How does thyroid disease affect sweating patterns. What are the signs of thyroid-related sweating issues. Which treatments can help manage excessive sweating caused by thyroid disorders.

The Thyroid Gland: Function and Impact on Body Temperature Regulation

The thyroid gland plays a crucial role in regulating various bodily functions, including metabolism and temperature control. Located in the throat, this butterfly-shaped organ produces thyroid hormones that influence numerous physiological processes. When thyroid function becomes imbalanced, it can lead to a range of symptoms, including changes in sweating patterns.

How does the thyroid gland regulate body temperature?

The thyroid gland helps maintain body temperature by:

• Controlling metabolic rate
• Influencing blood flow to the skin
• Affecting sweat gland activity
• Modulating heat production in tissues

When thyroid function is disrupted, these temperature regulation mechanisms can be compromised, potentially leading to excessive sweating or heat intolerance.

Hyperthyroidism and Excessive Sweating: Understanding the Connection

Hyperthyroidism, characterized by an overactive thyroid gland, is often associated with increased sweating. This condition can cause a variety of symptoms that may contribute to excessive perspiration.

Why does hyperthyroidism cause increased sweating?

Hyperthyroidism leads to excessive sweating due to:

1. Increased metabolic rate, generating more body heat
2. Heightened sensitivity to temperature changes
3. Overactive sweat glands
4. Anxiety and nervousness, which can trigger sweating

These factors combine to create a tendency for individuals with hyperthyroidism to sweat more profusely, even in mild temperatures or during minimal physical activity.

Hypothyroidism and Sweating: A Complex Relationship

While hypothyroidism is typically associated with cold intolerance, some individuals with this condition may experience sweating issues, particularly night sweats. The relationship between hypothyroidism and sweating is less straightforward than that of hyperthyroidism.

Can hypothyroidism cause night sweats?

Although less common, hypothyroidism can potentially cause night sweats due to:

• Hormonal imbalances affecting temperature regulation
• Side effects of thyroid medication (e.g., levothyroxine)
• Comorbid conditions that may influence sweating patterns

It’s important to note that research on hypothyroidism-related night sweats is limited, and more studies are needed to fully understand this phenomenon.

Differential Diagnosis: Other Causes of Excessive Sweating

While thyroid disorders can contribute to sweating issues, it’s essential to consider other potential causes of excessive perspiration. Understanding these alternatives can help in accurate diagnosis and appropriate treatment.

What are some common causes of excessive sweating besides thyroid disorders?

Several conditions and factors can lead to increased sweating:

• Menopause (hot flashes)
• Diabetes (gustatory sweating)
• Anxiety disorders
• Certain medications (e.g., antidepressants)
• Hyperhidrosis (primary excessive sweating)
• Infections
• Neurological disorders

Given the variety of potential causes, it’s crucial to consult with a healthcare professional for an accurate diagnosis when experiencing unusual sweating patterns.

Recognizing Thyroid-Related Sweating: Signs and Symptoms

Identifying thyroid-related sweating issues requires an understanding of the associated symptoms and their distinguishing features. Being aware of these signs can help individuals seek timely medical attention and appropriate treatment.

How can you differentiate thyroid-related sweating from other causes?

Thyroid-related sweating often presents with the following characteristics:

• Generalized sweating over the entire body
• Increased perspiration on the face, neck, armpits, and palms
• Night sweats (in some cases)
• Accompanying symptoms of thyroid dysfunction (e.g., weight changes, mood alterations)
• Sweating disproportionate to environmental conditions or physical activity

If you experience these symptoms along with other signs of thyroid dysfunction, it’s advisable to consult an endocrinologist for a thorough evaluation.

Diagnostic Approaches for Thyroid-Related Sweating Issues

Proper diagnosis of thyroid-related sweating problems involves a comprehensive evaluation of symptoms, medical history, and laboratory tests. Accurate diagnosis is crucial for developing an effective treatment plan.

Which tests are used to diagnose thyroid disorders associated with sweating?

Diagnostic procedures for thyroid-related sweating may include:

1. Thyroid function tests (TSH, T3, T4 levels)
2. Thyroid antibody tests
3. Thyroid imaging (ultrasound or radioiodine scan)
4. Physical examination
5. Detailed medical history assessment

These tests help healthcare providers determine the underlying cause of sweating issues and guide appropriate treatment strategies.

