Psychosomatics: thyroid gland - causes and consequences of diseases. (Hypothyroidism, as a consequence of passivity)

Depression with hypothyroidism develops quite often. Approximately 40-73% of patients with hypothyroidism experience mild depression and moderate severity. With a comprehensive examination of patients for depression, approximately half of them are diagnosed with implicit hypothyroidism.

Naturally, the question of the relationship between these two diseases is very relevant. In this publication we will look at why hypothyroidism and depression are combined in the same person, how they are diagnosed and treated.

Expert opinion

Elena Sergeevna

Gynecologist-obstetrician, professor, work experience 19 years.

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Women face cycle disorders. The same symptoms are characteristic of the development of depression. Therefore, a competent doctor, before treating depression, will definitely send the patient to check the condition thyroid gland. To do this, you will need to take a blood test for hormones.

If the level of pituitary hormone, which stimulates the production of thyroid hormones, is increased and T4 is decreased, then hypothyroidism is diagnosed. To treat it, hormone replacement therapy is prescribed. When the depressive state does not go away as a result of therapy, you will need the help of a psychotherapist.

How do two diseases manifest themselves simultaneously?

A sufficient amount of thyroid hormones makes people energetic and active, and their deficiency leads to a significant decrease in emotional levels.

Disturbances in the functioning of various systems in hypothyroidism.

Therefore, with the development of a depressive state, a patient with reduced amount The hormones T3 and T4 are different:

• almost constantly in a bad mood;
• loss of the ability to enjoy life;
• loss of interest in things that previously fascinated him;
• decreased ability to concentrate on something;
• deterioration in the ability to remember new information;
• development of insomnia at night and drowsiness during the day;
• the appearance of thoughts about own uselessness, which in some cases reach the point of unwillingness to live.

Quite often, asthenodepressive syndrome develops, in which depressive symptoms combined with asthenia - lack of strength to do something.

In this case, the patient will show irritability and excessive tearfulness despite the fact that he is characterized by lethargy of emotions. As a rule, a person has a inhibited mental and physical activity. He shows no initiative in anything.

Important differences

Experts note that women with hypothyroidism have high anxiety and have panic attacks. They are also prone to hypochondria - fear that treatment will not produce results, and against the background of existing symptoms, various complications will begin, as well as diseases of other organs.

When visiting a psychotherapist, such patients talk in detail about their complaints about their well-being. Patients with depression without hypothyroidism tend to be pessimistic and have low self-esteem. They are not as actively willing to discuss their health status with a doctor.

An experienced psychotherapist, suspecting signs of hypothyroidism in his patient, will refer him to an endocrinologist. To definitively diagnose hypothyroidism, it is necessary to take a blood test for hormones. During illness, the level of TSH is increased, and T4 and T3, on the contrary, are decreased.

How is depression treated with thyroid problems?

A qualified psychotherapist or psychiatrist will refer a patient with depression and signs of hypothyroidism to an endocrinologist to examine the condition of the thyroid gland. After all, both diseases can be combined.

The presence of hypothyroidism can be confirmed by the hormone TSH. With this diagnosis, the patient is prescribed thyroid hormone replacement therapy. The following drugs are prescribed: Eutirox or L-thyroxine.

When treated with hormones, the patient not only eliminates or alleviates the symptoms of hypothyroidism, but also reduces the manifestations of depression.

Against the background of normalized levels of thyroid hormones, depression can be cured with the help of special medications for 3-4 months. The use of specially selected antidepressants allows you to get rid of depression.

Conclusion

Patients with hypothyroidism often develop depression. Therefore, a competent doctor, before prescribing to a patient who has problems with mental activity antidepressants, will send him to check the condition of the thyroid gland.

Taking a properly selected dose of synthetic thyroid hormones will help get rid of hypothyroidism and reduce depression. If it persists after therapy, then it is treated with properly selected antidepressants. To eliminate asthenodepressive syndrome, medications are prescribed to get rid of the state of internal emptiness. We wish you good health!

