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Acquired hypothyroidism
Last reviewed: 04.07.2025
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Primary acquired hypothyroidism develops as a result of endemic iodine deficiency, autoimmune thyroiditis, thyroid surgery, inflammatory and tumor diseases of the thyroid gland, uncontrolled therapy with antithyroid drugs for thyrotoxicosis.
Secondary acquired hypothyroidism can be a consequence of various damages to the pituitary gland due to birth trauma, inflammatory and traumatic brain damage, surgical and radiation hypophysectomy.
[ Symptoms of acquired hypothyroidism
Clinical manifestations depend on the child's age at the onset of the disease and the degree of dysfunction. The older the child, the less hypothyroidism affects growth and intellectual development. However, dry skin, constipation, bradycardia, decreased intellectual activity, slowing down or cessation of growth require examination of the child with mandatory determination of the content of T3, T4 and TSH in the blood serum . A constant symptom of severe hypothyroidism is a peculiar mucous edema of the skin, most often localized in the forehead, eyelids, lips, cheeks. Due to eyelid edema, the eye slit becomes narrow, facial features are smoothed out, facial expressions become scanty. Due to water retention in the body, body weight increases.
Diagnosis of acquired hypothyroidism
The diagnosis is established by determining reduced levels of thyroxine and triiodothyronine in the blood serum. The TSH level is elevated in primary hypothyroidism and decreased in cerebral hypothyroidism. Hypercholesterolemia, bradycardia, and delayed bone age according to X-ray of the wrist joints are of auxiliary importance in the diagnosis.
Differential diagnosis
Differential diagnosis is carried out with all diseases accompanied by growth retardation.
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Treatment of acquired hypothyroidism
Treatment of acquired hypothyroidism (regardless of the cause) is carried out with sodium levothyroxine. The initial dose of the drug is 25 mcg per day, the drug is taken once a day in the morning on an empty stomach. Subsequently, the dose is increased weekly by 25 mcg to the maximum tolerated under the control of the hormone content in the blood serum. On average, the daily dose ranges from 50 to 150 mcg, depending on the need.
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Prognosis of acquired hypothyroidism
The prognosis for mild acquired forms of hypothyroidism that manifest in preschool and school age is quite favorable. Timely diagnosis and adequate replacement therapy eliminate the clinical symptoms of the disease and determine normal indicators of physical development.
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