What are the acupressure points for hypothyroidism
Underactive thyroid (hypothyroidism): causes, symptoms, therapy
What is hypothyroidism?
Underactive thyroid (hypothyroidism) is one of the most common metabolic diseases. Women are more often affected than men. In the case of hypothyroidism, the thyroid produces fewer hormones than the body actually needs. This lack of hormones leads to a slowdown of all metabolic processes and thus also to a significant reduction in performance.
The thyroid gland (glandula thyreoidea) is a butterfly-shaped organ and is located below the larynx, at the front of the neck. The gland is responsible for the production of vital thyroid hormones, such as thyroxine (T4) and triiodothyronine (T3). Both hormones influence important functions in the body. Among other things, the cardiovascular system, metabolism and psyche. The thyroid gland receives the iodine it needs to produce hormones from food.
Symptoms of hypothyroidism
In most cases, hypothyroidism leads to poor performance, a lack of concentration and fatigue. The severity of these typical symptoms depends on the severity of the hormone deficiency. With only a slight hormone deficit, the symptoms are correspondingly mild, with severe hypothyroidism there are clear symptoms. Other possible symptoms are disorders of consciousness, the sense of direction and memory as well as an increased sensitivity to cold. In addition, there may be a slowing down of the reflexes and a tendency to muscle cramps.
An underactive thyroid often shows itself externally. This can lead to a swollen face with thick lips and an enlarged tongue. Swelling around the eye sockets and thus slit-like narrowed eyelids are also possible. The skin of those affected is often dry, rough, thickened and also cool. Yellow discoloration may occur due to the storage of the carotene pigment. Hypothyroidism triggers hair loss in some patients. In addition, the hair can appear shaggy and dull. The formation of a goiter (goiter) is also evident in some people affected. Hypothyroidism can also affect the voice: Sometimes it becomes rough or hoarse. The voice change is caused by the pressure of the enlarged thyroid gland on the nerves of the larynx.
An insidious, long-lasting course is typical for an underactive thyroid. At the beginning, the symptoms are rather mild, so the disease is usually diagnosed late. In older people, hypothyroidism usually manifests itself with only individual symptoms such as increased sensitivity to cold and reduced mental and physical performance. This is often confused with the usual age-related changes.
Other possible symptoms of hypothyroidism
In addition to the characteristic symptoms of hypothyroidism, those affected can also suffer from the following symptoms:
- Depressive mood
- Gaining weight without changing your eating habits
- Slow heartbeat (bradycardia), enlarged heart and low blood pressure
- Circulatory disorders with abnormal sensations ("pins and needles")
- Menstrual cycle disorders
- Decrease in libido, fertility and potency
- Possible changes in blood values: such as a decrease in the amount of hemoglobin and red blood cells. Often high cholesterol levels. This can lead to premature hardening of the arteries (arteriosclerosis).
- Shrinkage of the gastric mucosa (chronic atrophic gastritis) in hypothyroidism due to Hashimoto's thyroiditis
Symptoms of latent hypothyroidism
In contrast to the manifest hypothyroidism with a measurable deficiency of thyroid hormones and increased TSH levels, the otherwise typical symptoms of latent hypothyroidism occur only to a lesser extent or not at all. In the case of latent or “hidden” hypothyroidism, the concentration of thyroid hormones is not yet reduced, only the TSH value is increased.
Causes of hypothyroidism
An underactive thyroid can have different causes. The function of the thyroid gland or the production of the hormone TSH in the pituitary gland can be disturbed. Inadequate stimulation of the pituitary gland by the hypothalamus is also possible. The hypothalamus and pituitary gland control the production of thyroid hormones. The hypothalamus releases the hormone TRH and stimulates the pituitary gland to release the hormone TSH. It promotes the production of thyroid hormones.
Depending on the different backgrounds that an underactive thyroid can have, a distinction is made between several forms of the disease:
- Primary hypothyroidism
- Secondary hypothyroidism
- Tertiary hypothyroidism
It is the most common type of hypothyroidism. Primary hypothyroidism is triggered by the thyroid gland itself. The disease can be congenital or appear later in life.
One out of 3,500 newborns suffers from congenital hypothyroidism. The cause of this congenital form is either the lack of the thyroid gland (athyroidism), changes in the thyroid tissue with loss of function, a disruption in the formation of thyroid hormones or damage to the child's thyroid during pregnancy in the womb. This can be caused, for example, by severe iodine deficiency, radioiodine therapy or an underactive thyroid in the mother.