The influence of thyroid diseases on the personality traits of patients and their behavior was first carefully studied in 1988 by Wagner von Jyuregg, who was the first to describe the symptoms of psychosis in myxedema.

Throughout the world, iodine deficiency is considered the main cause of hypothyroidism. In those regions where this deficiency is felt particularly acutely, autoimmune thyroiditis (Hashimoto's disease) is often recorded, which is 7 times more common in women and is quite often associated with other autoimmune diseases. Other causes of hypothyroidism include: congenital, thyroid dysgenesis; trauma to the thyroid gland, including radiation damage or surgical operations, drugs that can disrupt the functional activity of the thyroid gland, including lithium preparations, antithyroid drugs (radiiodine, carbimazole). infiltrative diseases (hemochromatosis, amyloidosis, sarcoidosis), subacute thyroiditis (de Quervain) and lymphocytic (postpartum) thyroiditis. The last two diseases generally manifest themselves as transient thyrotoxicosis followed by the development of hypothyroidism. In addition, hypothyroidism may be associated with pathology of the pituitary gland or hypothalamus.

What hypothyroidism causes mental disorders at any age, and, in particular, psychosis (“myxedematous insanity”) has been known for a long time. Although the prevalence of hypothyroidism is 4.6%, in most cases it is endocrine disease mostly (4.3%) is asymptomatic and is 4 times more often recorded in women than in men. Psychosis occurs in approximately 2% of patients with hypothyroidism and mainly in elderly patients with concomitant cerebrovascular diseases. In 1908, Marine and Williams noted the connection between cretinism and iodine deficiency and proposed the use of iodine salt to prevent cretinism. Hypothyroidism can manifest itself as manic and depressive states, cognitive impairment and, in particular, memory impairment and a peculiar, usually transient, dementia. Subclinical hypothyroidism is characterized by a tendency toward depression and mild cognitive deficits. Replacement therapy for subclinical hypothyroidism is considered a controversial topic.

Symptoms of thyroidism are: weakness, cold intolerance, dry skin, dry and brittle hair, weight gain, constipation, signs of pinched nerves (carpal tunnel syndrome), hearing loss, ataxia, muscle weakness, muscle spasms(cramps), menstrual irregularities (menorrhagia and late oligomenorrhea or amenorrhea), infertility, bradycardia, diastolic hypertension, dysphonia ( hoarse voice), goiter, periorbital and peripheral edema, galactorrhea, yellowing of the skin (due to carotene), hyporeflexia, slow-relaxed tendon reflexes, pleural and/or pericardial effusion.

Serum analysis shows: hypercholesterolemia, hyponatremia, hyperprolactinemia, hyperhomocysteinemia, anemia, increased levels of creatine phosphokinase, increased creatinine. Rarely myxidema occurs comatose state, collapse, hypothermia and heart failure. In subclinical hypothyroidism, TSH is usually elevated, and T4 is slightly reduced or shows normal values. When diagnosing hypothyroidism, it is recommended to look at TSH levels, as well as T4 and T3 free, biologically active forms. Measuring total T3 and T4 levels is meaningless. , binding proteins, mainly thyroxine-bound globulin, are also being examined. Thyroid hormones suppress thyrotropin-releasing hormone and thyroid-stimulating hormone according to the feedback principle. Thyroid-stimulating hormone mainly stimulates the release of T4 and, to a lesser extent, T3 (conversion of both T3 and T4 occurs in tissues). Hypothalamic thyrotropin-releasing hormone stimulates the release of thyroid-stimulating hormone. TSH measurement is more sensitive than free thyroid hormone measurement. The most common signs of thyroid disease are: elevated TSH levels with normal or reduced levels of T3 and T4 (subclinical or overt hypothyroidism); low TSH with normal or elevated levels of T3 and T4 (subclinical or overt hyperthyroidism). Pathology of the pituitary gland can cause hypothyroidism with low TSH and a subsequent decrease in free thyroid hormones, and a TSH-secreting pituitary adenoma can cause hyperthyroidism, manifested by an increased level of TSH and a subsequent increase in the level of free thyroid hormones. An elevated TSH level may manifest itself as a clear clinical picture of hypothyroidism (the level of free thyroid hormones is elevated), and subclinical hypothyroidism may have normal levels of free T3 and T4.

