Treatment of congenital hypothyroidism

The treatment plan for congenital hypothyroidism is developed from the moment of the final diagnosis. Therapy depends on the form of the disease and its symptoms, the patient's age, and the presence of concomitant pathologies.

Treatment consists of the following main stages:

1. Etiotropic therapy – at this stage, all causes and factors that provoke improper functioning of the thyroid gland are eliminated. Treatment of congenital hypothyroidism is aimed at stopping inflammatory processes, eliminating existing pathologies of the pituitary gland or hypothalamus. If the painful condition is associated with iodine deficiency in the body, then the patient is prescribed special iodine-based drugs.
2. Replacement therapy is the use of synthetic analogues of natural thyroid hormones. The duration of treatment with hormonal drugs depends on the type and stage of congenital pathology. In particularly severe cases, drug therapy may be lifelong.
3. Symptomatic therapy – aimed at improving the patient’s quality of life and minimizing the symptoms of endocrine disorders. Treatment often consists of taking the following medications:
   • Cardioprotectors – normalize heart rhythm, blood pressure and the functioning of the cardiovascular system.
   • Neuroprotectors and nootropics – normalize metabolic processes in the central nervous system and brain.
   • Cardiac glycosides are indicated for signs of heart failure.
   • Multivitamin complexes improve the functioning of all organs, systems and overall well-being.

All medications are prescribed by the attending physician, selecting the dosage and duration of therapy individually for each patient.

4. Diet is a mandatory component of hypothyroidism treatment. The main principle of nutrition is to prohibit foods that contain cholesterol and saturated fatty acids. It is necessary to reduce fast carbohydrates to a minimum, as well as hard-to-digest foods and those that increase secretion.

• Allowed products: meat and fish, cereals, dairy and plant products, dried fruits.
• Prohibited foods: fried, fatty, spicy, smoked, marinated and pickled foods, sauces, sweets and foods with high sugar content, alcohol, baked goods made from corn and wheat flour.

During the diet, special emphasis should be placed on fresh vegetables and fruits. It is also recommended to have at least one fasting day per week.

Medicines

Drug therapy is a mandatory component of the treatment of congenital hypothyroidism. The endocrinologist selects medications individually for each patient. The basis of treatment is hormone replacement therapy. The following drugs are most often prescribed for its implementation:

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Levothyroxine sodium

Synthetic levorotatory hormone of the thyroid gland. Enhances protein synthesis, stimulates growth and development of the body, increases tissue oxygen demand, stimulates metabolic reactions among proteins, fats and carbohydrates.

The drug increases the performance of the cardiovascular system and the central nervous system. Increased doses inhibit the production of thyrotropin-releasing hormone of the hypothalamus and thyroid-stimulating hormone of the pituitary gland. It is characterized by slow absorption, so the therapeutic effect develops within 7-12 days.

• Indications for use: primary and secondary hypothyroidism, complex therapy of diffuse enlargement of the thyroid gland and enhancement of its functions, euthyroid hyperplasia. Prevention of relapses of decreased organ functions after surgical treatment of nodular and malignant neoplasms. A sharp decline in mental and physical abilities, cretinism. The drug can be used for a differential diagnostic test in case of suppression of thyroid functions.
• Method of administration: the dosage is selected individually for each patient and depends on the indications. Therapy begins with small doses of 12-15 mg per day. The average daily dosage is 25-200 mg, the frequency of administration is 1 time per day before meals. Maintenance dosage is 25-200 mg per day. During the treatment period, it is not recommended to take antidepressants and anticoagulants, since Levothyroxine enhances their effect.
• Side effects: worsening of the symptoms of the underlying disease, signs of ischemic heart disease, diabetic disorders, adrenal insufficiency. Nausea, sleep disturbances, increased sweating, weakness and increased heart rate are also possible.
• Contraindications: acute myocardial infarction, Addison's disease in the acute stage, heart rhythm disturbances, increased thyroid function. The drug is prescribed with special caution in cases of ischemic heart disease, atherosclerosis, arterial hypertension, and circulatory failure.