Treatment Options for Thyroid-Related Sweating Problems

Managing excessive sweating caused by thyroid disorders typically involves addressing the underlying thyroid dysfunction. Treatment approaches may vary depending on whether the individual has hyperthyroidism or hypothyroidism.

How are thyroid-related sweating issues treated?

Treatment options for thyroid-related sweating may include:

• Antithyroid medications (for hyperthyroidism)
• Thyroid hormone replacement therapy (for hypothyroidism)
• Radioactive iodine treatment (for hyperthyroidism)
• Thyroid surgery (in severe cases)
• Symptomatic relief measures (e.g., antiperspirants, moisture-wicking clothing)
• Lifestyle modifications (e.g., stress reduction, dietary changes)

The specific treatment plan will depend on the individual’s thyroid condition, overall health, and severity of symptoms. Regular follow-ups with an endocrinologist are essential to monitor progress and adjust treatment as needed.

Living with Thyroid-Related Sweating: Coping Strategies and Lifestyle Adjustments

While medical treatment is crucial for managing thyroid-related sweating, implementing certain lifestyle changes and coping strategies can significantly improve quality of life for affected individuals.

What lifestyle modifications can help manage thyroid-related sweating?

Individuals dealing with thyroid-related sweating can benefit from the following strategies:

1. Wearing breathable, moisture-wicking fabrics
2. Using clinical-strength antiperspirants
3. Maintaining a cool environment
4. Practicing stress-reduction techniques (e.g., meditation, yoga)
5. Staying well-hydrated
6. Avoiding triggers (e.g., spicy foods, caffeine)
7. Keeping a sweating diary to identify patterns and triggers

These lifestyle adjustments, combined with proper medical treatment, can help individuals better manage their symptoms and improve overall well-being.

Understanding the relationship between thyroid function and sweating patterns is crucial for individuals experiencing excessive perspiration. While hyperthyroidism is more commonly associated with increased sweating, hypothyroidism can also contribute to sweating issues in some cases. Proper diagnosis and treatment of underlying thyroid disorders are essential for managing related sweating problems effectively.

It’s important to note that excessive sweating can have various causes beyond thyroid dysfunction. Conditions such as menopause, diabetes, and certain medications can also lead to increased perspiration. Therefore, a comprehensive evaluation by a healthcare professional is necessary to determine the root cause and develop an appropriate treatment plan.

For individuals dealing with thyroid-related sweating, a combination of medical treatment and lifestyle modifications can significantly improve symptom management and quality of life. Regular follow-ups with an endocrinologist, adherence to prescribed medications, and implementation of coping strategies are key components of successful management.

As research in this area continues to evolve, new insights into the relationship between thyroid function and sweating patterns may emerge. Staying informed about the latest developments and maintaining open communication with healthcare providers can help individuals navigate the challenges of thyroid-related sweating more effectively.

By addressing both the underlying thyroid dysfunction and its associated symptoms, individuals can work towards achieving better control over their sweating issues and overall health. With proper care and management, many people with thyroid-related sweating can lead comfortable and fulfilling lives, minimizing the impact of excessive perspiration on their daily activities and well-being.

Does Thyroid Disease Cause Sweating?

Content

• Overview
• Possible signs or symptoms of a thyroid condition
• How does the thyroid affect sweating?
• What else causes sweating?
• Medications that can cause night sweats
• Prevalence
• Risk
• Signs that you should get your thyroid checked 
• What helps with sweating and night sweats?
• Treatment
• The lowdown

The thyroid gland is a small organ that lies along the midline of the throat and wraps around the windpipe to form a butterfly shape. It releases thyroid hormone, which is essential to regulate many bodily functions, including metabolism, development, and temperature regulation. 

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In its healthy state, the thyroid gland helps regulate many of our bodily functions. However, over- or under-activity of the thyroid can cause issues throughout the body. 

Hyperthyroidism occurs with thyroid gland overactivity and thyroid hormone overproduction. Symptoms can include nervousness, irritability, and anxiety. This may explain why research has indicated high levels of comorbidity between anxiety disorders and hyperthyroidism. 