"Dry euthyroid syndrome" with decreased or normal function thyroid disease may occur during dopamine antagonist therapy, TSH-secreting pituitary adenoma (increased), resistant thyroid hormone syndrome (increased) or adrenal insufficiency (decreased or normal). Elevated TSH levels with normal or elevated free T3 and T4 levels can also occur as a result of non-compliant thyroid hormone replacement therapy. Low level TSH is fixed in case of obvious thyrotoxicosis (the level of free T3 and T4 is increased). , subclinical hyperthyroidism (T3 and T4 levels are normal). recent treatment of hyperthyroidism (normal values), thyroid - associated ophthalmoplegia without pregnancy. (normal), thyroxine replacement therapy (normal or increased), “dry euthyroid syndrome” (reduced or normal). first trimester of pregnancy (normal or increased), diseases of the hypothalamus or pituitary gland (reduced or normal), anorexia nervosa (reduced or normal), during the acute phase of treatment with dopamine or somatostatin (normal) or glucocorticoid therapy (normal). At TSH deviation Free T4 levels should be measured. A free T3 test should be carried out after the first two tests are positive (confirmation of hypothyroidism). A sensitive test for hypertiteotoxicosis is usually prescribed for elevated T.4 numbers, but there is also the so-called “T3 toxicosis”. At normal indicators TSH and T4, even if the T3 value goes beyond the reference values, therapy for thyroid diseases is not carried out. If hypothyroidism is confirmed, antithyroid antibodies should be examined: anti-thyroid peroxidase (TPO, antimicrosomal) with a positive result, one can assume with a 95% probability the presence of autoimmune thyroiditis. Hypothyroidism requires testing of pituitary and adrenal hormones.

Psychoses, in particular, manifesting themselves manic syndrome may occur during initial therapy with levothyroxine, a hormone used as replacement therapy in the treatment of hypothyroidism.

ID: 2011-07-35-R-1327

Mozerov S.A., Erkenova L.D./ Mozerov S.A., Erkenova L.D.

Stavropol State Medical Academy

Summary

Hypothyroidism has a significant negative impact on mental health a person at all stages of his life, causing the appearance of a variety of clinical syndromes, ranging from mild disorders to severe mental disorders.

Keywords

Hypothyroidism, mental health, mental disorders.

Review

Hypothyroidism is one of the most common diseases endocrine system, caused by a long-term, persistent lack of thyroid hormones in the body or a deficiency of their biological effect on tissue level. The problem of hypothyroidism is currently extremely relevant for doctors of any specialty, due to the increasing prevalence of this pathology in the population and the polymorphism of manifestations.

Taking into account the pathogenesis, hypothyroidism is divided into primary (thyroidogenic), secondary (pituitary), tertiary (hypothalamic), tissue (peripheral, transport). According to the severity, hypothyroidism is classified into latent (subclinical), manifest, and complicated. Separately, congenital forms of hypothyroidism are distinguished, which can also be associated with disorders at any level (primary, central, peripheral). It should be noted that in most cases hypothyroidism is permanent, but in some diseases of the thyroid gland it can also be transient.

Primary manifest hypothyroidism in the population occurs in 0.2-1% of cases, subclinical hypothyroidism - up to 10% among women and up to 3% among men. The incidence of congenital hypothyroidism is 1:4000-5000 newborns.

In most cases, hypothyroidism is primary and most often develops as a result of autoimmune thyroiditis, less often as a result of treatment of thyrotoxicosis syndrome. The causes of congenital hypothyroidism are most often aplasia and dysplasia of the thyroid gland, congenital enzyme deficiency, accompanied by impaired biosynthesis of thyroid hormones.

