiter);
• specific forms (occur in case of generalization of infection with syphilis, tuberculosis, fungal infections).

Causes of the disease

The causes of chronic thyroiditis are very diverse and largely depend on the type of disease. The most common predisposing factors for the development of pathology are:

• dysfunction of the immune system;
• increased ionizing radiation (in particular, previous irradiation of the head and neck area);
• the presence of foci of chronic infection (otitis, sinusitis, tonsillitis, cystitis, pyelonephritis, carious teeth);
• hereditary predisposition to autoimmune and thyroid pathologies;
• prolonged exposure to the sun;
• presence in the anamnesis of allergic diseases;
• bad habits (smoking, alcohol abuse);
• severe psycho-emotional shocks, chronic stress;
• suffered from ARVI, influenza;
• chronic intoxication;
• long-term uncontrolled use large doses Yoda.

Pathogenesis of the disease

Hashimoto's thyroiditis occupies a leading place in the structure of chronic inflammation of the thyroid gland.

The development of this disease is based on an inadequate immune response, when the endocrine organ’s own cells are perceived as a foreign agent.

This leads to destruction of thyroid tissue under the influence of protective antibodies with the development of an inflammatory reaction.

As a result of a decrease in the number of actively functioning thyrocytes, hypothyroidism becomes the outcome of autoimmune thyroiditis.

Postpartum thyroiditis is characterized by similar pathological processes, wherein trigger mechanism becomes pregnant.

As for Riedel's goiter, it is characterized by the proliferation of connective tissue inside the organ with invasion of the neurovascular bundles and capsule, as a result of which the thyroid gland acquires a “stony” density.

Autoimmune thyroiditis most often occurs in women 40-50 years old. Here you can familiarize yourself with the causes and possible complications of this disease.

Symptoms

The initial stages of chronic thyroiditis often occur in a latent form, without pronounced clinical manifestations. With him hypertrophic form a slight increase in the size of the thyroid gland may be detected, often not causing the patient any discomfort at all.

In some cases, the onset of the disease is accompanied by a temporary increase in the concentration of thyroid hormones, which is caused by the destruction of follicles. During this period, patients may present the following complaints:

• hypertension;
• tachycardia;
• hyperhidrosis;
• increased fatigue;
• low-grade fever;
• tremor of the limbs;
• irritability;
• dysmenorrhea;
• weight loss, etc.

As the thyroid tissue is destroyed, the symptoms of hypothyroidism come to the fore in the clinical picture of the disease. Among them are:

• bradycardia;
• decreased body temperature;
• apathy, depression;
• muscle weakness;
• slower speech and thinking;
• memory impairment;
• constipation;
• excessive dryness of the skin.

In advanced stages of the disease, especially with Riedel’s goiter, hypertrophic form of thyroiditis, or its combination with neoplasms, compression of nearby organs is possible, which is manifested by the following symptoms:

• dysphagia;
• breathing problems;
• hoarseness and change in voice timbre;
• feeling of the presence of a foreign body in the throat.

When the neurovascular bundles of the neck are compressed, unmotivated weakness, tinnitus, tachycardia, and pulsation of the neck veins appear.

The greatest importance should be given to the overall clinical picture, since individual symptoms can occur in a variety of diseases.

Diagnosis and treatment

Detection of chronic thyroiditis seems quite challenging task, since the early stages of the disease are characterized by a latent course and absence characteristic changes during laboratory and instrumental research.

A palpation examination of the thyroid gland can provide certain information: for example, with a hyperplastic autoimmune process, an increase in its size and volume is observed, while with an atrophic process, there is a decrease in their size. In the case of Riedel's goiter, a very dense and immobile gland is palpated, fused with the surrounding tissues.

Great importance is attached to the diagnosis of chronic thyroiditis ultrasound scanning endocrine organ and laboratory tests:

• general blood test;
• determining the content in the blood of specific markers of the autoimmune process - antibodies to thyroid tissue and thyroid peroxidase (TPO); with Riedel's goiter this indicator is normal.
• measuring the level of tri- and tetraiodothyronine, as well as thyroid-stimulating hormone (TSH).

In addition, for differential diagnosis inflammation with other thyroid pathologies are used:

• scintigraphy;
• fine-needle biopsy (if a cancerous tumor is suspected).

If there is a need for radioisotope research occurs in nursing mothers (for example, when diffuse toxic goiter is excluded or confirmed), then breastfeeding should be stopped.

Today the main diagnostic criteria, which allow you to confirm chronic autoimmune thyroiditis of the thyroid gland, serve:

• an increase in organ volume of more than 18 ml in women and 25 ml in men;
• presence of signs of hypothyroidism (according to the results of a hormonal study);
• increase in antibody titer to TPO and thyroid tissue;
• echographic signs of autoimmune thyroiditis (hypoechogenicity of the parenchyma).

Therapy of the disease

It is worth noting that today there is no specific treatment for chronic thyroiditis.

According to available clinical data, attempts to influence autoimmune processes through the use of immunomodulators, immunosuppressants, glucocorticosteroids or plasmapheresis have been unsuccessful and have not stopped the progression of the disease to hypothyroidism.

In those clinical situations when the onset of Hashimoto's thyroiditis, as well as postpartum inflammation of the thyroid tissue, is manifested by transient thyrotoxicosis, the prescription of thyreostatics is not indicated, since painful condition not associated with hyperfunction of the thyroid gland.

In the case of a pronounced clinical picture of hyperthyroidism, it is possible to carry out symptomatic therapy with beta-blockers to eliminate rapid heartbeat, excessive sweating, limb tremors and hypertension.