Hyperthyroidism can also cause:

• Sleep disruptions

• Heat sensitivity

• Muscle weakness

• Sexual dysfunction 

Hypothyroidism indicates thyroid gland under-activity, resulting in low thyroid hormone levels. Symptoms may include:

• Sensitivity to cold

• Depression

• Weight gain

• Dry skin

• Fatigue

Hypothyroidism can also reduce libido and cause irregular periods.

Hypothyroidism tends to be associated with a reduced ability to regulate body temperature and increased sensitivity to the cold. Hyperthyroidism is associated with excessive sweating and heat intolerance.

Can hypothyroidism cause night sweats?

While some cases of hypothyroidism do cause night sweats, research is limited as to this effect. Some suggest that night sweats in these individuals are caused by medications for hypothyroidism, especially levothyroxine. Levothyroxine is used to replace thyroid hormone in its absence.¹

Excessive doses of this medication can be especially dangerous, prompting heart attack and death in some cases. Milder symptoms include increased sweating.

How does hyperthyroidism affect sweating?

Hyperthyroidism tends to cause sweating over the entire body, including the face, neck, armpits, and palms. 

Night sweats are also a common symptom of hyperthyroidism. This may be due to the poor temperature regulation abilities of these individuals. Such poor heat regulation, in combination with a hot climate or thick, nonbreathable clothing, can exacerbate sweating.

Menopause is a common cause of sweating. This occurs in females when their menstrual periods come to an end. A common symptom of this is ‘hot flashes,’ during which an individual suddenly becomes hot and profusely sweats in an environment that does not usually cause much sweating.

Diabetes is another common cause of sweating, as both type 1 and 2 variants can affect heat regulation, often reducing sweating ability. Some individuals with diabetes experience increased sweating, particularly gustatory sweating, which occurs during or immediately after digestion.²

Levothyroxine, a medication for hypothyroidism, can cause excessive sweating. However, other medications can also have this effect. Antidepressants can cause night sweats in 8–22% of individuals. 

Such medication is often taken to mitigate depressive symptoms but can be used for other psychological conditions. 

Many other drugs also cause night sweats, including:

Hyperhidrosis, or excessive sweating, is reported to occur in around 3% of the U. S. population; however, this may be caused by factors outside of hyper- or hypothyroidism.³

Hypothyroidism is estimated to affect around 5% of the general population (with a possible additional 5% undiagnosed), while hyperthyroidism is estimated to occur in 0.8% of Europeans and 1.3% of Americans. There are yet to be any studies estimating the prevalence of excessive sweating in individuals with thyroid conditions.⁴ ⁵

Thyroid conditions tend to be more common in women than in men. Hyperthyroidism is more prevalent in women and people older than 60, with women being up to 10 times as likely to develop it. Other factors can also increase the risk of hyperthyroidism, including smoking. 

In terms of hypothyroidism, women are similarly at a higher risk than men; individuals over 60 are also more likely to develop this condition. Populations with high and low iodine intake are at greater risk of developing hypothyroidism. Autoimmune diseases also confer a higher risk of development.  

If you are experiencing any issues with heat tolerance, changes in your anxiety level, sleep disturbances, thirst, fatigue, or weight fluctuations, this might be a sign that you should visit your healthcare professional and get your thyroid checked.

Excessive sweating, whether at night or during the day, can be an extremely troubling issue. However, there are some methods that may relieve this symptom:

• Cooling your environment—While this may not be possible during the day, it can help to sleep in a cool room. Turning on a fan or opening a window can reduce the heat surrounding the body as you sleep, which can reduce the extent to which night sweats occur.

• Reduce consumption of substances that promote sweating—Cigarettes, alcohol, and spicy foods can all increase sweating both during the day and at night. Reduction or elimination of these substances can reduce sweating.

• Wear lightweight and breathable clothing—Choosing the right clothing can allow your skin to breathe. Cool air moving past your skin can help to naturally cool you.

• Use an icepack—Sleeping with an ice pack or applying an ice pack to the points where blood vessels are closest to the skin’s surface (i.e., wrists and neck) can help to cool one down and reduce sweating. An individual experiencing night sweats may find that special pillows with gel fillings help them stay cool during the night.