Deficiency of thyroid hormones leads to a slowdown of all metabolic processes in the body, a decrease in redox reactions and basal metabolic rates. The lack of thyroid hormones is accompanied by the accumulation of glycoproteins (glycosaminoglycans and hyaluronic acid), which are highly hydrophilic and contribute to the development of mucous edema (myxedema).

Hypothyroidism affects almost all organs and systems, which causes a varied clinical picture. In addition to typical manifestations, symptoms characteristic of damage to a particular system may dominate. This circumstance in some cases makes it difficult to diagnose hypothyroidism. However, despite the variety of symptoms encountered with hypothyroidism, the most pronounced changes are observed on the side nervous system and psyche. These disturbances increase as the disease progresses.

According to many authors, hypothyroidism has a significant impact on the psychological status of patients. There is evidence that a decrease in the level of optimism, love of life and activity is associated with a deficiency of thyroid hormones. The brain is extremely sensitive to thyroid hormone deficiency. The mechanisms by which thyroid hormones influence the psychological status of patients are not fully understood. Suggestions have been made about a decrease in blood flow velocity in hypothyroidism, inhibition of anabolic processes, glucose metabolism in the brain, and a disruption of the effect of thyroid hormones on post-receptor mechanisms that contribute to noradrenergic and serotonergic neurotransmission.

Subclinical hypothyroidism most often affects emotional sphere. In this case, depressed mood, inexplicable melancholy, severe depression are noted, distinctive feature which is the presence of a feeling of panic and the low effectiveness of antidepressants. There are indications in the literature that asthenodepressive conditions in this pathology are almost always observed. According to many authors, subclinical hypothyroidism is not the cause of the development of depression, but it can reduce the threshold for the development of depressive states. According to various sources, the frequency of subclinical hypothyroidism in patients with depressive disorders ranges from 9 to 52%. In addition, cognitive function, memory, attention, and intelligence decrease.

With manifest hypothyroidism, neuropsychiatric disorders are most pronounced, especially in elderly patients. There is evidence of a decrease in constant brain potential in hypothyroidism due to a profound disruption of neuroendocrine interaction. Hypothyroid encephalopathy is characterized by general lethargy, dizziness, decreased social adaptation, and significant impairment of intelligence. Patients note that they have difficulty analyzing current events. When using neuropsychological testing, torpidity of thought processes and a decrease in the volume of short-term memory are objectively revealed. Decrease in intelligence often occurs in elderly patients and, as a rule, proceeds identically to senile dementia, but unlike the latter, it is reversible.

Most patients with hypothyroidism develop depressive and hypochondriacal states due to asthenia. Astheno-depressive syndrome is manifested by emotional lethargy, apathy, lack of initiative, tearfulness, mental and motor retardation. With asthenic-hypochondriacal syndrome, an anxious-suspicious mood and increased fixation of attention on one’s feelings are observed.

Dissomnia disorders in hypothyroidism are characterized by pathological drowsiness, disturbances in night sleep, interrupted sleep without a feeling of rest. So-called “sleep apnea” is common, and is a risk factor for the development of cerebral stroke and myocardial infarction.

Against the background of monotonous, indifferent, aspontaneous behavior of patients with hypothyroidism, both exogenously organic psychoses and those similar in structure to endogenous ones - schizophrenia-like, manic-depressive, etc. can arise. Anxiety-depressive, delirious-hallucinatory (myxedema delirium) and paranoid states may also occur. It should be noted that after thyroidectomy, psychosis occurs most often.

Mental disorders are natural, which is important for diagnosis. Thus, hypothyroidism against the background of autoimmune thyroiditis is characterized by a predominance psycho-emotional disorders(asthenia, neurosis-like syndrome), while postoperative hypothyroidism is characterized by a predominance of cognitive impairment. In addition, in the initial stages and with a relatively benign course of hypothyroidism, elements of a psychoendocrine or psychopathic syndrome are diagnosed, which, as the disease progresses, gradually turns into psychoorganic (amnestic-organic). Against this background, with severe, long-term hypothyroidism, acute psychosis can develop.