An underactive thyroid that has been acquired in the course of life can also have several causes. The disease very often develops as a result of an inflammation of the thyroid gland (thyroiditis). A common form of thyroid inflammation is so-called Hashimoto's thyroiditis. In this autoimmune disease, the body mistakenly sees its own thyroid as a foreign body and therefore produces antibodies against the tissue. Chronic thyroiditis gradually destroys this. The loss of originally functional thyroid tissue as a result of Hashimoto's thyroiditis is by far the most common cause of hypothyroidism. Women over the age of 40 are particularly affected.
After giving birth, around four percent of women suffer from postpartum thyroiditis. With this special form of thyroid inflammation, there is temporary hypothyroidism after birth. Usually this heals without any consequences.
Even after medical treatment or medical interventions on the thyroid gland - mostly due to an overactive thyroid gland - an underactive thyroid can occur. For example, irradiation with radioactive iodine or treatment with medication for hyperthyroidism (overactive thyroid) lead to such a lasting disruption of hormone production that the thyroid gland is underactive. An operation on the thyroid gland, for example in the case of goiter, can also trigger an underactive thyroid. But iodine deficiency is also often a decisive factor in the development of an underactive thyroid. If too little iodine is absorbed with food and there is a severe iodine deficiency, it is possible that hypothyroidism develops.
Secondary hypothyroidism is rare. The pituitary gland (pituitary gland) produces too little TSH hormone, which stimulates the thyroid to produce hormones. Possible reasons for this could be a tumor in the pituitary gland, irradiation of the pituitary gland or its surgical removal. The pituitary gland may also have been damaged by a traumatic brain injury.
Tertiary hypothyroidism is far less common than the secondary form of the disease. The hypothalamus produces too little of the hormone TRH. This controls thyroid hormone production by way of the pituitary gland.
Hypothyroidism - Diagnosis
The patient should describe his or her symptoms comprehensively to the attending physician, as well as the previous medical history. This medical history is followed by a physical examination. If an underactive thyroid is suspected, the doctor will, among other things, examine the texture of the skin and feel the anterior neck region in order to assess the size and consistency of the thyroid.
The blood test is crucial for the diagnosis. The concentration of thyroid hormones and the TSH value are particularly relevant. If the thyroid is underactive, the TSH concentration is usually increased. In the case of an inflammation of the thyroid, such as a disease of Hashimoto's thyroiditis, certain thyroid antibodies can often be detected.
Further examinations may often be necessary. Among other things, sonography. With the help of ultrasound, the size and structure of the thyroid gland can be assessed during this control. In some cases, the doctor also takes a small tissue sample from the thyroid gland (fine needle biopsy) for subsequent examination under the microscope. A scintigraphy can also be indicated. It is used to check the thyroid function by measuring the iodine accumulation in the thyroid. During this examination, a radioactively labeled substance is injected into the patient's vein. If the thyroid is underactive, it absorbs the marked substance little or not at all.
Every newborn is tested for hypothyroidism as part of the early detection examination. A few days after the birth, one to two drops of blood are taken from the baby's heel. Then the TSH value is determined.
After the diagnosis of hypothyroidism, patients usually receive the missing thyroid hormone in tablet form for life. The hormone deficiency can be compensated for. One speaks of replacement or substitution therapy. If the dosage is optimally adapted to the individual needs, neither quality of life nor life expectancy are restricted. The therapy of hypothyroidism is carried out with the artificial thyroid hormone levothyroxine (L-thyroxine, L-T4). It acts like the natural thyroid hormone thyroxine (T4) and is partially converted into the thyroid hormone T3 by the body. Patients take the tablets in the morning on an empty stomach.
Therapy starts with a low dose and is gradually increased, accompanied by regular blood tests, until the desired dose is reached. This medication creeping into the therapy is important, because if the thyroid hormone is administered too high or too quickly, life-threatening cardiac arrhythmias and angina pectoris attacks can occur. For the dosage of the final dose, the basal TSH value, which is supposed to normalize, and the subjective well-being are taken as a basis. This is usually followed by annual blood tests for control purposes; the intervals are shorter for newborns.
Latent hypothyroidism is usually treated with L-thyroxine. The dose is usually lower than for the manifest form of the disease. The aim here is to reduce the risks of early arteriosclerosis and infertility.
Hypothyroidism - Diet
Since the hormone tablets used to treat hypothyroidism are not compatible with all foods, there are a number of things that patients have to consider when it comes to diet. For example, calcium-rich drinks such as milk and certain fruit juices or foods made from dairy products block the absorption of L-thyroxine from the intestine and thus change the hormone level in the blood. The drug can also interact with other foods and beverages. Patients should seek advice on this from their doctor. - If the thyroid still has some residual function, it is important to take in sufficient iodine with food. This can prevent an enlargement of the thyroid gland, the so-called goiter. Foods particularly rich in iodine include sea fish such as salmon, cod and plaice, seafood and algae. The use of iodized table salt is also useful in preventing an underactive thyroid.
