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[Up] [Hypothyroidism classification] [Risk factors] [Clinical features] [End organ impact] [Associated illnesses] [Diagnosis] [Treatment] [Dose titration] [Drug interactions] [Monitoring & follow up] [Myxedema coma]

 

Hypothyroidism can affect body systems and organs

 

                                                                                              

             Heart may be enlarged                        Increased Diastolic blood pressure                                          Anemia

 

                                                                                                     

         Weak, stiff, aching muscles                          Dry skin, brittle nails                                            Impaired linear growth .

 

                                                                                             

  Decreased. intellectual functions                  Pleural effusion, sleep apnea                             Decreased renal filtration

 

                                                                                            

              Constipation                                Decreased fertility                     Increased eye ball pressure

 

Hypothyroidism can affect all systems of the body, if not treated.

 

Cardiovascular system
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Cardiac output is reduced but peripheral vascular resistance is increased. 

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Diastolic blood pressure may be increased and pulse pressure decreased.

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Heart may be enlarged and pericardial effusion may occur.

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Sinus bradycardia, low amplitude 'p' wave ST segment alterations may be obvious on the ECG

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Angina pectoris can occur rarely

 

 Central Nervous system

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Deficiency in fetal /neonatal life leads to maldevelopment of CNS which is irreversible

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All intellectual functions are decreased. 

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Lethargy, somnolence prevail. 

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Headaches are frequent

 

 Skeletal system

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Impaired linear growth occurs.

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Joint pain and stiffness

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In early life if hypothyroidism occurs epiphyseal dysgenesis is known to occur

 

 Muscular system

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Stiffness and aching of muscles

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Slow muscle-stretch reflexes 

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Muscle enlargement, or atrophy

 

 Gastrointestinal system

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Appetite is decreased

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Gaseous distension of abdomen

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Constipation

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Rarely ascites is present

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Achlorhydria and pernicious anemia may be occasionally present

 

 Renal system

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Decrease in GFR (Kidney Filtration Rate)

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Hyponatraemia

 

Reproductive system

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Sexual development may be arrested or it may be

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Decreased fertility or recurrent abortions

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In woman, decreased libido and anovulation are known to occur

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Menorrhagia, amenorrhea

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In man there is decreased libido or impotence and/ or oligospermia.

 

 Skin

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Myxedemotus appearance (thickened features and puffiness) due to accumulation of mucopoly- saccharides on dermis and other tissues

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Non-pitting edema, localized-around the eyes, on legs / Generalized.

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Enlarged tongue 

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Dry, coarse icthyotic skin 

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Hair-dry and brittle 

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Loss of scalp hair and /or lateral eyebrow hair 

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Nails-brittle-break easily and grow slowly 

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In central hypothyroidism these changes are not seen. 

 

 Haemopoetic system

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Microcytic /macrocytic anaemia can occur 

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Capillary fragility is seen 

 

 Pituitary and adrenal 

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Longstanding hypothyroidism causes increase in size of the thyroid gland Hyperprolactinaemia can be present 

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Increased turnover of cortisol 

 

 Respiratory system

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Pleural effusion may occur in hypothyroidism, 

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Obstructive sleep apnea is seen commonly

 

 Ocular System

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Increased intraocular pressure (pressure of eye balls)

 

 Metabolic system

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Low metabolic rate

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Increased lipids cholesterol, LDL cholesterol, and triglycerides

 

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