In the later stages of chronic thyroiditis, hypothyroidism always develops. In this case, treatment tactics involve prescribing hormone replacement therapy. If for Hashimoto's thyroiditis and Riedel's goiter Levothyroxine must be taken for life, then for postpartum thyroiditis the duration of correction is only 9-12 months, since during this time the disease completely regresses.

Modern recommendations regarding the treatment of autoimmune thyroiditis state that hormonal therapy should be carried out only when hypothyroidism is manifested according to laboratory test results (increased TSH levels and decreased T4 concentrations).

In the subclinical form of the disease (increased thyrotropin levels with normal content in the blood of thyroxine) dynamic observation with repeated analysis of hormones after 3–6 months is indicated.

However, if subclinical hypothyroidism is detected during pregnancy, Levothyroxine should be prescribed immediately.

Surgical treatments are rarely used to correct the disease.

They are relevant only for severe hyperplasia of the thyroid gland, causing compression of the trachea and esophagus, as well as when the inflammatory process is combined with various neoplasms in the thyroid tissue.

Chronic thyroiditis often requires hormonal therapy throughout the patient's life due to developed hypothyroidism.

Therefore, the main task of a specialist is to select correct dose drugs that will maintain TSH levels within the physiological norm.

Conclusion

It is obvious that a specialist should study, diagnose and treat the disease, since only qualified medical care can guarantee success in the fight against the disease and contribute to effective prevention development of dangerous complications.

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Thyroiditis is a group of inflammatory diseases of the thyroid gland of various origins and pathogenesis.

In modern times, thyroiditis is the most common endocrine disease in the world after diabetes mellitus, and autoimmune thyroiditis is the most common autoimmune disease. Scientists suggest that almost half of the population on Earth has one or another pathology of the thyroid gland, although not everyone can be treated. But there are no official statistics on thyroiditis in Russia and in the world due to the impossibility of conducting reliable studies of the endemicity of this pathology.

A little history

So famous surgeon E. T. Kocher was the first to operate on the thyroid gland and provided evidence of the effectiveness of iodine in the treatment of goiter (enlarged thyroid gland), for which he received the Nobel Prize in 1909. Although Kocher already had patients in whom iodine therapy did not give a positive result.

In 1912, Japanese surgeon Hakaru Hashimoto, while performing operations to remove the thyroid gland in people living in Japan, the country richest in iodine, saw the first inflammatory changes in the thyroid gland. This suggested that goiter may not only be the result of iodine deficiency. These assumptions were confirmed in 1930 - 1932. O. A. Grochem, and in 1956 E. Vitebsky and N. Rose created an experimental animal model of Hashimoto's disease and proved the autoimmune etiology of thyroid diseases, accompanied by its enlargement. The path to research into thyroiditis has been long and continues in our times.

• Excess iodine as proven by scientists, plays a significant role in the development of autoimmune thyroiditis.
• Thyroiditis is more common young people, children and adolescents, while the incidence among women is higher, but men suffer the disease more severely.
• Effect of radiation. Following the Chernobyl disaster, there was an increase in cases of autoimmune thyroiditis among those affected by the accident. Scientists have proven that this fact occurred due to massive and unjustified prophylaxis with non-radioactive iodine, which was carried out in areas of radiation, and not due to the effects of radiation itself.
• State environment directly affects the condition of the human thyroid gland.
• Timely treatment thyroiditis leads to a favorable outcome.
• Thyroid hormones and reproductive health. Thyroid dysfunction can cause decreased fertility, infertility and miscarriage in women, as well as impaired sperm production in men. After restoration of the hormonal levels of the thyroid gland, fertility in men and women is restored.
• Lack of thyroid hormones during pregnancy increases the risk of developing autism in children, and can also lead to deafness and retardation in the mental, mental and physical development of the child.

Anatomy of the thyroid gland

Structure of the thyroid gland

Sections of the thyroid gland:

• left lobe,
• right lobe,
• isthmus.

Thyroid size
Each lobe has a length from 2 to 4 cm (can reach 6 cm), and a width of up to 2 cm (sometimes up to 4 cm). The weight of the gland also ranges from 15 to 25 g (can weigh up to 60 g). Normal sizes and the mass of the thyroid gland depend on many factors (gender, adolescence, menstruation in women, age, etc.).

Histology of the thyroid gland

1. Follicular vesicle (follicle):
   • epithelial follicular cells (thyrocytes),
   • colloid (contains hormone).
2. Capillary network around the follicle.
3. Gland stroma– connective tissue around the follicle.
4. Islands of interfollicular epithelium, which may be underdeveloped thyrocytes and contribute to the proliferation of thyrocytes.
5. C cells located singly between thyrocyte cells.

1. Iodinated (thyroxine or T4, triiodothyronine or T3) produced by thyrocytes from the thyroglobulin protein, bind to iodine (form iodides) in the follicle colloid.

   Functions of thyroxine and triiodothyronine:

   • Effect on tissue growth (bone, muscle and other tissues).
   • Effect on metabolic processes in the body: protein, lipid, carbohydrate, water, electrolyte, vitamin and basal metabolism.
   • Effect on the central nervous system : brain development, differentiation of nerve centers.
   • Effect on the autonomic nervous system (nervous system internal organs).
   • Regulation of other endocrine organs (sex glands, thymus, pituitary gland, adrenal cortex)
   • Participation in the blood coagulation system (affects platelets and other blood clotting factors).
2. Thyrocalcitonin (calcitonin) produced by C-cells of the thyroid gland, takes part in phosphorus-calcium metabolism, its level normally increases with an increase in blood calcium levels and during breastfeeding. Is counteracting parathyroid hormone (a parathyroid hormone that affects calcium metabolism).

