Thursday, 28 November 2013

Thyroid disease: Hypothyroidism – The Risk factors

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.
B.2 Risk factors
1. Genetic and environmental factors and family history
Genetic and environmental factors are involved in the pathogenesis of autoimmune thyroid disease (AITD). Family members of patients with AITD are at increased risk for AITD, but not all will develop overt hypothyroidism or hyperthyroidism, according to the study by the Academic Medical Center, Netherlands(11)
2. Smoking
smoking is a powerful risk factor for thyroid disease, especially in populations with a high smoking frequency, according to the study by the Aarhus University Hospital(12). Other study indicated that smoking reduced the risk of hypothyroidism and increased the risk of hyperthyroidism(13).
3. Age
Hypothyroidism is associated to increased age. In the study to evaluate the ability of the aged rat pituitary to increase TSH secretion in response to major decreases in serum thyroid hormones, hypothyroidism was induced by methimazole in young and old, male and female, Dutch-Miranda and Wistar rats, showed that the ability of the pituitary thyrotrophs to increase hormonal secretion in response to decreased levels of thyroid hormones is impaired in the old rat, even when the thyroid hormone levels are dramatically reduced(14).
4. Autoimmune disorders, thyroid injury, post partum state, non-thyroidal illness, or medications
According to the study by the Universitätsspital Basel, in the study of Hypothyroidism suggested that s
earch for hypothyroidism should therefore focus on patients with symptoms and signs and/or those presenting risk factors for development of hypothyroidism (e.g., autoimmune disorders, thyroid injury, post partum state). Because of the lack of specificity of sings and symptoms of this frequent disorder the diagnosis is based on measurement of TSH or TSH and fT4 in case of conditions that may affect TSH values such as non-thyroidal illness, or medications(15).
5. Radiation
In the study to investigate the possible histopathological effects of pulse modulated Radiofrequency (RF) fields on the thyroid gland using light microscopy, electron microscopy and immunohistochemical methods, indicated that whole body exposure to pulse-modulated RF radiation that is similar to that emitted by global system for mobile communications (GSM) mobile phones can cause pathological changes in the thyroid gland by altering the gland structure and enhancing caspase-dependent pathways of apoptosis(16).
6. Post preganacy
In the study of the spontaneous occurrence of, and recovery from primary hypothyroidism were observed after delivery in 6 women with autoimmune thyroiditis, showed that diffuse goiter was noticed 1-3 months after delivery. The blood thyroid hormone level was found to be lowest at 3-6 months post-partum, with a thyroxine iodine value of 1.0 +/- 0.6 mug/dl (mean +/- SD) (normal 3.0-7.2), triiodithyronine value of 77 +/- 11 ng/dl (normal 90-190) and T3 resin sponge uptake of 21 +/- 2.8% (normal 24-37)(17).
7. Partial thyroidectomy
is associated to increased risk of hypothyroidism, but according to study of one hundred and twenty-two patients reviewed 1-7 years after partial thyroidectomy for thyrotoxicosis by two surgeons who had left thyroid remnants of different size, there was no significant difference in the prevalence of hypothyroidism or in the serum levels of thyroxine, tri-iodothyronine or thyroid-stimulating hormone between the two groups of patients. The overall prevalence of hypothyroidism was 16 per cent(18).
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