When analyzing psychological indicators in children suffering from hypothyroidism, using projective technique « Children's drawing“The following changes were identified: depression, asthenia, personal anxiety, aggression.

There is evidence of the adverse effects of neonatal transient hypothyroidism on further neuropsychiatric and speech development children, since thyroid hormones determine the formation and maturation of the child's brain.

In children with congenital hypothyroidism, even with early initiation of replacement therapy, neuropsychiatric disorders are detected. Features of the psychological status of these children are difficulties in communication, low self-esteem, fears, asthenia, and psychological instability.

Thus, hypothyroidism has a significant negative impact on a person’s mental health at all stages of his life, causing the appearance of a variety of clinical syndromes, ranging from mild disorders to severe mental disorders.

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Symptoms of hypothyroidism are a combination of signs and clinical manifestations that occur in the body when the level of thyroid hormones decreases due to a deficiency in the body, the influence of radioactive iodine-131, the absence of the thyroid gland due to organ surgery or congenital pathology, autoimmune diseases thyroid gland. If the symptoms of hypothyroidism are ignored and left untreated this state, severe consequences may occur, including myxoedema coma, leading to fatal outcome. The thyroid gland is responsible for the full functioning of the entire body, therefore, when there is a lack of hormones synthesized by it, very diverse symptoms arise.

First manifestations

Every person needs to periodically examine the area where the thyroid gland is located. Normally, it can be felt on the lower front of the neck under the Adam's apple. In relation to the internal organs, it is located below the larynx, in front of the thyroid cartilage, from which it got its name. In the normal state of the organ, it is not at all visible externally. If a person notices a minimal change in the size of the gland, or other deformation in this area, then this should be a reason to contact a specialist. The first clinical signs of hypothyroidism may be general weakness, increased fatigue, the appearance of dense swelling of soft tissues on the skin, low blood pressure, after which arterial hypotension, bradycardia, impaired cognitive function, and sexual dysfunction develop.

All these symptoms are a reason to consult with a specialist, take tests and identify the problem, especially when they arise in a complex manner.

Main features

The thyroid gland is an organ rightfully called the “conductor” of the entire body. Although this element cannot boast of large size, it is responsible for the full functioning of the entire body. It is designed to carry out the orders of the brain and control the functioning of the internal organs. Under the influence of the main glands, such as the pituitary gland, hypothalamus, thyroid ensures the synthesis of hormones responsible for a number of processes in the body.

External signs

Hypothyroidism is one of the few diseases in the diagnosis of which clinical symptoms are not decisive and are secondary. Errors in the diagnosis of hypothyroidism, as a rule, are associated with the polymorphism of manifestations of the syndrome; its numerous “clinical masks” often serve as the basis for misdiagnosis, and sometimes inadequate treatment. Hypothyroidism syndrome can occur by simulating diseases of almost all body systems.

For timely detection of hypothyroidism, it is important to know it external signs. Gastrointestinal dysfunction in hypothyroidism is accompanied by constipation or diarrhea, nausea and pain in the abdominal area. On the part of the cardiovascular system, there is a violation of rhythm and conduction, lability blood pressure, the occurrence of pericarditis. General immunity decreases, a person is susceptible to infectious and viral diseases more often than in the general population. However, the skin and ENT organs behave most clearly in hypothyroidism. Skin often become cold, pale, dry, areas of skin on the elbow and knee joints become rough, and hair loss is noted. There may be decreased hearing and vision, and the timbre of the voice changes slightly. The latter occurs due to swelling of the vocal cords in the throat. All these signs are very obvious and if they are present, you should absolutely not postpone a visit to the doctor.