Disturbances in the level of thyroid hormones (thyroxine and triiodothyronine)

Factors	Excess hormones (hyperthyroidism)	Lack of hormones (hypothyroidism)
Children		Dwarfism, cretinism, behavioral disorders, delayed puberty.
Pregnancy	Miscarriage	Fading of pregnancy, disruption of the physical and neuropsychic development of the child.
Metabolism	Acceleration of metabolism (weight loss, reduction of liver glycogen reserves).	Metabolic slowdown (excess weight gain).
Function of the nervous system	Increased nervous system arousal: emotionality, exhaustion (“burnout”) of the nervous system, psychosis, tachycardia (increased heartbeat), increased intestinal motility (diarrhea), increased sweating, violation of thermoregulation (increase in body temperature), exophthalmos (bulging of the eyeballs).	Suppression of the nervous system: drowsiness, malaise, bradycardia (slow heart rate), decreased intestinal motility (constipation), decreased sweating, decrease in body temperature
Disruption of other endocrine organs	Disorders of the menstrual cycle, decreased fertility.	Decreased fertility, infertility, menstruation disorders in women.
Photo of a patient with thyroid dysfunction	N.K. Krupskaya (1869 - 1939) - revolutionary, famous political and cultural figure of the USSR, wife of V.I. Lenin, suffered from Graves' disease.	A child with cretinism.

Regulation of the thyroid gland

The work of the thyroid gland is carried out under the regulation of the central nervous system, or rather - hypothalamic-pituitary system.

The hypothalamus and pituitary gland are brain structures that perform endocrine function. The hypothalamus, located in the brain, produces thyrotropin-releasing hormone (thyrotropin-releasing hormone), which in turn affects the anterior pituitary gland (adenohypophysis). In the adenohypophysis, under the influence of TRH, thyroid-stimulating hormone (TSH) is formed. TSH stimulates the production of thyroxine (T4) and triiodothyronine (T3) by thyroid cells.

There is also an inverse negative relationship between the regulation of thyroid function. Thus, the level of hormones T3 and T4 influence the production of thyroid-stimulating hormone and thyrotropin-releasing hormone. With insufficient iodine levels in the body, the production of T3 and T4 decreases, which contributes to an increase in the production of TSH and TRH. In turn, the hormones of the pituitary gland and hypothalamus begin to stimulate the thyroid gland, while the gland itself gradually increases in size. Thus, a cyclical cascade process is launched, which cannot be interrupted until the level of iodine in the thyroid gland is normalized.

Also, the process of production of thyroid hormones is influenced by other hormonal substances (glucocorticoids, estrogens, dopamine and many other factors), which explains the mutual influence of the thyroid gland on other endocrine organs.

Causes and types of thyroiditis

Symptoms of thyroiditis

• symptoms of hypothyroidism,
• symptoms of hyperthyroidism,
• symptoms of compression by an altered thyroid gland,
• general symptoms inflammation.

Symptoms of hypothyroidism

Degrees of hypothyroidism:

• Latent hypothyroidism – without visible clinical symptoms
• Manifest hypothyroidism – hypothyroidism with clinical manifestations. Happens compensated and decompensated .
• Complicated hypothyroidism (heart failure, polyserositis (effusion in the cavity), cretinism in children, pituitary tumors, myxematous coma).

Symptoms of hyperthyroidism

• Light degree: moderate loss of body weight, tachycardia from 90 to 100 beats per minute, no damage to other endocrine organs.
• Average degree: pronounced weight loss, tachycardia from 100 to 120 per minute, changes in heart rate, disruption of the digestive system and adrenal glands.
• Severe hyperthyroidism: severe changes at work individual systems and organs of the body.
• Complicated hyperthyroidism: manifests itself as a thyrotoxic crisis.

Symptoms of compression by an altered thyroid gland

• 0 tbsp. – The enlargement of the thyroid gland is not detected during examination.
• 1 tbsp. – enlargement of the thyroid gland is determined by palpation, but is not visually detected.
• 2 tbsp. – enlargement of the gland is visible upon examination and palpation.

Complaints regarding changes in the thyroid gland:

• Pain in the thyroid gland, which can radiate to the neck, ear, jaw, tongue and intensify when swallowing. The pain is associated with the presence of inflammation in the gland, which is accompanied by swelling and a local increase in temperature.
• Voice change . A rough voice is associated with pressure from an enlarged gland on vocal cords.
• Compression of neighboring organs may be accompanied by pain when swallowing, choking on food, a feeling of a lump in the throat, and difficulty breathing.
• Compression syndrome (compression of mediastinal organs): when the vessels of the neck are compressed, headaches, tinnitus, decreased vision, etc. may develop.

General symptoms of inflammation:

• General intoxication : weakness, aching joints, increased body temperature, headache; associated with an infectious process in the body, the ingress of toxic waste products of bacteria.
• Increase lymph nodes : enlarged lymph nodes of the neck, painful on palpation, possible formation of lymphadenitis (purulent inflammation of the lymph node, accompanied by pain, redness of the skin over it, an increase in size of more than 10 mm). The reaction of lymph nodes is associated with the body’s attempts to destroy the infection through the lymphatic system.