Levothyroxine sodium is available as tablets for oral administration.

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L-thyroxine

A medicinal product with the active substance levothyroxine. Its action is similar to the activity of endogenous human thyroid hormones. Regulates the processes of growth and development of the body, affects metabolism and oxidative reactions. Stimulates the central nervous system.

The therapeutic effect on hypothyroidism is observed on the 3rd-5th day of therapy. With continuous treatment for 3-6 months, diffuse goiter significantly decreases or completely disappears, and hormone production is normalized.

• Indications for use: replacement therapy for hypothyroidism of various etiologies, after thyroid surgery and a course of treatment with radioactive iodine. Prescribed for myxedema, cretinism, excess body weight with signs of dysfunction of the gland, as well as for cerebro-pituitary diseases. Prevents relapses of nodular goiter after resection. Also used in the complex therapy of autoimmune Hashimoto's thyroiditis and Graves' disease. Effective in the treatment of hormone-dependent highly differentiated malignant tumors of the gland, follicular and papillary carcinomas.
• Method of administration: the drug is taken once a day, in the morning 30 minutes before meals. The daily dosage is calculated by the attending physician, individually for each patient. In the first days of treatment, 25-100 mg is used, and then the dose is increased every 2-3 weeks by 25-50 mg until the desired therapeutic effect of maintenance therapy is achieved.
• Side effects: appetite changes and weight gain, hair loss, kidney dysfunction. Deterioration of visual acuity, tachycardia, arrhythmia, sleep and wakefulness disorders, tremor of the extremities. In rare cases, allergic dermatitis, diarrhea, vomiting are observed. Treatment is symptomatic with mandatory dosage adjustment.
• Contraindications: individual intolerance to the components of the drug, thyrotoxicosis of any etiology, cardiac arrhythmia, ischemia, circulatory disorders, severe forms of hypertension and heart failure. Patients over 65 years old, Addison's disease, adrenal insufficiency. The drug is allowed during pregnancy and lactation.
• Overdose: signs of thyrotoxicosis, and in particularly severe cases, thyrotoxic crisis. Cardiovascular disorders, tremors of the extremities, increased irritability. Treatment consists of discontinuing the drug.

L-thyroxine is available in the form of tablets of 25, 50 and 100 mg in blisters of 50 capsules each.

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Euthyrox

A synthetic analogue of the hormone thyroxine. Contains the active component - sodium salt of the levorotatory isomer of thyroxine. The pharmacological effect of the drug depends on its dosage:

• Low doses stimulate protein and lipid metabolism.
• The average ones enhance the synthesis of proteins and nucleic acids, regulate growth processes, improve tissue respiration. Increase the functional activity of the cardiovascular and central nervous systems.
• High doses reduce the synthesis of releasing factor in the hypothalamus, which helps to reduce the concentration of thyroid-stimulating hormone in the pituitary gland.

A pronounced therapeutic effect develops within 1-2 weeks after the start of treatment. In case of pathological decrease in the level of thyroid hormones, the effect of the drug develops faster.

• Indications for use: primary and secondary hypothyroidism, euthyroid goiter, replacement therapy after thyroid surgery. Prevention of relapses after complete or partial removal of the gland. Complex therapy of diffuse toxic goiter. Diagnostic tool for thyroid suppression test.
• Method of application: the dosage and duration of treatment are determined by the attending physician, individually for each patient. For hypothyroidism in patients under 55 years of age and with normal cardiovascular function, 75-150 mg per day is prescribed. For patients over 55 years of age with impaired cardiovascular function, the initial dose is 25 mg, then the dose is increased by 25 mg every 2 months until a normal TSH level is achieved.
• Side effects: allergic reactions due to intolerance to the components of the medication.
• Contraindications: hypersensitivity to active substances, acute myocardial infarction and myocarditis, adrenal insufficiency. It is prescribed with caution to patients with diabetes mellitus, cardiovascular dysfunction and malabsorption syndrome. Use of the drug during pregnancy and lactation is permitted.
• Overdose: signs of thyrotoxicosis, tachycardia, heart pain, tremor of the extremities, sleep and wakefulness disorders, increased irritability and anxiety. Loss of appetite, sweating, bowel disorders are also possible. There is no specific antidote, treatment is symptomatic with mandatory dosage adjustment.