Treatments for hyperthyroidism depend upon the presentation of symptoms. Possible options include radioactive iodine, surgery, or antithyroid hormone drugs. In less severe presentations, such as thyroiditis, symptomatic treatment is usually recommended.

Treatments for hypothyroidism include hormone replacement therapies such as levothyroxine. This replaces thyroxine (T4). Additional low-dosage triiodothyronine (T3) might be used in some cases. It is important to note that improper dosing of levothyroxine can cause profuse sweating.

The thyroid gland is useful and important to the body; however, its dysfunction can cause some issues, including profuse sweating. In the case of hyperthyroidism, sweating is a direct effect of the condition. 

Conversely, in hypothyroidism, excessive sweating can happen as a result of medications used to treat thyroid dysfunction. While these symptoms can be troublesome, there are many possible treatments available.

Does hypothyroidism cause night sweats?

Although doctors associate hypothyroidism with feeling cold and hyperthyroidism with feeling hot, it is possible that having low levels of thyroid hormone may cause general difficulty regulating body temperature. This may mean that some people with hypothyroidism experience sweating because thyroid hormones help regulate body temperature, so a lack of them causes instability. However, there is little scientific evidence to support this.

However, there are other, more likely explanations for these symptoms.

For example, a medication for hypothyroidism called levothyroxine can also cause sweating as a side effect if someone is taking more than they need. Other factors, such as menopause, can also cause sweating and may occur alongside hypothyroidism. Overuse of levothyroxine replaces thyroid substances that the body does not produce enough of, leading to the following:

• sweating
• headaches
• a racing heartbeat
• anxiety or agitation
• difficulty sleeping
• chest pain
• nausea or vomiting
• diarrhea

Thyroid hormone levels also influence the levels of other hormones in the body and vice versa. This is especially relevant for females, who are five to eight times more likely to have hypothyroidism than males.

Most females enter the first stage of menopause in their mid-to-late 40sTrusted Source. At this time, levels of estrogen and progesterone start to decrease. This can cause symptoms, with hot flashes and night sweats among the most common. Doctors believe that estrogen levels may also affect thyroid function.

Hypothyroidism and menopause share some similar symptoms, and each condition may aggravate the other. This may mean that some people with hypothyroidism experience both thyroid- and menopause-related symptoms at the same time.

Estrogen affects how much triiodothyronine and thyroxine the thyroid makes, and during menopause, the thyroid may struggle to meet the body’s needs. A 2011 studyTrusted Source noted that estrogen has a direct effect on human thyroid cells.

An earlier study from 2007Trusted Source looked at females with either hypothyroidism or hyperthyroidism and severe menopause symptoms. The researchers found that treating thyroid dysfunction significantly improved their menopause symptoms, including night sweats.

What helps with sweating and night sweats?

People who experience regular sweating and night sweats should discuss their symptoms with a doctor. They may require testing for thyroid disease. Or, if they already have a diagnosis, they may require changes to their medication dosage.

To reduce the discomfort of sweating, it may help to:

• Sleep in a cool bedroom: Turning the thermostat down and using less or lighter bedding can help reduce heat around the body as someone sleeps. Try to use bedding made from breathable, natural fabrics, such as cotton.
• Choose breathable clothing: Choose lightweight, loose clothing made with natural fibers wherever possible. This can help keep the body cool and wick away moisture. Wearing light layers can give someone the option to take clothing off or put it back on again as their body temperature changes.
• Reduce sweat triggers: Spicy foods, cigarettes, and alcohol may worsen night sweats, so avoiding these may reduce this symptom.
• Use a cooling pillow or ice pack: Some pillows have a gel filling that stays cool during the night. Alternatively, a person can keep a cool pack under the pillow. Flipping the pillow to the cool side during the night can help a person cool down when they have night sweats.

References

https://www.medicalnewstoday.com/articles/what-to-know-about-hypothyroidism-sweating-and-night-sweats#:~:text=Hypothyroidism%20may%20cause%20night%20sweats,in%20general%2C%20including%20at%20night.

