COMPLICATIONS OF HYPOTHYROIDISM

COMPLICATIONS OF HYPOTHYROIDISM
  •  Heart disease and stroke
  •  Hypothyroidism can lead to insulin resistance
  •  The risks of untreated hypothyroidism
  •  The myxedema coma

 

● Heart disease and stroke
Thyroid hormone plays a role in regulating the synthesis, metabolism, and mobilization of lipids.
In patients with overt hypothyroidism there is an increase in serum total cholesterol, low-density-lipoprotein (LDL – the "bad" cholesterol) cholesterol, apolipoprotein B, and lipoprotein(a); some have high serum concentrations of triglycerides (Click Here).

The serum HDL cholesterol concentrations are usually respected in overt hypothyroidism. However, high or low values have been reported in different series.

It is of prime importance to treat the underactive thyroid to lower the cholesterol level, especially LDL, which causes buildup of fat deposits on the wall of arteries, in order to reduce the risk of heart disease and stroke. Studies have shown that early detection and treatment of hypothyroidism is important, as it will also help to reduce the cholesterol levels by nearly 20%.
According to the study at Boston University Medical Center mentioned above in inset: "Most lipid abnormalities in patients with over hypothyroidism will resolve with thyroid hormone replacement therapy. However, clinical trials to date have not shown a beneficial effect of thyroid hormone treatment on serum lipid levels in patients with subclinical hypothyroidism". Therefore, this study reveals that in subclinical hypothyroidism, if thyroid therapy has not normalized the serum lipid concentrations, specific lipid-lowering therapy will be added (Click Here).

In conclusion, all patients with hypercholesterolemia (and/or hypertriglyceridemia) should be screened for hypothyroidism (and other secondary causes of dyslipidemia) before being given specific lipid-lowering drug therapy.

In elderly women
According to research published in Annals of Internal Medicine, a slightly underactive thyroid is a major heart disease risk for older women. In another study, a Dutch study, which is being called "The Rotterdam Study", it was found that older women with subclinical hypothyroidism were almost twice as likely as women without this condition to have blockage in the aorta. They were also twice as likely to have had heart attacks (Click Here).
This study concluded that the common subclinical hypothyroidism condition, which frequently has no obvious symptoms for patients, and no observable symptoms for doctors, is a strong risk factor for both hardening of the arteries and heart attacks in older women.
The Rotterdam Study's finding is a strong indication that screening programs to evaluate even slight hypothyroidism in older women could help patient cardiovascular illness.

 

● Hypothyroidism can also lead to Insulin Resistance
Thyroid hormones have a large impact on glucose metabolism. Hypothyroidism has been linked to decreased insulin sensitivity leading to insulin resistance. Insulin resistance occurs when the body does not respond as well to the insulin that the pancreas produces. Insulin resistance is a condition that increases the risk of developing type II diabetes. Low thyroid function may also increase the risk of developing certain diabetes-related complications.
Although seldom happening, hypothyroid patients can experience hypoglycemia (Click Here).

● Risks of untreated hypothyroidism
People with untreated hypothyroidism are at increased risk for:

  • Infection
  • Infertility
  • Miscarriage
  • Giving birth to a baby with birth defects
  • Heart failure: hypothyroidism can affect the heart muscle's contraction and increase the risk of heart failure in people with heart disease
  • Iron deficiency anemia
  • Depression (common in hypothyroidism) can be severe. Hypothyroidism should be considered as a possible cause of chronic depression, particularly in older women. Untreated hypothyroidism can, over time, cause mental and behavioral impairment and, eventually, even dementia

● Myxedema coma
It is a rare, life-threatening complication of untreated hypothyroidism that occurs when the body's level of thyroid hormones becomes very low. It may develop in untreated patients subjected to severe stress, such as infection, surgery, or extreme cold. Certain drugs (such as sedatives, painkillers, narcotic, amiodarone and lithium) may increase the risk. Symptoms include a severe drop in body temperature (hypothermia), delirium, reduction lung function, slow heart rate, constipation, urine retention, fluid buildup, stupor, and finally coma. Emergency treatment is required. Mortality rates are high (30 -60%) with the highest risk in older patients and those with persistent hypothermia or heart problems.
 

norkurld@zahav.net.il
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