Euthyrox is available in tablet form with 25, 50, 75, 100, 125 and 150 mg of active substance. One blister contains 25 capsules.

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Tyro-4

A drug that replenishes the deficiency of thyroid hormones. It exhibits a pharmacological thyroid action.

• Indications for use: hypothyroidism, autoimmune thyroiditis, euthyroid hyperplasia of the gland. Prevention of relapses of the disease after surgical treatment of nodular and malignant neoplasms. The dosage is selected by the attending physician for each patient individually.
• Contraindications: ischemic heart disease, myocarditis, myocardial infarction, adrenal insufficiency, hyperthyroidism, severe arrhythmia, severe atherosclerosis, arterial hypertension, heart failure, cardiopathy.
• Side effects: hyperthyroidism, insomnia, increased sweating and weakness, increased heart rate, arrhythmia, angina. Also possible are stool disorders, vomiting attacks, weight changes, hyperglycemia, exacerbation of Addison's disease. Treatment is symptomatic with dose adjustment or drug withdrawal.

Thyro-4 is available as tablets for oral use.

Thyroidin

Hormonal medicine from dried defatted thyroid glands of slaughter cattle. It has biological activity of organ hormones, contains from 0.17 to 0.23% iodine. Small doses of the medicine enhance protein synthesis and activity of the pituitary gland. Increased dosage slows down the thyroid-stimulating activity of the pituitary gland and hormone synthesis.

• Indications for use: primary hypothyroidism, myxedema, cretinism, cerebro-pituitary diseases, obesity with decreased organ function, endemic and sporadic goiter, oncological lesions of the gland.
• Method of application: adult patients are prescribed 50-200 mg per day with constant dosage adjustment to achieve normalization of heart rhythm, metabolic processes and blood cholesterol levels. The dosage for children is calculated by the attending physician, individually for each child. The therapeutic effect manifests itself 2-3 days after the start of taking the drug. A persistent therapeutic effect is noted after 3-4 weeks.
• Side effects: in case of overdose, signs of thyrotoxicosis, angina pectoris, allergic reactions, and worsening of diabetes mellitus appear.
• Contraindications: thyrotoxicosis, diabetes mellitus, general exhaustion of the body, acute coronary insufficiency, Addison's disease.

Thyroidin is available in two forms: powder and enteric-coated tablets.

Thyroid disorders negatively affect the functional capabilities of the brain and its cognitive activity. For this reason, medication therapy includes drugs to improve metabolism in the brain.

Piracetam

Enhances dopamine synthesis in the brain and increases norepinephrine levels. Positively affects metabolic processes and blood circulation. Stimulates oxidation-reduction reactions, increases energy potential.

• Indications for use: cerebral atherosclerosis, vascular parkinsonism, chronic cerebrovascular insufficiency, memory, attention and speech disorders. Dizziness, cerebral circulatory disorders, brain injuries and intoxications. CNS diseases, pathologies with decreased intellectual and mnestic functions.
• Method of administration: for parenteral intravenous administration, the initial dose is 10 g, in severe conditions - up to 2 g per day with a gradual reduction in dosage after improvement of the condition. For oral administration, the initial dose is 800 mg, divided into three doses. The course of treatment is from 3 weeks to 6 months.
• Side effects: increased irritability, mental agitation, decreased concentration. Increased anxiety, sleep disorders, dizziness and headaches, nausea, vomiting and bowel disorders. Convulsions, tremors of the extremities, increased libido are also possible. Side effects develop at a dosage higher than 5 g per day.
• Contraindications: acute renal failure, diabetes, allergic reactions to drug components, patients under 1 year of age.
• Overdose: increased irritability, sleep disturbances, tremors of the extremities, exacerbation of heart failure.