Neurological disorders in hypothyroidism

It is known that hypothyroidism is caused by a persistent decrease in the action of thyroid hormones on target tissues, which is associated with a lack of thyroid hormones in the body or a decrease in their biological effect at the tissue level [3, 4]. Thyroxine (T4) and triiodothyronine (T3) secreted by the thyroid gland regulate protein synthesis and affect the metabolic and functional activity of the structures of the nervous system [8]. Iodine is a key component of thyroid hormones. The synthesis of thyroid hormones is regulated by thyroid-stimulating hormone (TSH), which is synthesized in the anterior pituitary gland. The formation of TSH decreases under the influence of glucocorticoids and increases under the influence of estrogens. The level of TSH is regulated by the structures of the hypothalamus with the participation of somatostatin and dopamine. It is subject to circadian fluctuations and can change under the influence of environmental factors, such as ambient temperature. The inhibitory effect is realized under the influence of the serotonergic system of the brain. TSH is present in many parts of the central nervous system and in itself has the ability to inhibit the bioelectric activity of neurons.

Hypothyroidism occurs in the population in 0.2-2% of cases, among the elderly – in 2-4%, and in women 3 times more often than in men [3, 4, 16]. Women aged 40-60 years are especially susceptible to this disease, the prevalence rate among women of the older age group reaches 12% [3]. Subclinical hypothyroidism (increased TSH level without any clinical symptoms) is observed in 7.5-10% of women and 3% of men [3, 8, 23].

Various causes can lead to hypothyroidism: congenital changes in the thyroid gland (hypo- or aplasia), its surgical removal, dysfunction of the pituitary gland. However, in adults, it is more often the result of autoimmune processes. Chronic autoimmune thyroiditis occurs in 3-4.5% of individuals in the general population. Violate the biosynthesis of thyroid hormones drugs such as amiodarone, sulfonamides, lithium preparations [15]. Sometimes hypothyroidism is accompanied by other endocrine disorders.

In a significant proportion of cases, hypothyroidism is associated with iodine deficiency. WHO recommends a daily intake of iodine at a dose of 150 micrograms for adults, 200 micrograms for pregnant and lactating women, and 50 to 120 micrograms for children. With a daily intake of iodine less than 50 micrograms, the thyroid gland begins to produce less hormones than required, which is clinically manifested by hypothyroidism. Almost a billion people worldwide are thought to be at risk of developing iodine deficiency disorders [17]; Almost 13% of the population has an iodine deficiency [15]. These are mainly the countries of Asia and Africa, where iodine is absent in water and food or its use in the form of iodized salt is insufficient [15]. In areas where there is iodine deficiency, the incidence of hypothyroidism is 10-20 times higher.

Pathogenesis

The pathogenesis of clinical disorders in hypothyroidism is based on metabolic disorders caused by a sharp decrease in the production of a number of cellular enzymes due to a deficiency of thyroid hormones [3, 15]. This leads to a decrease in metabolic processes, a slowdown in redox reactions. At the same time, mucinous edema (myxedema) of tissues develops [3]. Violation of the metabolism of glycosaminoglycans – with increased hydrophilicity of protein breakdown products (derivatives of protein, glucuronic and chondroitinsulfuric acids) leads to infiltration of mucous membranes, skin and subcutaneous tissue, muscles, myocardium [3]. Cerebral hypoxia occurs, contributing to the development of episodes of confusion and syncope. In the pathogenesis of cognitive disorders in this category of patients, certain importance is attached to neurotransmitter disorders caused, in particular, by the effect of thyroid hormones on the acetylcholinergic system [10, 22]. In this regard, it should be noted that thyroid pathology is detected in 38% of patients with frontotemporal dementia, and hypothyroidism is a risk factor for the development of Alzheimer’s disease [22]. Even in the euthyroid state in clinically healthy elderly individuals, there is a relationship between lower levels of thyroid hormones (which are within normal limits) and cognitive decline. Decreased cerebral blood flow, cerebral hypoxia, cerebral edema, and hyponatremia also have pathogenetic significance. The influence of thyroid hormones on electrolytes and blood pressure is carried out through the reticular activating system [15]. Even a slight decrease in the level of thyroid hormones in the blood can lead to severe cognitive impairment [15].

