Is acquired hypothyroidism hereditary?

Many people often encounter the problem of hypothyroidism in life. In fact, hypothyroidism belongs to low hyperthyroidism ability. For this kind of functional decline, it is best to cooperate with the relevant pathological cause diagnosis and pathological examination to know whether this disease is hereditary. In addition, it is necessary to look at the functional state of the disease, because it is very likely related to insufficient and uneven secretion of thyroid hormones.

Causes and Diagnosis/Hypothyroidism

Hashimoto's thyroiditis (30%):

It is the most common cause of hypothyroidism. The thyroid gland often swells, and as the functional area of ​​the thyroid gland is gradually destroyed, its function declines often only after many years, as abnormalities in thyroid enzymes prevent the thyroid gland from synthesizing or secreting sufficient amounts of thyroid hormone. Other rare disorders result from either insufficient secretion of thyrotropin-releasing hormone (TRH) from the hypothalamus or insufficient secretion of thyroid-stimulating hormone (TSH) from the pituitary gland, which in turn fails to stimulate the thyroid gland to produce or secrete sufficient thyroid hormone. .

Chronic iodine deficiency in food (40%):

It can cause an enlarged thyroid gland and an underactive thyroid gland (goiter-induced hypothyroidism). This is the most common cause of hypothyroidism in many less developed countries. Since the introduction of iodine into table salt and the use of iodine-containing disinfectants to disinfect cow udders, this type of hypothyroidism has disappeared in the United States. Certain rare hereditary disorders cause abnormalities in thyroid enzymes that prevent the thyroid gland from making or producing adequate amounts of thyroid hormone. Other rare disorders result from either insufficient secretion of thyrotropin-releasing hormone (TRH) from the hypothalamus or insufficient secretion of thyroid-stimulating hormone (TSH) from the pituitary gland, which in turn fails to stimulate the thyroid gland to produce or secrete sufficient thyroid hormone.

examine

1. The basal metabolic rate is lower than normal, serum TT4 <40ng/ml, serum TT3 <0.6ng/ml, and the thyroid 131I uptake rate is low (3 hours <10%, 24 hours <15%). 2. Serum TSH value (1) Primary hypothyroidism: In subclinical hypothyroidism, the serum TT4 and TT3 values ​​may be normal, while the serum TSH is elevated (>10mu/l). After the TRH stimulant test, the serum TSH level reacts higher than that of normal people. (2) Pituitary hypothyroidism: The serum TSH level is low and there is no response to the TRH stimulation test. After the application of TSH, the serum TT4 level increases. (3) Hypothalamic hypothyroidism: serum TSH level is low or normal, and the response to TRH stimulation test is good. 3. X-ray: enlarged heart, bradycardia, pericardial effusion, skull plain film shows enlarged sella turcica, electrocardiogram shows low voltage, prolonged Q-T interval, ST-T abnormality, echocardiogram shows myocardial thickening, pericardial effusion, 4. Blood lipids, increased creatine phosphokinase activity, flat glucose tolerance curve, anemia.

Differential diagnosis

1. Medical history and symptoms:

Hypothyroidism

The onset is slow, with early symptoms including weakness, fatigue, weight gain, and inability to tolerate cold. This is followed by drowsiness, slow reaction, low and rough voice, facial swelling, dry skin, hair loss, abdominal distension, constipation, sallow complexion, decreased libido, infertility/infertility, menstrual disorders, etc.

2. Physical examination findings:

Rough skin, varying degrees of myxedema all over the body, especially in the lower limbs, anemic appearance, enlarged tongue, hoarse voice, partial thyroid enlargement, slow heart rate, enlarged heart, pericardial effusion and even pleural and abdominal effusion in severe cases.