Piracetam increases the effect of thyroid hormones, neuroleptics, psychostimulants and indirect anticoagulants. It is available in capsules of 400 mg of active ingredient each, in the form of tablets with an enteric coating, and also as a solution in ampoules.

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Aminalon

Gamma-aminobutyric acid (GABA) is a biogenic amine that is found in the central nervous system and is involved in metabolic and neurotransmitter processes in the brain. It restores metabolic processes, improves glucose utilization, activates energy processes, and improves blood supply. It removes toxic metabolic products and has a psychostimulating effect, restoring speech and movement after serious cerebrovascular accidents.

• Indications for use: cerebrovascular accidents, craniocerebral and birth injuries, atherosclerosis of cerebral arteries, vascular diseases, cerebral palsy. Mental retardation with decreased mental activity, motion sickness symptom complex, alcoholic encephalopathy and polyneuritis.

• Method of application: the dosage and duration of treatment are determined by the attending physician, individually for each patient. As a rule, patients are prescribed 500 mg 2 times a day with a gradual increase in the dose. Therapy lasts from 2 weeks to 4 months.

• Side effects: dyspeptic symptoms, sleep and wakefulness disorders, blood pressure surges, feeling of heat. The drug is contraindicated in case of intolerance to its components.

Aminolone is available in tablet form, 6 and 12 tablets in a blister pack.

Pyriditol

Affects metabolic processes in the central nervous system, accelerates the penetration of glucose through the blood-brain barrier. Reduces lactic acid levels and improves the supply of brain tissue with amino acids. Increases the resistance of brain tissue to insufficient oxygen supply.

• Indications for use: increased weakness, neurosis-like and adynamic conditions, traumatic and vascular diseases of the brain. Residual effects after neuroinfections, injuries and cerebrovascular accidents. Complex therapy of depressive conditions. Mental retardation, cretinism, oligophrenia. Alcohol withdrawal, asthenic conditions.
• Method of administration: orally 2-3 times a day after meals. The daily dose for adults is 100-300 mg, for children 50-100 mg. Duration of treatment is from 1 to 8 months, repeated courses are carried out after 1-6 months.
• Side effects: headaches and dizziness, insomnia, nausea, irritability. The drug is contraindicated in case of hypersensitivity to its components, severe psychomotor agitation, epilepsy, increased convulsive activity.

Pyriditol is available in two forms: enteric-coated tablets of 50 and 100 mg, dragees of 100 mg, and syrup in bottles (every 5 ml of the drug is 100 mg of the active ingredient).

Mexidol

Inhibitor of free radical processes, increases tissue resistance to oxygen deficiency. Has a wide range of biological activity, is effective in hypoxia of various etiologies. Mexidol increases the body's resistance to oxygen-dependent conditions, improves memory, reduces the toxic and damaging effects of alcohol.

• Indications for use: acute cerebrovascular accidents, discirculatory encephalopathy, vegetative-vascular dystonia, atherosclerotic disorders. Withdrawal syndrome in alcoholism, drug addiction and other conditions with severe tissue hypoxia.
• Method of administration: intramuscularly or intravenously, the dosage is determined by the attending physician for each patient individually.
• Side effects: nausea and dry mouth. The drug is contraindicated in case of intolerance to its components, severe renal and hepatic dysfunction, allergic reactions to pyridoxine.

Mexidol is available as a 5% solution in 2 ml ampoules.

Cerebrolysin

Protein-free hydrolysate of brain matter. The preparation contains 85% amino acids and 15% low-molecular peptides. Improves metabolic processes in brain tissue. Cerebrolysin penetrates the blood-brain barrier, regulates intracellular metabolism and improves the transmission of nerve excitation. Increases the survival of brain cells in cases of insufficient oxygen supply to tissues and the action of other damaging factors.