Neurological signs

The neurological symptoms of primary hypothyroidism are usually quite mild, without leading to the patient’s social maladaptation or disability. However, the quality of life when it occurs deteriorates so much that this serves as a reason for separate therapy when visiting a doctor. When subclinical hypothyroidism occurs, all parts of the nervous system are involved in the process of dysfunction. You can often observe a combination of damage to the peripheral and central nervous systems with a pronounced clinical picture. Mild deficiency of thyroid hormones leads to a syndrome complex, the manifestations of which are:

1. Neurosis-like syndrome, asthenia and other psycho-emotional disorders. Patients experience an increase in fatigue, irritability, drowsiness (or interruptions in sleep at night), anxiety, which periodically occurs in addition to everything. The instability of apathy is caused by increased metabolism or disruption of hormonal compensation, which is typical for hypothyroidism.
2. Headache. This is a very common syndrome in this pathology, explained by meningeal-hypertensive, venous, vertebrogenic and mixed mechanisms of occurrence. Insufficiency of thyroid hormones leads to myxedematous edema in the connective tissue, poor cardiac function in conditions of increasing peripheral resistance vessels, reduced blood flow speed. As a result, patients complain of heaviness in the head, an internal feeling of pressure, and discomfort. This is often accompanied by severe periorbital edema with complaints of pressure in the eye area in the morning or evening in an inclined position. Less common are nighttime bursting headaches with vomiting.
3. Cognitive impairment, which manifests itself in the inability to concentrate, delve into something, or pay attention. Sometimes a symptom such as forgetfulness occurs, but this is noted much less frequently.
4. Autonomic disorders in the form of paroxysmal states similar to panic attacks. Also common symptom is a vegetative-vascular-trophic syndrome, manifested by hyperhidrosis, progression of autonomic failure. Patients complain of weakness, dizziness when changing from a lying position to a standing position.
5. Focal neurological symptoms. It can be determined during an examination by a doctor when he sees convergence paresis, lack of eyeball, increased periosteal and tendon reflexes, staggering during the Romberg position, slight intention during the knee-heel and finger-nose tests. Also, some patients suffer from mild polyneuropathy upper limbs, combined with the clinical picture tunnel syndromes. When interviewing a patient, the doctor often finds out that there are complaints of “pins and needles” and a feeling of numbness in the hands at night or in the morning.
6. Myopathic syndrome and myotonic phenomenon in very rare cases. These are mild manifestations of weakness of the proximal leg muscles, which can be verified by needle testing. Also likely to occur in the foot or lower leg, less commonly in the hand area.

Psychological condition

With hypothyroidism, the metabolism of brain cells is severely affected, which is manifested by a decrease in the patient’s intelligence, his ability to perform mental work, attentiveness and creativity.

Intellectual decline is very pronounced, but with the help of psychological techniques it is possible to determine the degree of decline in such abilities in relation to the average statistical indicators. Patients themselves notice their inability to concentrate, find a way out of a situation, or solve a problem. A person’s memory also fails, especially short-term memory. A person stops remembering faces, dates, what is happening here and now. Long-term memory is not affected by hypothyroidism.

A decrease in the level of thyroid hormones in the body leads to apathy and lack of will of a person, which is important for all his loved ones to take into account, since such a psychological state will lead to the fact that the patient will not even have the strength to seek medical help. The emotional side of life also suffers, a person acquires pessimistic views of the future, his mood is always depressed, he is dejected. Interest in family, friends, and all the people around you is also lost. They often give referrals to their patients for consultations with or to identify the scope of depression in which a person is due to hypothyroidism. Severe depressive states with hypothyroidism can be observed in 5-12% of all patients.

Manifestations of the disease in women

It is no secret that women are more susceptible to hypothyroidism, since their hormonal levels, under the influence of natural processes, change much more often than men’s. It is necessary to understand the signs and symptoms of female hypothyroidism in special conditions– during menopause and pregnancy.

Features of symptoms during menopause

The problem in identifying the symptoms of hypothyroidism during menopause is the high similarity of these symptoms with the manifestations of menopause itself, since both conditions are closely related to the functioning of the thyroid gland. Menopause is characterized by a decrease in the production of sex hormones in a woman’s body.

Hormone deficiency in hypothyroidism can lead to fatigue, apathy, and alopecia - the same symptoms that are characteristic of early menopause.