Symptoms of thyroiditis depending on the type

Diagnosis of thyroiditis

Laboratory research

• TSH – norm from 0.4 to 4 mU/l,
• T3 – norm from 2.6 to 5.7 pmol/l,
• T4 – norm from 9 to 22 pmol/l,
• microsomal antibodies to thyroid peroxidase (AT TPO) – norm up to 18 U/l,
• antibodies to thyroglobulin (AT TG) – norm up to 5.6 U/l,
• second colloidal antigen and antibodies to thyroid hormones.

1. Acute thyroiditis – deviations in thyroid hormone levels TSH, T3 and T4, as well as antibodies to thyroglobulin and thyroid pyroxidase are most often not detected. Changes in the form of an increase in TSH with normal values ​​of T3 and T4 appear in latent hypothyroidism, and an increase in TSH in combination with a decrease in the levels of T3 and T4 in manifest hypothyroidism.


2. Subacute thyroiditis. At the II euthyroid stage, with the appearance of hyperthyroidism, an increase in T3 and T4 levels and a decrease in TSH levels are specific. At the third hypothyroid stage, TSH levels increase and/or T3 and T4 levels decrease. When the thyroid follicles are destroyed, antibodies to thyroid peroxidase and thyroglobulin may increase.


3. At chronic autoimmune thyroiditis AT TG, AT TPO, a second colloidal antigen and antibodies to thyroid-stimulating hormone appear. When hypothyroidism occurs, TSH levels increase and/or T3 and T4 levels decrease.


4. At immunological and hormonal changes most often absent. In the presence of concomitant autoimmune thyroiditis, a low titer of antibodies to thyroglobulin, peroxidase, thyroid-stimulating hormones, and a second colloidal antigen may appear. As symptoms of hypothyroidism increase, TSH levels increase and/or T3 and T4 levels decrease.

Instrumental studies of the thyroid gland

• sizes,
• location,
• structure,
• condition of the parathyroid glands, regional lymph nodes, blood flow condition (Doppler ultrasound),
• control of puncture biopsy of the thyroid gland

Ultrasound – signs of thyroiditis, depending on the type:

• Acute purulent thyroiditis – the dimensions are normal or slightly enlarged, the echo structure is heterogeneous, foci of reduced echogenicity (abscesses) can be detected.


• Acute non-purulent thyroiditis – the sizes are not increased or diffusely increased, spots with reduced echogenicity; when examining Doppler ultrasound, there is an increase in blood supply.


• Subacute de Quervain's thyroiditis – the size of the gland is enlarged, foci of reduced echogenicity; when examining Doppler ultrasound, there is an absence or decrease in the blood flow of the gland.


• Chronic autoimmune thyroiditis Hashimoto's – diffusely reduced echogenicity of the thyroid gland, the presence of foci of increased echogenicity. With atrophic autoimmune thyroiditis, the volume of the gland decreases (up to 3 times), with hypertrophic thyroiditis it increases (up to 3 times), and the size of the gland may also remain unchanged. Doppler ultrasound shows increased blood filling and vascular deformation.


• Chronic fibrous thyroiditis – diffuse decrease in echogenicity of the thyroid gland, increased parenchyma density, with Doppler ultrasound – decreased blood flow.

Using scintigraphy, you can determine the location of the gland, its size, the presence of nodes, and developmental anomalies.

For thyroiditis this method uninformative, rarely used. It is important to use scintigraphy when making a differential diagnosis of thyroiditis and gland tumors (presence of cold and hot nodes).

Computed and magnetic resonance imaging (CT and MRI) allows you to fully assess the condition of the thyroid gland and surrounding organs and tissues. However, not all CT and MRI machines have the ability to examine the thyroid gland. MRI has advantages over CT due to the lack of radiation exposure.

Fine needle biopsy of the thyroid gland – invasive method diagnostics, which is carried out for further cytological examination of gland tissue. It is carried out under ultrasound control or without it by inserting a needle into the parenchyma of the gland and collecting material.

A biopsy is performed for almost all diseases of the thyroid gland; the method is very informative and will allow diagnosing diseases and neoplasms of the gland at an early stage.

Cytological diagnostic method for thyroiditis.

Cytological examination for thyroiditis is carried out more often than histological examination due to the fact that material for cytology can be taken during a fine-needle biopsy, and for histology - only as postoperative material (surgical treatment for thyroiditis is rarely used).

Cytology is microscopic examination biopsy cells are inferior in information content to histological examination. However, it often remains the method on the basis of which the diagnosis of thyroiditis is made.

Cytological picture depending on the type of thyroiditis:

• Acute purulent thyroiditis . Cytological examination of the aspirate reveals pus: neutrophils, necrosis. If these changes are detected, a bacteriological study is necessary - culture of microflora, which will determine the type of bacterial pathogen, as well as sensitivity to antibiotics.
• Acute non-purulent thyroiditis characterized by aseptic inflammation, neutrophils are not detected in the preparation, a large number of leukocytes (eosinophils, lymphocytes, monocytes) are detected; when inoculating this material, the pathogen is not determined.
• Subacute thyroiditis characterized by the presence in the preparation of normal follicular cells alternating with altered (mutated). Also in the preparation, inflammatory cells are determined: lymphocytes, giant multinucleated cells, epithelioid granulomas (it is by the predominance of these cells that subacute thyroiditis is divided into giant cell, granulomatous and lymphocytic).
• Chronic autoimmune thyroiditis. In the cytological preparation, many cells are detected, among which there is no colloid, and there are practically no thyrocytes. The cells are represented by a variety of immune cells: lymphocytes, plasma cells, eosinophils, giant cells of B lymphocytes and others.
• At chronic fibrous thyroiditis in the preparation the number of cells is very meager, a large number of fibroblasts (precursor cells of fibrosis), destroyed inflammatory cells (leukocytes, lymphocytes, plasma cells and others), a small number of dystrophically altered follicular cells, thyrocytes are determined.

