The cold winter tests people's ability to resist freezing, and some people, when there are snowflakes in the sky, still expose half of their legs. On the contrary, some people wrap themselves in thick clothes before cooling down, but they still cry cold. What is more exaggerated is that some women will say that they are frozen and menstrual periods are not normal, and some people say that they are about to freeze and pass out, lying in bed all day, without energy. If you encounter such a situation, you need to be careful, which may be a manifestation of a fatal hypothyroid crisis.
Hypothyroidism, referred to as hypothyroidism, is a decrease in the synthesis and secretion of thyroid hormones, or a decrease in the role of thyroid tissue, resulting in a decrease in the level of metabolism throughout the body. The typical symptoms of hypothyroidism are chills, less sweating, fatigue, weight gain, slow movement, slower speaking, low voice, and a feeling that the rhythm of life is half a beat slower. Hypothyroidism, a common disease, has an overall incidence of about 6.8%, but clinical hypothyroidism with typical symptoms is only 0.9%, and subclinical hypothyroidism without obvious discomfort symptoms is 5.9%. Therefore, patients with hypothyroidism are prone to delayed treatment due to missed or misdiagnosed diagnosis.
Hypothyroidism, which not only affects metabolism, but also adversely affects the health of the whole body, leading to a variety of complications. The most severe of these is a hypothyroid crisis, also known as myxoedema coma. The mortality rate for hypothyroid crisis exceeds 50%. Hypothyroidism occurs mainly in elderly patients, or in special groups such as children and pregnant women, and cold and low temperature environments are precipitating factors. In addition, severe or uncontrolled hypothyroidism, infection, mental stimulation, stressful states such as cardiovascular and cerebrovascular accidents, trauma or surgery, and the use of sedatives or anesthetics are all factors associated with the occurrence of hypothyroid crisis.
Thyroid hormones have a variety of physiological functions, such as promoting material metabolism, producing energy, and maintaining normal body temperature. In the cold winter, the body needs more calories, the demand for thyroid hormones also increases accordingly, however, hypothyroidism patients themselves thyroid hormone synthesis and secretion is insufficient, so that it will form a worse effect, the elderly and pregnant women, the ability to regulate the body temperature declines, the children's body temperature regulation ability is weaker, therefore, it is easier to be recruited. When thyroid hormones are reduced, the activity of mucopolysaccharides in the lysosome is reduced, and the acidic mucopolysaccharides will accumulate too much in the body tissues, forming myxoedema of the skin and muscle diseases, and due to the metabolic disorders of mucopolysaccharides, a number of important organs are affected, and eventually lead to functional failure. For example, mucopolysaccharides infiltrate the myocardium and exude in the pericardium, resulting in decreased left heart function.
When a hypothyroid crisis occurs, the main manifestations are from drowsiness to unconsciousness, gradually falling into a coma, at the same time, the body temperature decreases, and hypotension, bradycardia, hyponatremia, hypoglycemia, hypoventilation occur, the patient's skin is dry, bruised, bleeding gums, black stool, sparse hair, hoarse voice, delirium, myxoedema and coma are characteristic manifestations. In severe cases, there will also be respiratory muscle weakness and reduced respiratory center function, resulting in insufficient alveolar ventilation, resulting in hypoxia and respiratory acidosis. Due to the increased fragility of capillaries, bleeding from the skin, digestive tract mucosa, gums and other parts will eventually occur shock, wheezing failure, heart failure, kidney failure, even if rescue is carried out, the mortality rate will reach more than 50%.
Hypothyroid crisis occurs more often in frail elderly patients, especially those with underlying diseases, and then encounters serious infections, cardiovascular and cerebrovascular accidents, and is more likely to occur hypothermia crisis characterized by hypothermia. Winter is easy to catch a cold, if hypothyroidism patients lack scientific common sense, too much medication containing sedatives, but also induce hypothyroid crisis. In addition, the proportion of women experiencing hypothyroid crisis is about 3.5 times that of men, and mental stimulation is an important related factor that should be vigilant.
Studies have shown that within a few months to a few years before the onset of hypothyroid crisis, patients will have significant drowsiness, depression, and unresponsiveness, and before coma occurs, the main manifestation is fatigue and drowsiness, and some patients can sleep for up to 20 hours a day. Therefore, there are hypothyroid patients at home, who are unwilling to get up when it is cold, and when they are particularly afraid of cold, they must be careful and seek medical treatment in time. After the occurrence of hypothyroid crisis, it is usually necessary to enter the ICU ward for treatment, timely supplementation of thyroid hormones and glucocorticoids, at the same time, it is necessary to pay attention to keep warm, however, it is not appropriate to use electric blankets or hot water bottles and other methods for heating, so as not to heat acutely, lead to peripheral vasodilation, induce hypotension shock.
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