Looks like "spring sleepiness"? It is actually "hypothyroidism"!

Young zhang, usually working hard and sharp, the work efficiency is particularly high. After the Spring Festival this year, she is like a new person, the whole person is very lazy, she always can't lift her spirits at work, and she always loses everything. At first, colleagues thought that it might be that young people were playful, had a rich nightlife, slept less at night, and were prone to "spring sleepiness" in this season, so they advised her to rest early at night and not to stay up late. Xiao Zhang said that she used to sleep only 6 to 7 hours a day, people are more than energetic, and now she sleeps more than 10 hours a day and does not sleep enough, she is always listless, she is not willing to eat, she eats very little every day, but her weight does not decrease but increases, and menstruation is not regular. Everyone suggested that she go to the hospital to check the endocrine system.

After examination, Xiao Zhang confirmed hypothyroidism.

Hypothyroidism (abbreviated hypothyroidism) is a systemic hypometabolic syndrome caused by insufficient secretion or decreased functioning of thyroid hormones caused by a variety of causes.

According to the results published in the 2010 Epidemiological Survey of Thyroid Diseases among Residents of Ten Urban Communities in China, the prevalence of hypothyroidism in China (including "clinical hypothyroidism" and "subclinical hypothyroidism") has reached 6.5%, that is, 1 in every 15 people has hypothyroidism, and the prevalence of women over 40 years old is as high as 10%. Therefore, hypothyroidism is not uncommon clinically.

Why is "hypothyroidism" easy to be mistaken for "spring sleepiness"?

The thyroid gland is the largest endocrine organ of the human body, and the thyroid hormones it secretes can promote the body's metabolism and growth and development, and has an important regulatory effect on the functions of various organ systems throughout the body (such as cardiovascular, digestive tract, hematopoietic system, reproductive system, neuropsychiatric system, etc.). Therefore, thyroid hormone deficiency (that is, "hypothyroidism") will affect all aspects of the body, and the clinical manifestations are also diverse, such as fatigue and weakness, drowsiness, malaise, sluggishness, cold intolerance, slow heartbeat, bloating and constipation, hoarseness, menstrual irregularities, obesity and puffiness, dry skin, hair loss and so on.

In the early spring, people generally feel that the body is easy to fatigue, can not lift the spirit, always want to sleep, and this phenomenon is attributed to "spring sleepiness", which is actually a normal physiological response of the human body to the change of winter and spring, and most people do not care too much about it.

From the perspective of symptoms, the similarity between "hypothyroidism" and "spring sleepiness" is very high, and because of this, clinically there are often "hypothyroidism" patients who are missed as "spring sleepiness", so that diagnosis and treatment are delayed.

How to avoid missed and misdiagnosed hypothyroidism?

Because of the insidious, slow progression, diverse symptoms, and lack of specificity, it is easy to miss or misdiagnose. Clinically, hypothyroidism is mistaken for chronic fatigue syndrome (sub-health status), menopausal syndrome, depression, Alzheimer's disease, heart disease, and chronic nephritis.

However, as long as we firmly grasp the two characteristics of hypothyroidism , " decreased metabolic rate ( such as slow heartbeat , cold intolerance , less sweating , loss of appetite , obesity, etc.) and " decreased excitability ( such as less speech, slow response, drowsiness, mental depression, etc.) " , it is not difficult to find out "hypothyroidism".

Clinically, when patients have the following symptoms, it is important to think of testing thyroid function:

(1) Easy to fatigue, but also extra afraid of cold;

(2) Memory loss, less speech, slow response, low mood;

(3) Don't eat much, but still get fat;

(4) Anorexia, bloating, constipation;

(5) Chest tightness and shortness of breath, slowed heartbeat, pericardial effusion;

(6) The skin is dry and rough, and the nails become brittle;

(7) Weakness of limbs and muscle pain throughout the body;

(8) Unexplained body swelling and yellowing of the skin;

If the patient has the above "low metabolism" symptoms, the nail work examination shows: TSH (thyroid stimulating hormone) is increased, FT4 (free thyroid hormone) is reduced, the diagnosis of "hypothyroidism"; if the patient's TSH is high, but TT3, FT4 is normal, this situation is called "subclinical hypothyroidism".

How is hypothyroidism treated?

Once "hypothyroidism" is diagnosed, its treatment is very simple, and only an appropriate amount of thyroid hormones needs to be supplemented daily.

However, in the specific use of drugs, we must pay attention to individualization, for example, the elderly and patients with hypothyroidism with heart disease, the starting dose must be small (12.5 ~ 25μg / day), the adjustment of the dose must be slow, so as to avoid cardiovascular accidents (such as angina, heart failure, etc.); maternal hypothyroidism, the dosage of Youjiale is best to be in place in one step (about 100μg / d), the purpose is to restore the normal work of pregnant women as soon as possible to reduce the impact of hypothyroidism on the fetus.

Finally, I would like to remind everyone:

In the spring when everything is revived and the spring grass is green, if your colleagues, relatives and friends around you feel tired and sleepy uncharacteristically, especially with cold and fear of cold, slow heartbeat, loss of appetite, and weight gain, you must think of "hypothyroidism" and go to the hospital in time to test "Nail Gong".

Text: Wang Jianhua, Chief Physician of Diabetes Diagnosis and Treatment Center, Jinan Hospital, Shandong Province

Editor-in-charge: Rena

Image source: 123RF

Disclaimer: WuXi AppTec's content team focuses on the global biomedical health research process. This article is for informational purposes only and the views expressed herein do not represent the position of WuXi AppTec, nor do they represent WuXi AppTec's support for or opposition to the views expressed herein. This article is also not recommended for treatment options. For guidance on treatment options, please visit a regular hospital.

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