Treatment of thyroiditis

Drug treatment for thyroiditis

• Antibiotic therapy. A broad-spectrum antibiotic (cephalosporins or protected penicillins) is prescribed, and when culture results with antibiotic sensitivity are obtained, treatment is adjusted.
• Antihistamines.
• Vitamin therapy.
• Surgery in the presence of thyroid abscesses.

• Antibiotic therapy usually not performed, since there is no thyroiditis with this type infectious agent, but with reduced immunity, antibiotics are prescribed as prophylaxis.
• Sedatives (soothing tinctures).
• Non-steroidal anti-inflammatory drugs.
• Vitamin therapy.

• is the main treatment for de Quervain's thyroiditis.
• Nonsteroidal anti-inflammatory drugs prescribed at the beginning of treatment for pain relief. A short course is administered orally and in the form of applications to the thyroid gland for 10 days.
• Thyroid e a drug s recommended 1 - 1.5 months from the start of hormonal therapy in the presence of symptoms of hypothyroidism, prescribed for 1 month. But if persistent symptoms of hypothyroidism persist, thyroid medications are prescribed for life.
• Vitamin therapy.
• Beta blockers as symptomatic therapy are prescribed in the presence of tachycardia.

• Thyroid drugs used for a long time for several months and years.
• Glucocorticosteroid therapy orally for 3 months. and locally through the skin in the form of physiotherapy (electrodraging).
• Immunomodulatory drugs prescribed for low effectiveness of thyroid and hormonal drugs.
• Maybe surgery.

Treatment of chronic fibrous thyroiditis:

• Surgery – the main method of treating fibrous thyroiditis.
• Thyroid drugs are recommended for life replacement therapy with persistent hypothyroidism.

Types of surgical treatment for thyroiditis

Removal of the thyroid gland (thyroidectomy)

Indications for chronic thyroiditis:

• hypertrophy of the thyroid gland 2 degrees (chronic thyroiditis),
• compression of the trachea and esophagus by an enlarged gland,
• growth of the thyroid gland against the background of adequate therapy,
• the presence of large nodes in the gland, suspicion of malignant formations.

Types of operations on the thyroid gland for chronic thyroiditis:

• partial resection thyroid gland(hemithyroidectomy),
• subtotal resection(with saved upper sections glands),
• total extirpation of the thyroid gland(strumectomy, removal of the entire gland).

Traditional medicine and thyroiditis

Compresses on the thyroid area
Pour 200 g of hot pork lard into 200 g of dry wormwood, leave for 20 minutes, apply warm to the neck area overnight. Recommended daily use within 14 days. Compresses are effective for chronic thyroiditis.

Infusion with seaweed
50 g of seaweed, 25 g of pine buds, 3 plantain leaves, pour 1 liter of boiling water and place in a water bath for 15 minutes, then add 10 g of honey and 2 grated lemons. Continue simmering the mixture in a water bath for another 15 minutes. Take 1 tbsp. l. 3 times a day for 20 – 30 minutes. before meals for one month. Effective for autoimmune thyroiditis.

Tincture of pine buds.
2 packs crushed pine buds fill with vodka to a volume of 500 ml, leave in a warm dark place 21 days, then strain. Rub this tincture onto the thyroid gland 3-4 times a day until recovery. Effective for autoimmune thyroiditis.

Nutrition for thyroiditis

• seafood,
• seaweed,
• lean meat,
• bran,
• porridge,
• wholemeal bread,
• vegetables fruits,
• dairy products (cheese, cottage cheese, yogurt, kefir, etc.),
• vitamin juices daily.

Prevention of thyroiditis

• Healthy image life and nutrition (physical activity, healthy eating, giving up bad habits, walking in the fresh air).
• Prevention of infectious and viral diseases (hardening, taking vitamins, preventive vaccination).
• Treatment of foci of chronic respiratory tract infection, oral cavity.
• Prevention of HIV and other sexually transmitted diseases.
• Refusal to self-medicate and take medications (antibiotics, immunomodulators and immunostimulants).
• Timely contact a doctor if any complaints appear for further examination.
• Reducing exposure to radiation.
• Adequate consumption of foods that contain iodine.
• Timely periodic preventive examination.

What is autoimmune thyroiditis? Hashimoto's thyroiditis, what is it?

Features of autoimmune thyroiditis:

• The most common thyroid disease.
• It is often hereditary (family) in nature.
• Postpartum autoimmune thyroiditis may develop due to immunosuppression during pregnancy.
• Children often get sick adolescence and young people.
• It is characterized by a long asymptomatic course.
• It can manifest itself as either an enlargement of the thyroid gland or a decrease in it.
• It almost always manifests itself as a lack of thyroid hormones (hypothyroidism).
• Complications of autoimmune thyroiditis can be persistent hypothyroidism (lifelong hormonal therapy is required), “malignancy” (degeneration into a cancerous tumor), transition to fibrous form chronic thyroiditis (often requires extirpation of the gland).
• With timely long-term treatment the prognosis is favorable.