Thyroid hormones play a very important role in the development of the nervous system. In particular, when they are deficient during pregnancy, the development of the nervous system is disrupted in the fetus, which is manifested by cortical hypoplasia, delayed myelination processes, and slowed down the formation of cerebral vessels. If hypothyroidism is not corrected in the early postnatal period, these changes become irreversible. However, if hypothyroidism occurs in adults, then changes in the nervous system are less pronounced and usually regress with treatment.

Clinical manifestations

The most common clinical manifestations of hypothyroidism are increased fatigue, general weakness, drowsiness, decreased appetite, weight gain, hypomia, and impaired tolerance to low ambient temperatures [3, 8, 16]. Patients often complain of constipation, muscle and joint pain, especially headache (it should be noted that the headache in these cases often disappears with adequate hormone replacement therapy for hypothyroidism).

These symptoms of hypothyroidism are very nonspecific. In this regard, hypothyroidism is often diagnosed months and even years after the onset of its first symptoms [8]. Signs such as weight gain (even against the background of reduced appetite), baldness and slowness of movement are often mistaken for signs of “normal” aging, and hypomia is a manifestation of depression or parkinsonism. Since depression can develop with hypothyroidism, diagnostic errors in relation to this form of affective disorders become less obvious [5]. In addition, according to some reports, subclinical hypothyroidism is often detected in patients with depression [5]. Therefore, it has been argued [5] that thyroid function testing is mandatory in any depressed patient who “does not respond” to antidepressant therapy.

In patients with hypothyroidism, sweating decreases, the skin becomes dry. The hairline on the body changes up to its complete loss, especially in the pubic region and in the outer third of the eyebrows. There is swelling of the hands and feet. The appearance of patients is changing, which is largely due to swelling of the eyelids and face. Hoarseness of the voice and articulation disorders are quite characteristic, which is due to infiltration of the vocal cords and tongue with glucosaminoglycan. The pulse often drops to 60 beats per minute or less. There may be an expansion of the boundaries of the heart, but heart failure rarely develops. Echocardiography may reveal a pericardial effusion. Against this background, aggravation (or occurrence) of pain such as angina pectoris may occur. Hypercholesterolemia characteristic of hypothyroidism increases the risk of developing vascular diseases. With hypothyroidism, women often experience heavy periods and infertility.

Neurological and mental disorders that have been known since the end of the 19th century range from mild disorders of higher brain functions, peripheral myoneuropathy and cranial nerve pathology to psychosis, ataxia, paroxysmal disturbances of consciousness (syncope, epileptic seizures) and coma [1, 5, 8 ].

Hypothyroidism may not be accompanied by neurological symptoms for a number of years. The development of neurological disorders is characterized by an inconspicuous onset and slow progression [25]. In these cases, the presence of increased fatigue and drowsiness often does not attract due attention of either the doctor or the patient himself or people close to him and relatives.

In some cases, the onset is acute with seizures. At one stage or another of the disease, they are observed in 20-25% of patients with hypothyroidism [5]. It is important to note that anticonvulsants do not lead to thyroid dysfunction [5]. A rare debut of hypothyroidism is acute psychosis, which occurs with visual and auditory hallucinations. It is believed that hypothyroidism as a cause of the disease should be taken into account when making a differential diagnosis in any patient with sudden onset mental disorders, depression or hallucinations [15].

With untreated hypothyroidism, about 1% of cases develop a coma quite quickly (often accompanied by epileptic seizures). In these cases, in addition to hypothermia, arterial hypotension, bradycardia, and rare breathing are noted [5]; the prognosis is often poor, with the cause of death in most cases being cardiac arrhythmia. Pathological examination reveals only pronounced cerebral edema, in the most severe cases – diffuse damage to neurons [5]. Elderly women are most susceptible to the development of a coma in the winter season [15].

Vestibulo-atactic disorders are quite typical for patients with hypothyroidism [1, 4]. Cerebellar dysfunction occurs in 5–10% of patients [5, 16]. Most often, it manifests itself as walking disorders in the form of a gait with legs wide apart, tandem walking is disturbed, often patients have impaired coordination in the limbs, tremor, dysarthria and nystagmus. Such disorders are probably based on atrophy of the anterior parts of the cerebellar vermis, which, however, (with adequate therapy) is reversible [5].