• Indications for use: pathological conditions with dysfunction of the central nervous system, cerebrovascular accidents, brain surgery, mental retardation, psychiatric illnesses.
• The method of administration and dosage depend on the indications for use of the drug, therefore they are determined and regulated by the attending physician.
• Side effects: feeling of heat, change in body temperature. Treatment is symptomatic.
• Contraindications: intolerance to the components of the drug, pregnancy and lactation, allergic rashes, severe renal dysfunction. The drug is not used with amino acid solution.

Cerebrolysin is available in ampoules of 1 and 5 ml of 5% solution.

Thyroid dysfunctions lead to a number of complications, including disorders of red blood cell synthesis and iron absorption in the stomach. Antianemic drugs are used to treat and prevent anemia: Ferrum Lek, Ferroplex, Aktiferrin, Totema, as well as folic acid and B vitamins.

Another common symptom-complication of hypothyroidism is constipation. To eliminate it, patients are recommended to take laxatives: Bisacodyl, Senade, Lactulose, Regulax.

Vitamins

Decreased thyroid function occurs due to many factors, including vitamin and mineral deficiencies in the body. Let's look at the main substances that the body needs for hypothyroidism:

• Iodine

It is necessary for the normal functioning of the thyroid gland and its production of hormones. It takes part in the exchange and metabolic processes of the body, affects the speed of biochemical reactions. Iodine deficiency leads to hypothyroidism and is manifested by the following symptoms: increased sleepiness, weight gain, decreased performance, deterioration of general well-being.

Increased levels of the microelement in the body cause thyrotoxicosis or hyperthyroidism. The recommended daily intake of iodine should be between 2 and 5 g. The substance is found in seafood, beef liver, and eggs. To replenish iodine deficiency, it is enough to consume iodized salt daily.

• Vitamin A

Retinol is not produced independently in the human body. The substance is formed from beta-carotene, which comes with food. In thyroid pathologies, the rate of retinol formation decreases, which entails a violation of metabolic reactions, vision problems and a decrease in the protective properties of the immune system.

When synthesized normally, vitamin A fights infectious agents, and maintains normal functioning and integrity of internal organs. Retinol is found in raw potatoes, carrots, persimmons, sea buckthorn and other foods with high beta-carotene content.

• B vitamins

They have a beneficial effect on the endocrine system, increase the functionality of the cardiovascular system and improve metabolic processes. Vitamin B deficiency manifests itself in digestive system disorders, swelling of soft tissues and joints, dermatological diseases. Secretory disorders and sleep problems are also noted. The daily norm of the microelement is 2.6 mg. It is found in nuts and cereals, vegetables and dairy products. Particular attention should be paid to magnesium, that is, vitamin B6.

• Ascorbic acid

Vitamin C increases the protective properties of the immune system, improves the functioning of the thyroid and pancreas. Prevents atherosclerosis. Deficiency of this vitamin is manifested by deterioration of general health, loss of appetite, bleeding gums and impaired blood clotting. Ascorbic acid is found in citrus fruits, rose hips, bell peppers, black currants. The vitamin is quickly destroyed by high temperatures and does not tolerate direct sunlight.

• Vitamin D

Accumulates in cells and tissues, refers to fat-soluble microelements. Responsible for normal bone growth and calcium absorption. Vitamin deficiency manifests itself in increased fragility and deformation of bones. To obtain a daily dose of the substance, it is necessary to be in the sun for 1-2 hours a day. Calciferol is found in fatty fish, eggs, sour cream and cream.

• Vitamin E

Responsible for the physical condition of the thyroid gland. Tocopherol deficiency leads to gradual destruction of organ tissues and even to the formation of diffuse goiter. The vitamin is not synthesized in the body, so it must be taken with food. It improves the functioning of the endocrine system, thyroid gland, pituitary gland and adrenal glands. Contained in cereals, nuts and eggs.

You can also provide your body with the necessary vitamins and minerals using multivitamin medications, dietary supplements and food additives. For thyroid pathologies, the following complexes are recommended:

• Iodomarin, Iodine-balance – restore and maintain iodine levels in the body.
• Aevit is a vitamin complex with a high content of retinol, suitable for supporting the functioning of the endocrine system.
• Vitrum, Alphabet, Complevit are multivitamin preparations that contain the most essential substances for the body.