• Determination of antibodies to own cells thyroid gland: microsomal antibodies to thyroid peroxidase (AT TPO), antibodies to thyroglobulin (AT TG), second colloid antigen and antibodies to thyroid hormones. When these antibodies appear, we can talk about the presence of autoimmune thyroiditis in the patient.
• Determination of thyroid hormones thyroxine and triiodothyronine (T3 and T4), as well as thyroid-stimulating hormone (TSH) in the patient’s blood. In Hashimoto's thyroiditis, hormone levels may be normal at the onset of the disease. When hypothyroidism occurs, TSH levels first increase, followed by a decrease in T3 and T4 levels.
• Ultrasound of the thyroid gland with autoimmune thyroiditis, it may indicate a decrease or increase in its size, the presence of foci of increased or decreased echogenicity, the presence or absence of nodes, deformation of blood vessels and an increase in blood supply to the gland.
• For fine needle biopsy of the thyroid gland (invasive method) it is possible to reliably confirm the presence of autoimmune thyroiditis and exclude oncological pathology.

How to treat thyroiditis during pregnancy?

It is very important to promptly detect the disease or its relapse by full examination thyroid gland. To do this, you need to see an endocrinologist, undergo a blood test for TSH, T3 and T4, antibodies to the thyroid gland, and an ultrasound of the thyroid gland. If there are changes in these studies, you should be re-examined every three months. If the diagnosis of thyroiditis is confirmed, then treatment is mandatory to prevent miscarriage, stillbirth and damage to the baby’s nervous system, and to prevent persistent hypothyroidism in the mother in the future.

To treat thyroiditis during pregnancy, L-thyroxine (contains thyroid hormone), iodine preparations (iodomarin), calcium and vitamin D3 preparations (calcium D3) are used. Treatment should be continued until delivery and for at least another 6 months after delivery. In case of thyroiditis, it is often carried out C-section, however, this issue will be decided by the obstetrician-gynecologist together with the endocrinologist individually. Breast-feeding while taking medications, it is possible and necessary for normal development baby.

With adequate treatment, the likelihood of giving birth to a full-term baby healthy child very high, the prognosis is favorable. It is very important for the mother to continue treatment after childbirth until complete recovery under the supervision of an endocrinologist.

Thyroiditis is a whole group of diseases of various etiologies with one common feature– inflammatory process of thyroid tissue. It is customary to distinguish 4 main forms of thyroiditis:

• autoimmune thyroiditis or Hashimoto's chronic thyroiditis;
• acute thyroiditis, which in turn can be purulent or non-purulent;
• subacute thyroiditis or de Quervain's thyroiditis
• and asymptomatic thyroiditis.

Each form of the disease requires specific treatment.

Autoimmune thyroiditis of chronic form

Autoimmune thyroiditis occurs as a result of destruction of the follicular cells of the thyroid gland. This process develops due to a genetic defect in the body's immune response to its own thyrocytes. In patients with chronic autoimmune thyroiditis, antibodies to thyroid cells circulate in the blood.

The disease is often combined with other autoimmune diseases: primary hypocortisolism, hepatitis, diabetes mellitus, rheumatoid arthritis and has high risk(up to 70%) may be complicated by the development of hypothyroidism (deficiency of thyroid hormones).

The euthyroid asymptomatic phase of chronic thyroiditis can last for decades. In this regard, it is difficult to establish the exact incidence of the disease. In relatives of patients diagnosed with autoimmune thyroiditis, antibodies to thyroid cells are diagnosed in 50% of cases.

Among the symptoms of autoimmune thyroiditis in the subclinical and clinical stages are:

• increased volume of the thyroid gland,
• discomfort in the thyroid gland,
• difficulty swallowing,
• pain on palpation,
• weakness,
• joint pain.

In chronic thyroiditis complicated by hypothyroidism, the patient exhibits:

• trembling fingers,
• tachycardia,
• sweating,
• hypertension.

A special form of autoimmune thyroiditis is postpartum thyroiditis. It is observed in 5-9% of all pregnancies. Symptoms of this form of thyroiditis usually go away without treatment within a year after giving birth.

Subacute thyroiditis

Subacute thyroiditis is an inflammation of the thyroid gland, presumably of viral origin. Thyroiditis of this form usually develops 2 weeks after an infection: influenza, mumps, measles, etc.

Inflammation of the thyroid tissue is manifested by the following symptoms of thyroiditis:

• headache,
• decreased performance,
• feeling broken
• aches in joints and muscles,
• chills,
• increase in body temperature.

Among the local symptoms of subacute thyroiditis are swelling and tenderness of the thyroid gland. Pain may also be felt in the chin, ear or back of the head. Most often the disease is diagnosed in women 20-50 years old. In men, subacute thyroiditis is diagnosed 5 times less often than in women.

Asymptomatic thyroiditis

With this type of disease there are no specific symptoms of thyroiditis. The only sign of pathology is a slight increase in the size of the thyroid gland. After a few weeks, the inflammation goes away on its own and the size of the organ returns to normal. During a transient enlargement of the thyroid gland, the level of thyroid hormones in the patient’s body increases.

Asymptomatic thyroiditis has a high likelihood of recurrence. The nature of its origin has not been studied by medicine.

Acute thyroiditis

Acute thyroiditis is the rarest form of the disease. The appearance of a purulent or non-purulent inflammatory process of thyroid tissue is provoked by an infection caused by tonsillitis, pneumonia or sepsis. Nonsuppurative acute thyroiditis can also result from trauma to the thyroid gland or radiation exposure.

Symptoms of acute thyroiditis include:

• thickening of the thyroid gland,
• the appearance of an abscess,
• a sharp increase in temperature up to 40 degrees,
• tachycardia,
• pain in the lower part of the head,
• signs of intoxication of the body.