Neuromuscular disorders in the form of neuropathies and dysmetabolic myopathy are very characteristic disorders of hypothyroidism and occur in 30-80% of patients (differences in the figures given depend on the severity of hypothyroidism). Against the background of therapy, these disorders can regress. The main manifestation of hypothyroid myopathy is a slowdown in muscle contraction and relaxation. Microscopic examination of muscles reveals local necrosis of muscle fibers and basophilic degeneration of skeletal muscles. In rare cases, muscle hypertrophies resembling those in Hoffman’s syndrome are detected. Severe muscle weakness is rare, but mild disorders occur in almost 40% of cases [12]. The proximal limbs are most often affected [19, 20]. Myopathic syndrome in hypothyroidism can occur with both atrophy and muscle hypertrophy [4]. The severity of muscle weakness increases at low temperatures. However, much more often, patients have muscle cramps, pain and paresthesia, usually in the proximal limbs, as well as reduced exercise tolerance [14, 16]. There is also a description in the literature [6] of “reversible dropped head syndrome” in hypothyroidism, as well as myopathy in acute hypothyroidism (with its development within 2-6 weeks) [18]. In the blood serum of patients with hypothyroid myopathy, elevated levels of creatine phosphokinase (CPK) may be detected [4, 14, 16]. This is especially true for cases that occur with muscle weakness in the proximal limbs, but there was no correlation between an increase in CPK and the severity of muscle weakness [12].

In some cases, patients with hypothyroidism may have myasthenic syndrome with corresponding changes in EMG.

An association between hypothyroidism and fibromyalgia has been noted [26]. At the same time, it was argued that fibromyalgia is a form of hormone-resistant hypothyroidism. However, it should be noted that against the background of hypothyroidism therapy, there is a decrease in the severity of the pain syndrome caused by fibromyalgia.

The presence of hypothyroidism is an important factor in the development of dystrophic changes in the spine, which is associated with a violation of the synthesis of collagen, which is part of the disc structure [4]. Therefore, for this category of patients, the presence of pain in various parts of the spine, impaired mobility, soreness of the spinous processes and paravertebral points, and the occurrence of tension symptoms are quite typical [4].

Damage to peripheral nerves is one of the characteristic manifestations of hypothyroidism [2, 16, 17]. At the same time, damage to sensory fibers develops at earlier stages of the disease, when there are no changes in the propagation of excitation along motor fibers [11], however, there is evidence that motor fibers are more often involved in the pathological process [13]. The most common (14-81% of patients) complaint is paresthesia [17]. Paresthesia may be based on carpal tunnel syndrome (for example, carpal tunnel syndrome), the presence of which is noted in 70% of patients [4]. Its development is associated with the deposition of mucopolysaccharides in the skin and around peripheral nerves [5]. A significant decrease in axonal regeneration under conditions of thyroid hormone deficiency may also be important [4]. The most common carpal tunnel syndrome in hypothyroidism is carpal tunnel syndrome – in 10-35% of patients [5, 12, 16]. As a rule, it is bilateral. However, in clinical practice, there may be situations when on one side the existing disorders do not manifest clinical symptoms [5]. A feature of tunnel neuropathies is their multiple, combined nature [4].

One of the typical manifestations of the pathology of the nervous system in hypothyroidism is also demyelinating polyneuropathy [16]. Polyneuropathy due to hypothyroidism is characterized by a decrease in reflexes and the development of muscle weakness, in addition, patients may have a decrease in vibration sensitivity and musculo-articular feeling. According to electron microscopy, there are ultrastructural changes in endoneural vessels [9]. Peripheral nerve damage can be detected by electromyography even in patients without neurological symptoms [13]. Changes caused by segmental demyelination are manifested by a decrease in the rate of propagation of excitation along the nerve fiber. At the same time, damage to peripheral nerves can be observed even in subclinical hypothyroidism [17]. Under the influence of hormone replacement therapy, the corresponding symptoms may undergo a reverse development. In experimental studies [24], a positive effect of thyroid hormones on the state of nerve fibers and regeneration of nervous tissue was established.

The pathogenesis of peripheral (including cranial) neuropathies, in addition to compression, is based on other factors, including impaired microcirculation and metabolic neuronal disorders. Sensorimotor axonal polyneuropathy occurs in 40-90% of patients [4, 12].