To independently distinguish the onset of menopause from problems with a lack of thyroid hormones in the body, you need to pay attention to conditions that arise in the body due to metabolic inhibition as a result of hypothyroidism, for example, decreased mental activity, slow speech, pasty face, cold intolerance.

During pregnancy

During pregnancy, under the influence of a complex of specific factors, significant stimulation of the thyroid gland occurs, mainly this occurs in the first half of pregnancy, i.e. during the period when the fetus does not yet have its own thyroid gland, and all embryogenesis is provided by the mother’s thyroid hormones.

The symptoms of hypothyroidism in its overt form are identical to those in the general population, simulating diseases of almost all body systems. On the other hand, subclinical hypothyroidism has virtually no clinical symptoms and is most often diagnosed by random TSH measurement, including during pregnancy.

Thus, hypothyroidism that develops for the first time or is insufficiently compensated during pregnancy can be associated with serious and irreversible complications for both the fetus and the pregnant woman herself.

Factors that provoke complications during pregnancy can be simple hypothermia and stress.

Features of symptoms in infants

In infants, hypothyroidism may appear at birth. This indicates a congenital form of the disease.

According to statistics, each of 5 thousand newborns suffers from it, and there are 2 times more girls with the pathology than boys.

During intrauterine development of the fetus, the maternal thyroid gland or replacement therapy should fully cover the need for the appropriate hormones. But when a child is born, his thyroid becomes unable to synthesize the required amount of biologically active substances, which is expressed in specific symptoms.

With congenital hypothyroidism, infants may experience:

• persistent jaundice;
• profuse swelling of the feet and hands, lips, face;
• dry skin;
• lethargy, weak and infrequent crying, weakened sucking reflex;
• skeletal muscle tone decreases;
• The child has big tongue, umbilical hernia, ;
• visualized;
• delay in closing the fontanel on the head;
• difficult and noisy nasal breathing;
• poor weight gain.

If hypothyroidism in infants is not detected in a timely manner, by the age of six months the child will be very significantly behind in physical and mental development, and the functioning of internal organs will begin to be disrupted.

Even if congenital hypothyroidism has a transient form, was detected in a timely manner and disappeared by two years, the child may have noticeable disproportions in body development for the rest of his life - wide hands on the arms, a wide bridge of the nose, elongation of the forehead, hypertelorism (increased spaces between paired organs on the body ).

For an experienced specialist, diagnosing congenital hypothyroidism is not difficult; usually such babies are large, weighing more than 4 kilograms, have swelling, and sometimes hydrocephalus (disproportionately large head). It is also important to pay attention to the fact that in some cases the symptoms may be hidden, leading to late diagnosis and delayed treatment.

Signs of hypothyroidism can manifest themselves in a slow metabolic process in the baby’s body, which is why he is too calm and apathetic.

Because of the serious consequences of hypothyroidism in newborns, modern conditions In maternity hospitals, screening is carried out to immediately identify a number of hereditary pathologies, including problems with thyroid function. Blood is taken by percutaneous puncture (usually from the heel) on days 4-5 after birth in full-term babies and on days 7-14 in premature babies. The interpretation takes into account the TSH level. When its value is less than 20 mIU/l, the child is considered healthy; at a level of 20-50 mIU/l, a re-examination is carried out, and at a level of more than 50 mIU/l, hypothyroidism is suspected.

Sometimes hypothyroidism in children can also be acquired, and the disease can start at any age. It manifests itself, first of all, as a delay in intellectual development, which parents need to pay close attention to.

Ber's symptom

Beer's symptom in hypothyroidism is manifested by severe thickening and keratinization of the epidermis on the elbows, knees, feet, and inner surfaces of the ankles. The skin with Beer syndrome becomes a dirty gray color.

All manifestations of hypothyroidism are quite common and can indicate a number of other diseases. However, in case of recurring symptoms and their complex, it is important to carry out a timely diagnosis so as not to start the process of globalization of the disease.