If treatment for acute thyroiditis is not started in a timely manner, the disease can lead to irreversible thyroid failure.

Diagnosis of thyroiditis

The diagnosis of “chronic autoimmune thyroiditis” is confirmed if a large amount of antibodies to thyroid cells is detected in the patient. To establish a final diagnosis of chronic thyroiditis, a biopsy of the thyroid gland is required.

Subacute thyroiditis is diagnosed based on patient complaints of pain in the thyroid gland and painful swallowing. In this case, the patient's medical history must indicate a recent infection. The diagnosis of “subacute thyroiditis” can be confirmed using ultrasound and the Crail test. The latter is the administration of Prednisolone and monitoring the patient's condition. In case of subacute thyroiditis, a daily dose of Prednisolone (30 mg) significantly improves the patient’s well-being.

With asymptomatic thyroiditis, a large amount of thyroid hormones and low level absorption of radioactive iodine by the thyroid gland.

In the diagnosis of acute thyroiditis, the study of blood composition is also used. In this form of the disease, a high level of leukocytes and increase in ESR. The amount of thyroid hormones is usually not changed. An area of ​​softening of the thyroid gland with a formed abscess is visually determined.

Treatment of thyroiditis

An effective treatment for autoimmune thyroiditis that guarantees healing for the patient has not yet been developed. The standard treatment for chronic thyroiditis is lifelong replacement therapy with thyroid drugs, for example, L-Thyroxine.

By taking artificial thyroid hormones, it is possible to reduce the size of the goiter and prevent further hypertrophy of the organ tissue. Postpartum autoimmune thyroiditis usually does not require treatment. The exception is cases of chronic thyroiditis of this type lasting a year or more.

In the treatment of subacute thyroiditis, glucocorticoids, for example, Prednisolone, are widely used. It helps relieve swelling of the thyroid gland. The duration of therapy is purely individual.

In the treatment of acute purulent thyroiditis, antibiotics and antihistamines are used. At the same time, intravenous drip administration is carried out in a hospital setting. saline solutions, drinking plenty of fluids is prescribed to reduce general intoxication of the body.

If an abscess is present, treatment of thyroiditis is surgical. It consists of opening and draining the purulent focus. If the abscess is not removed in time, it may spontaneously open and allow pus to enter the patient’s mediastinum or trachea. With adequate treatment of acute thyroiditis, recovery occurs within 1-2 months.

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The result of a violation of the healthy functional performance of the thyroid gland is considered to be various factors leading to inflammatory processes of the thyroid gland, one of which is autoimmune thyroiditis of the thyroid gland.

What is it and what are the cause-and-effect relationships of the appearance of Hashimoto’s thyroiditis (another name for chronic inflammation) and other gland-related diseases internal secretion, we will consider in this article.

Factors contributing to the development of thyroid diseases

Poor environmental conditions, food oversaturated with carcinogens, lack of iodine in water and food - all these components lead to various thyroid diseases. The functional purpose of this endocrine gland is hormonal production and control of various processes. Thus, thyroxine and triiodothyronine are responsible for controlling the growth, maturation and energy state of tissue structures, and the control of calcium metabolic cellular processes is entrusted to calcitonins. As a result of a lack (hypothyroidism) and/or excess (thyrotoxicosis or hyperthyroidism) of the functional activity of the thyroid gland, various diseases can occur.

Thyroiditis of the thyroid gland: what is it?

Thyroiditis is a number of diseases of the endocrine system associated with inflammatory processes of the thyroid gland, which have different typical origins and corresponding pathogenesis. In endocrinology, there are several types of thyroiditis, differing in type, occurrence and course of the disease:

• Hoshimoto's thyroiditis;
• chronic fibrous;
• spicy;
• de Quervain's thyroiditis or granulosa (subacute) thyroiditis.

Let's consider the symptomatic signs of the development of thyroiditis and their mechanisms of action on the thyroid gland.

Acute or purulent thyroiditis develops against the background of chronic or acute infectious lesions of the body, such as:

• sinusitis;
• sepsis;
• pneumonia;
• quinsy.

The results of tissue damage to the thyroid gland are hematogenous infectious processes that have a focal or diffusion nature of penetration into the cellular structures of the endocrine system.

The non-purulent, aseptic form of acute thyroiditis is revealed as a result of mechanical damage glands, or due to radiation. The result of follicle failure is blood entering the thyroid stroma, and, as a result, hormonal disruption occurs.

Subacute thyroiditis occurs when affected by acute viral infections:

• mumps;
• flu;
• rubella;
• chicken pox;
• measles and so on.

Under the active influence of viral agents, hyperplasia of follicular cells occurs with the formation of fibrosis and various types of adhesions that have multinuclear cellular structures that negatively affect the epithelium. Common symptomatic signs that contribute to the development of thyroiditis include:

• A sharp increase in body weight as a result of slow metabolic processes.
• Decrease in body temperature. A person begins to freeze at temperatures not exceeding 36 degrees Celsius.
• Swelling of the eyelids appears, the sense of smell is impaired, hearing decreases and the thickness of the upper and lower extremities increases.

In addition, it is revealed various disorders digestive system, and cyclic menstrual processes among women. With such symptomatic signs, urgent clinical diagnosis is required, and, as a result, appropriate treatment of thyroiditis of the thyroid gland. A special feature disruption of endocrine processes is an enlargement of lymph nodes. You should not hope for recovery through treatment at home with various folk remedies.