The dosage of vitamins is selected by the doctor, individually for each patient. Microelements are best taken in the first half of the day after meals. This will help maintain good health throughout the day. Vitamins cannot be taken on a permanent basis; treatment consists of several courses, between which there should be a temporary break.

Physiotherapy treatment

Complex treatment of hypothyroidism includes physiotherapy. Physiotherapy procedures have the following effect on the body:

• Increase the effectiveness of the medications used.
• Normalizes the functioning of secretory organs.
• Stimulates the thyroid gland and other endocrine organs.
• Improve oxidation-reduction and metabolic processes in the body.
• They have a beneficial effect on the cardiovascular and nervous systems, and digestion.
• Restores hormone production.
• Improve overall well-being.

For thyroid diseases, climate therapy and heat therapy methods are used in combination with medications, as well as massages and electrophoresis. The most effective physiotherapeutic procedures for correcting thyroid insufficiency include:

1. Thyroid stimulating methods:

• Iodine-bromine baths.
• Low intensity CMV therapy of the thyroid gland.

2. Enzyme-stimulating methods:

• Oxygen baths.
• Ozone baths.
• Vibration vacuum therapy.
• Contrast and air baths.
• Thalassotherapy.

3. Hormone-correcting methods:

• Transcranial electroanalgesia.
• Carbon dioxide baths.
• Radon baths.
• Transcerebral UHF therapy.
• Transcerebral low frequency electrotherapy.

To improve organ functions, DMB therapy is used, i.e. the effect of microwaves of the decimeter range on the anterior surface of the neck and adrenal glands. Microwaves increase glucocorticoid activity, the level of free forms of hydrocortisone and cortisol, and immunological tolerance.

To stimulate the thyroid gland, iodine electrophoresis and UHF therapy are used on the affected organ. Ultraviolet irradiation, exercise therapy and massages are also recommended. If hypothyroidism is accompanied by a violation of the motor function of the gastrointestinal tract, then drinking low-mineralized mineral waters and thermal procedures are prescribed. In case of arthropathy, mud therapy is indicated, which increases motor activity and reduces joint pain. In severe forms of the disease, sanatorium and resort treatment is carried out.

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Folk remedies

To speed up the recovery process, many patients resort to using unconventional methods. Folk treatment of congenital hypothyroidism is carried out using the following recipes:

1. Pour a glass of boiling water over a tablespoon of crushed lemon peel and 30 g of flax seeds. Boil the mixture over medium heat for 5-10 minutes. After cooling, strain and take as tea, ½ glass 2-3 times a day.
2. Peel 300 g of wild apples and chop finely. Pour 1 liter of boiling water over the apples and simmer for 10-15 minutes. Cool and drink in small portions throughout the day.
3. Take a tablespoon of crushed walnut internal partitions and shoots. Pour 250 ml of vodka over the raw material and leave to infuse in a closed container for 3-4 weeks. Take the finished tincture 1 teaspoon per glass of water in the morning and evening.
4. Take fresh potatoes, carrots and beets. Grate the vegetables and squeeze out the juice or prepare the drink in a juicer. You can drink the juice in a mixture or separately from each vegetable, ½ cup 3 times a day.
5. If you have iodine deficiency in your body, dilute 1 drop of iodine and a teaspoon of vinegar in a glass of water. Take the drink 2 times a day during meals.

Before using the above methods, you should consult your doctor.

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Herbal treatment

Today, medicine knows many medicinal plants that have a beneficial effect on the functioning of the thyroid gland.