Homeopathy for hypothyroidism
Hypothyroidism (underactive thyroid) cannot be treated homoeopathically. The symptoms of the disease can often be alleviated with homeopathic medicines. The conventional medical treatment can thus be accompanied in a supportive manner. The following homeopathic remedies can reduce the symptoms in many cases (selection):
- Fucus vesiculosus: For hypothyroidism and goiter formation.
- Thyreoidinum: For water retention in the subcutaneous tissue (myxedema). Especially if the edema occurs on the hands and feet, as well as on the tongue or the mucous membrane of the throat. Patients then often have a hoarse voice.
- Graphites: For hypothyroidism with overweight and frequent freezing.
Acupuncture for hypothyroidism
If the hypothyroidism was caused, for example, by an autoimmune disease (such as Hashimoto's thyroiditis), acupuncture can often support conventional medical treatment. An experienced acupuncturist will adjust the therapy with the fine needles to the individual symptoms of the patient. There are usually ten appointments for acupuncture treatment. The aim is to have a balancing effect on the immune disorder, but also to alleviate the patient's specific complaints.
Hypothyroidism in the elderly
In older people, the symptoms of hypothyroidism are a little different than usual. Often only symptoms such as sensitivity to cold, poor performance or depression occur. The symptoms are then often attributed to other causes. Signs of old age, dementia or depression are often suspected. The actual disease of hypothyroidism therefore remains undetected for a long time. - In the treatment of hypothyroidism, older patients require a lower amount of L-thyroxine than younger ones, as the natural hormone levels change with age. People older than 60 years get a levothyroxine dose 30 percent lower than younger ones.
Hypothyroidism in babies
Babies with congenital hypothyroidism suffer from a sedentary lifestyle, weakened muscle reflexes and a reluctance to drink. Newborn hypothyroidism can also be indicated by constipation and prolonged neonatal jaundice. If left untreated, the disease leads to growth retardation, impaired intellectual development and disorders in language development. If this form of untreated hypothyroidism occurs, it is called cretinism. So that this does not happen in the first place, every newborn in this country is examined for a possible hypofunction of the thyroid gland. To do this, the TSH level in the blood is determined. Children with congenital hypothyroidism are given the missing thyroid hormone to take on a daily basis. If treatment begins in the newborn phase, the children develop mentally normally. If diagnosis or treatment occurs later, for example only at the age of three to six months, permanent mental damage can be expected.
Hypothyroidism in pregnant women
During pregnancy, it is important to have your doctor regularly check your hypothyroidism. Since the body then needs more thyroid hormones, expectant mothers with an underactive thyroid get an increased dose of L-thyroxine. In the worst case, failure to take the tablets can result in miscarriage or premature birth. Premature discontinuation of the drug can damage the unborn child's physical and mental development, because the child's thyroid gland does not begin to synthesize thyroxine until the twelfth week of pregnancy.
Hypothyroidism - ICD Code
In medicine, each illness is assigned its own ICD code. The abbreviation ICD stands for International Statistical Classification of Diseases and Related Health Problems. The classification system is recognized worldwide and is one of the most important for medical diagnoses. For example, an underactive thyroid “other hypothyroidism” is recorded under the ICD code “E03.0”. Entering this code often helps with research on the Internet.
Hypothyroidism - What does the health insurance company pay for and what do you have to pay for yourself?
Members of a statutory health insurance basically have the right to inpatient and outpatient care, to drugs and other services. As a rule, however, certain personal contributions (additional payments) are stipulated by law. These additional payments amount to 10 percent of the costs, but a maximum of 10 euros per additional payment.If the service costs less than 5 euros, the insured person must pay the actual price.
These limits also apply to pharmaceuticals. If the person concerned receives a particularly inexpensive preparation, there is no additional payment. The health insurances can determine fixed amounts that they reimburse if several preparations with the same active ingredient are available. Medicines, the price of which is 30 percent below this fixed amount, are reimbursed by the health insurance companies without additional payment.
In addition, there is a regulation that the statutory health insurance no longer has to reimburse the individual price of the respective drug for certain preparations, but only the fixed amount that has been set for a group of comparable preparations. If the prescribed medication is more expensive, the patient has to pay the additional price himself plus the statutory additional payment for the reimbursed portion of the costs.
Co-payments are also incurred in the event of a hospital stay. They amount to 10 euros per calendar day, whereby the additional payment only has to be made for a maximum of 28 days per year. Several hospital stays can be combined in one year, so that the maximum additional payment for inpatient treatment is 280 euros per calendar year.
In the case of home nursing, a one-time fee of ten euros is due for the prescription. In addition, a personal contribution of 10 percent per day is to be borne. The co-payment is limited to 28 calendar days per calendar year and is only charged for adults over 18 years of age. The upper limit of EUR 280 per calendar year also applies to home care. Co-payments for hospital stays count towards the cap on co-payment for home nursing.
