Thyroid disease is defined as a condition of malfunction of thyroid.
Hyperthyroidism is a condition in which the thyroid gland is over active
and produces too much thyroid hormones. Hypothyroidism is a condition
in which the thyroid gland is under active and produces very little
thyroid hormones.
C.1. Complications
1. Coronary heart disease and mortality
In the study to assess the risks of coronary heart disease (CHD) and
total mortality for adults with subclinical hypothyroidism of Individual
data on 55,287 participants with 542,494 person-years of follow-up
between 1972 and 2007 were supplied from 11 prospective cohorts in the
United States, Europe, Australia, Brazil, and Japan. The risk of CHD
events was examined in 25,977 participants from 7 cohorts with available
data. showed that subclinical hypothyroidism is associated with an
increased risk of CHD events and CHD mortality in those with higher TSH
levels, particularly in those with a TSH concentration of 10 mIU/L or
greater(19).
2. Recurrent pregnancy loss
Thyroid disturbances are common in women during their reproductive
years. Thyroid dysfunction interferes with human reproductive
physiology, reduces the likelihood of pregnancy and adversely affects
pregnancy outcome, thus becoming relevant in the algorithm of
reproductive dysfunction. According to the study by the MGM Medical
College, pregnant women with subclinical hypothyroidism or thyroid
antibodies have an increased risk of complications, especially
pre-eclampsia, perinatal mortality, and miscarriage. Universal screening
for thyroid hormone abnormalities is not routinely recommended at
present, but thyroid function must be examined in female with fetal loss
or menstrual disturbances. Practitioners providing health care for
women should be alert to thyroid disorders as an underlying etiology for
recurrent pregnancy loss(21).
3. Ovulatory dysfunction, adverse pregnancy, miscarriage rate, sperm
motility, decrease fertility and increased genetic malformation rate
Subclinical hypothyroidism may be associated with ovulatory dysfunction
and adverse pregnancy outcome. Thyroid autoimmunity increases the
miscarriage rate, and thyroxine treatment does not seem to protect.
Menstrual disturbances, frequent in thyrotoxicosis are restored
following treatment. In males, thyrotoxicosis has a significant but
reversible effect on sperm motility. Although radioactive Iodine (I) in
ablation doses may transiently affect the gonads, it does not decrease
fertility or increase genetic malformation rate in the offspring,
according to the study by the Pedieos IVF Center, Cyprus(21).
Other study indicated that pregnant women with subclinical
hypothyroidism or thyroid antibodies have an increased risk of
complications, especially pre-eclampsia, perinatal mortality, and
miscarriage(22)
4. Increased susceptibility to inflammatory diseases in the CNS of offspring
A deficiency in maternal thyroid hormones during gestation can influence
the outcome of a CNS inflammatory disease, such as EAE, in their
offspring. These data strongly support evaluating thyroid hormones in
pregnant women and treating hypothyroidism during pregnancy to prevent
increased susceptibility to inflammatory diseases in the CNS of
offspring, according to the study by the Universidad Andres Bello,
Ciencias Biologicas(23).
5. Auditory function
Although only a limited number of studies have directly investigated the
relationship between iodine deficiency and auditory function, most
studies point toward an association. However, evidence from good
randomised controlled trials is lacking. Inclusion of auditory outcomes
in iodine supplementation studies is therefore to be recommended,
especially for trials in pregnancy. Hearing deficit is an invisible
abnormality, but has major consequences for educational and social
skills if not detected, according to the study by the Wageningen
University, Wageningen(24).
6. Hearing loss
In the study to assess hearing and its determinants in a
population-based registry of young adult patients with CH, showed that
despite major improvements in prognosis, hearing loss remains a
significant problem, particularly in patients with severe CH. Parents
and primary care providers should be aware of this risk, as early
diagnosis and intervention could improve the long-term prognosis of
these patients(25).
7. Goiter
There is a report of IgG4 thyroiditis in a Graves’ disease patient with
large goiter developing hypothyroidism, according to the study by the
Kuma Hospital(25a)
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Sources
(a) http://www.ncbi.nlm.nih.gov/pubmed/17933284
(19) http://www.ncbi.nlm.nih.gov/pubmed/20858880
(20) http://www.ncbi.nlm.nih.gov/pubmed/23565424
(21) http://www.ncbi.nlm.nih.gov/pubmed/16794427
(22) http://www.ncbi.nlm.nih.gov/pubmed/23565424
(23) http://www.ncbi.nlm.nih.gov/pubmed/23777566
(24) http://www.ncbi.nlm.nih.gov/pubmed/23759468
(25) http://www.ncbi.nlm.nih.gov/pubmed/23780375
(25a) http://www.ncbi.nlm.nih.gov/pubmed/23750835
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