[Hypothyreodism. From the latent functional disorder up to coma]

Area of Science:

• Endocrinology
• Immunology
• Internal Medicine

Context:

• Autoimmune thyroiditis is the leading cause of hypothyroidism, characterized by the immune system attacking thyroid follicles.
• Hypothyroidism results in insufficient thyroid hormone production, impacting metabolic processes.
• Subclinical hypothyroidism is diagnosed via elevated TSH with normal peripheral hormones, while overt hypothyroidism presents with distinct symptoms.

Purpose:

• To outline the diagnostic markers and treatment strategies for hypothyroidism, particularly autoimmune thyroiditis.
• To differentiate between subclinical and overt hypothyroidism based on clinical and laboratory findings.
• To provide guidance on levothyroxine substitution therapy for various hypothyroidism presentations.

Summary:

• Autoimmune thyroiditis, marked by antibodies against thyroid peroxidase (80%) and thyroglobulin (40-50%), destroys thyroid follicles.
• Levothyroxine is the standard treatment for diagnosed hypothyroidism, targeting TSH normalization.
• Levothyroxine is indicated for subclinical hypothyroidism with high TSH, positive antibodies, or characteristic ultrasound findings, but not for all elevated TSH levels.

Impact:

• Improved patient management through targeted levothyroxine therapy based on hypothyroidism type and severity.
• Enhanced understanding of autoimmune thyroiditis's role in hypothyroidism.
• Potential reduction in overt hypothyroidism complications by timely and appropriate intervention.