Thyroid: autoimmune thyroiditis

Lymphomatous or chronic autoimmune thyroiditis occurs against the background of destructive destruction of healthy thyroid cells by antithyroid autoantibodies. Disease of the thyroid gland - thyroiditis autoimmune type In most cases, there is a behavioral factor in the asymptomatic course of the disease, which greatly complicates its diagnosis in initial stage development of pathology. In some cases, the lymphomatous condition of the thyroid gland produces a sufficient amount of hormones, so-called euthyroidism of the thyroid gland occurs, symptoms and treatment, which can only be determined by a qualified specialist in the field of endocrinology. Changes in the hormonal system due to functional deficiencies or hyperfunctions occurring in the cells of the thyroid gland are also influenced by other clinical symptoms: hyperthyroidism and thyrotoxicosis of the thyroid gland, what they are and what their symptomatic manifestations are will be discussed below.

Causes and symptoms of euthyroidism

Euthyroidism of the thyroid gland, what it is and what are its symptomatic manifestations, worries people who first heard this medical term. The absolute definition of euthyroidism is the clinical state of thyroid hormones being within reference limits. In a word, during laboratory testing, the level of thyroid-stimulating and thyroid hormones is within normal limits, so the disease is asymptomatic. Despite normal condition hormonal structure, detection of euthyroidism may be a harbinger of various endocrine disorders. However, according to leading experts, there is no drug treatment for euthyroidism. The main treatment and preventive measure should be periodic consultation visits to an endocrinologist at the patient’s place of residence.

Hypothyroidism of the thyroid gland, what is it and what are the causes

A pathological condition caused by a quantitative deficiency of the hormonal structure of the thyroid gland is called hypothyroidism in endocrinology. The etiology of the disease can be expressed in primary or secondary signs hypothyroidism. In the first case, direct damage to the gland is diagnosed due to various anomalies or inflammatory processes, as well as as a result of mechanical damage after surgical or radioactive exposure.

If the thyroid gland, hypothyroidism, which is defined as secondary, then the determining factors here are infectious or tumor lesions. Various categories of the population who have the following clinical manifestations may be at risk:

• presence of a confirmed diagnosis of thyroiditis;
• diabetes mellitus and/or pernicious anemia;
• poisoning due to overdose of various pharmacological drugs;
• hyponatremia, high atherogenic index, increased prolactin and other biochemical components in the blood test.

The main symptoms of hypothyroidism are as follows:

• Body temperature decreases, jaundice appears skin, early atherosclerosis manifests itself. All these components belong to the so-called metabolic-hypothermic syndrome.
• Disturbances in tissue connections are detected, which are expressed in facial swelling, hearing loss, difficulty in nasal breathing, hoarseness in the throat, etc.
• Disturbances in the rhythm of the cardiovascular and nervous system, which are expressed in the development of heart failure, slow heart rate, decreased memory, and so on.

With hypothyroidism of the thyroid gland, in addition to the above symptoms, various disorders associated with the digestive organs, circulatory system, as well as qualitative changes associated with dermatology may develop. For female body hypothyroidism can present surprises in the form of infertility, cyclical menstrual irregularities and others unpleasant symptoms associated with disorders of the reproductive functions of the body. Drug treatment of hypothyroidism involves A complex approach to the problem, the result of which should be the elimination of hormonal deficiency of the thyroid gland and ensuring the healthy functioning of other anatomical organs.

Thyrotoxicosis

With an excessive quantitative composition of the hormonal constituents of the thyroid gland in the cellular structures human body, another type is diagnosed endocrine disease, called thyrotoxicosis. This disease characterizes qualitative violations in the functioning of the human cardiovascular and nervous system. It is believed that thyrotoxicosis is one of the most dangerous diseases of the thyroid gland, since active release large quantity hormones into the blood can, if treated inadequately or not seek medical help in a timely manner, significantly worsen the patient’s life situation. Characteristic external signs diseases are the following:

• disturbance of rhythmic processes in the work of the heart;
• tremor, that is, shaking of the hands, reminiscent of symptoms of Parkinson's disease;
• fussiness, verbosity, bulging eyes;
• rare blinking, irritability, restlessness, and so on.

All these symptomatic manifestations are very typical for people with a confirmed diagnosis of thyrotoxicosis. A dangerous complication diseases with improper treatment hypothyroid coma may occur, in which the patient’s body temperature drops sharply, as well as blood pressure, heart rate is disrupted, shortness of breath appears and manifests itself mucous edema face (myxedema). Complex therapy, which includes dietary nutrition, herbal medicine and combined pharmacology, is the only correct solution in the treatment of thyrotoxicosis.

Prevention of thyroid diseases

Modern living conditions in a rapid industrial rhythm not only complicate the lives of people prone to diseases associated with the thyroid gland, but also significantly shorten the life of all humanity. A lack of iodine-containing components in the human body causes irreparable harm. Weak physical activity not only reduces a person’s performance, but also has a detrimental effect on all vital organs of the anatomical body. Not only the heart, liver, but also the organs of the endocrine system suffer from extra pounds. Therefore, to avoid possible problems with thyroid diseases, you must adhere to the following standards:

• food products must contain a sufficient and necessary amount of iodine, mineral components and vitamin groups;
• physical activity in the form of daily gymnastic exercises, will strengthen the body not only in the form of normalization of metabolic processes, but also strengthen protective functions.

Particular importance should be given to preventive measures for people in the middle and older age categories.

Take care of yourself and always be healthy!