If the costs for household help are covered by the health insurance, the insured must make an additional payment of 10 percent of the costs incurred. The limits are at least 5 and a maximum of 10 euros per calendar day. This co-payment obligation applies to the entire period in which domestic help is used.
In the case of aids, the insured must make an additional payment of 10 percent of the selling price, with an upper and lower limit of 10 and 5 euros per prescription.
The amount of co-payments for rehabilitation measures depends on the measure and the respective cost bearer.
The costs for pain therapy in a pain clinic are usually covered by any statutory health insurance company, as it is a contracted medical service. However, additional costs (such as additional payments for prescriptions) may arise privately.
The costs of a classic body acupuncture are covered by all statutory health insurances for chronic pain in the lumbar spine or knee osteoarthritis. It is assumed that the pain has existed for at least six months. In such cases, legally insured persons are entitled to up to ten acupuncture sessions per case of illness within a maximum of six weeks. A new treatment can take place no earlier than twelve months after completion of the last acupuncture treatment. The health insurance will only reimburse the costs if the treatment is carried out by a qualified doctor. Acupuncture from a naturopath is not accepted. The costs are then to be paid privately.
Hypothyroidism - What does the DFV do?
The outpatient supplementary health insurance DFV-AmbulantSchutz reimburses you for additional payments provided for by law for medicines, bandages, remedies and aids and travel costs as part of outpatient treatment. The DFV-AmbulantSchutz also offers you extended pension benefits and is also there to support you financially if a serious illness is diagnosed.
In the event of illness, with the additional hospital insurance DFV-KlinikSchutz Exklusiv, you do not wait longer than 5 days for an appointment with a specialist doctor.
You also benefit from head physician treatment, a single room, free choice of hospital and daily hospital allowance for an inpatient clinic stay. DFV-KlinikSchutz makes you a private patient in the hospital including international health insurance.
FAQ about hypothyroidism
What can you do if you have an underactive thyroid?
Those who suffer from an underactive thyroid gland usually have to take the missing thyroid hormone for life in order to balance their hormone levels. Patients receive the artificial thyroid hormone levothyroxine in tablet form. A balanced diet and plenty of exercise are also important. It is important to keep the body weight in the normal range or to lose weight. The most important goal, however, is a normalization of the thyroid values. If you are aiming for weight loss, this should only take place in the second step.
How dangerous is hypothyroidism?
With constant use of artificial thyroid hormones, patients can usually lead a completely normal life. Pregnancy with an underactive thyroid is also possible. However, if the disease is not treated for years, there is a risk of increased cholesterol levels, arteriosclerosis (hardening of the arteries) and infertility. If an underactive thyroid is not treated or treated too late in newborns, physical and mental development is restricted. These include deformities of the skeletal system, short stature, speech disorders, hearing loss and obesity.
How can you prevent an underactive thyroid?
It is not always possible to prevent an underactive thyroid. If the cause of hypothyroidism is, for example, Hashimoto's thyroiditis, an autoimmune disease, this cannot be influenced prophylactically. If, on the other hand, the hypofunction was triggered by iodine deficiency, you can pay attention to a diet rich in iodine in the future. It is best to only use iodized table salt and regularly eat sea fish such as salmon or cod, as well as algae or seafood.
Why is it difficult to get pregnant with an underactive thyroid?
Thyroid hormones influence the metabolism and thus also the gonads and sexual function. If a woman has an underactive thyroid gland (hypothyroidism), this can interfere with egg maturation and the menstrual cycle. Even a latent hypothyroidism with an increased TSH value is enough to make pregnancy more difficult. However, the lack of thyroid hormones can be compensated for by taking hormone tablets daily. With adequate substitution therapy, this also enables women with hypothyroidism to conceive.
How often does an underactive thyroid occur?
In Germany, around one percent of the population suffers from an underactive thyroid (hypothyroidism). One in 3,500 newborns is born with what is known as primary congenital hypothyroidism. Many people also suffer from latent hypothyroidism. Although the blood levels of the thyroid hormones are normal, the TSH level is already elevated. Latent hypothyroidism can later become manifest hypothyroidism.
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- German Society for Endocrinology, www.endokrinlogie.net (accessed October 13, 2020)
- German Thyroid Center, www.deutsches-schilddruesenzentrum.de (accessed October 15, 2020)
- Professional Association of German Internists, www.internisten-im-netz.de (accessed October 13, 2020)
- S2k guideline "Congenital primary hypothyroidism: diagnosis, therapy and follow-up", German Society for Child and Adolescent Medicine and German Society for Endocrinology (February 2011), www.awmf.org (accessed October 12, 2020)
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