Medicinal herbal recipes:

1. Grind 50 g of anise fruits together with 300 g of walnuts. Add 100 g of boiled and crushed to a uniform consistency garlic to the mixture. Combine all ingredients and mix thoroughly. Take 1 tablespoon 2-3 times a day 20 minutes before meals.
2. Take 100 g of common cocklebur and pour 500 ml of water. Boil on low heat for 5-10 minutes, cool, strain. Take 1 glass 3 times a day. More effective is the juice of the plant, diluted with 25% alcohol. It is taken 10-15 drops with a spoon of honey. Cocklebur contains a large amount of iodine, so it works no worse than pharmaceutical drugs.
3. Grind 15 g of dried May lilies and pour 100 ml of vodka/alcohol. The remedy should be infused for 1-2 weeks in a warm place. The medicine is taken 15-30 drops per glass of water 2-3 times a day.
4. Take three parts of nettle leaves, one part of crushed eleutherococcus root, the same amount of dyer's broom, dandelion and carrot seeds. Add two parts of cocklebur to the herbal mixture and mix thoroughly. Pour 1.5 tablespoons of the dry mixture with 500 ml of warm water, boil for 5-10 minutes. Strain and add 80 drops of walnut partition alcohol infusion to the decoction. Take the drink 100 ml before meals 1-2 times a day.

Herbal treatment for congenital hypothyroidism is carried out as prescribed by a herbalist.

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Homeopathy

Another alternative method of treating hypothyroidism is homeopathy. Homeopathic therapy normalizes hormone production, having a positive effect on the entire body. It helps restore physical and mental health, normalizes weight.

When thyroid function decreases, the following medications are used:

1. Arnica – traumatic injuries and thyroid surgeries, muscle pain and cramps. Hematomas, blood clotting disorders, increased liver enzymes.
2. Sepia is a depressive state, slow reactions and speech, swelling of the upper eyelids, flaky skin with dark pigmentation in the cheekbones. Stool disorders, gynecological pathologies.
3. Thyroidin (calf thyroid tissue) – disproportionate body structure, swollen neck, elevated liver enzymes.
4. Colchicum - increased weakness and swelling, puffiness around the eyes, increased sensitivity to odors, bowel disorders.
5. Graphite – swelling and thickening of the skin, folliculitis in the shoulder area. Increased loss and brittleness of hair and nails. Excess body weight, depression, melancholy, gastrointestinal disorders, constipation.

All homeopathic remedies are used only as prescribed by a doctor, with individual selection of dosage and duration of therapy.

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Surgical treatment

Surgical intervention for hypothyroidism is extremely rare. Surgery is prescribed for the nodular form of the disease or significant enlargement of the organ. Surgery is also possible if it is necessary to achieve radically positive results in a short time.

The main indications for surgical treatment of congenital thyroid pathology:

• Large size of the organ, making breathing and swallowing difficult.
• Suspected oncological processes.
• Side effects, contraindications or ineffectiveness of other treatments.
• Using radioactive therapy to shrink goiter.
• Nodular lesions that are not sensitive to radioactive iodine.

Today, both open surgeries and surgical interventions using an endoscope are used, i.e. minimally invasive techniques. The minimum volume of tissue removed is one lobe, the maximum is the entire gland. Removal of individual nodular neoplasms is not performed, since relapses almost always occur, and the powerful fibrous membrane of the gland does not allow for a repeat operation.

As for surgical treatment of other organs in patients with congenital and other forms of hypothyroidism, there is a high risk of complications. The most likely consequences of surgical intervention are:

• Respiratory failure.
• Intestinal obstruction.
• Blood clotting disorders and increased tissue bleeding.
• Cardiac arrest and coma.
• Hypothermia.
• Hypotension.
• Adrenal insufficiency.

Patients with thyroid dysfunction undergo treatment with hormonal drugs before surgery to minimize the development of the above complications.

There is also such a thing as postoperative hypothyroidism. The disease develops after surgery in the thyroid gland. The prevalence of this complication is 20% among women and 16% among men. The risk group includes elderly patients, patients with anemia, diabetes, and renal failure. In this case, the disruption of the synthesis of organ hormones is the result of the suppression of its functional capabilities, iodine deficiency, or destructive processes in the hypothalamic-pituitary region.

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