Pyramidal symptoms are rare, but a decrease in deep reflexes is one of the characteristic (in 85% of patients) signs of hypothyroidism. Despite the normal process of muscle contraction, there is a significant lengthening of the muscle relaxation phase [5, 8]. This phenomenon is detected in more than 2/3 of patients with hypothyroidism. It should be noted that similar changes can occur with hypothermia, limb edema, diabetes mellitus, parkinsonism, neurosyphilis, sarcoidosis, and pernicious anemia. In hypothyroidism, reflexes are normalized with hormone replacement therapy.

Hypothyroidism can also cause damage to the II, V, VII, VIII pairs of cranial nerves [5]. Quite often, various ophthalmic disorders develop. So, with primary hypothyroidism, there may be a loss of visual fields due to an increase in the pituitary gland. Perhaps the development of a pseudotumor, leading to swelling of the optic discs. Mostly this syndrome occurs in children a few weeks after the start of hormone replacement therapy, however, similar cases have been described in adults [5]. Rare manifestations include uveitis and ptosis. With hypothyroidism, typical and atypical trigeminal neuralgia is sometimes detected. Peripheral paresis of the facial nerve may also develop. There are data [5] about the defeat of the VIII pair of cranial nerves (although some researchers do not confirm this). Tinnitus and hearing loss, probably due to cochlear disease, may regress with therapy. In patients with hypothyroidism receiving L-thyroxine, there may also be a decrease in taste, accompanied by a burning sensation in the mouth [5].

Cognitive and psychiatric disorders can range from mental retardation and mild mnestic disorders (in some cases resembling the initial manifestations of Alzheimer’s disease) to severe psychotic disorders occurring with illusions and hallucinations [5]. In severe cases, patients become apathetic, the speed of mental processes decreases sharply, and speech slows down. In the neuropsychological status, in addition to memory and attention disorders, disorders of constructive praxis and visual-spatial functions are revealed. This category of patients is characterized by sleep apnea, both central and peripheral, while in the second case, improvement can be obtained against the background of hormone replacement therapy [4, 5].

Cretinism, a term that was proposed as early as the beginning of the 19th century. to denote severe encephalopathy in hypothyroidism, develops when pathology occurs in early childhood (even from the moment of birth). In these cases, we are usually talking about congenital absence of the thyroid gland, congenital metabolic disorders, iodine deficiency during pregnancy and in the early postpartum period. However, the onset of clinical symptoms can be “delayed” by hormones obtained from the mother. It should be noted that the prevalence of congenital hypothyroidism has significantly decreased due to the introduction of appropriate methods of early diagnosis and adequate therapy into clinical practice [15]. However, studies in adolescents, even after correctly and actively treated congenital hypothyroidism, have noted impairments in memory, attention, and visuospatial functions [15].

Mild cases of iodine-deficiency-associated encephalopathy now occur in nearly 50 million children worldwide, resulting in an average IQ decrease of 15 points [15]. In the cognitive sphere, this category of patients has impaired memory and attention, apathy, drowsiness, depression, and behavioral disorders [15]. Selenium deficiency also plays a role in the pathogenesis of neurological disorders in cretinism. In patients with cretinism, in addition to mental retardation, weight loss, abnormal tooth development, thinning of the tongue, protruding abdominal wall (usually with an umbilical hernia), and bone anomalies are usually detected. In the neurological status, deafness, pyramidal and sometimes extrapyramidal symptoms, and strabismus are also often detected. Pyramidal symptoms in the form of muscle rigidity are more often detected in the lower extremities, and revival of knee reflexes is often noted. Unfortunately, therapy with already developed cretinism with neurological disorders is ineffective. Therefore, it is so relevant to start hormonal treatment immediately after the birth of a child with signs of hypothyroidism or with suspicion of the possibility of its development.

In patients with hypothyroidism, an increase in gamma globulins in the blood serum and cerebrospinal fluid (CSF) is often detected, and in 40-90% of patients – an increase in total protein in it. CSF pressure is usually not elevated in hypothyroidism. According to the EEG, there is a decrease in -activity. X-ray or magnetic resonance computed tomography (CT or MRI) of the brain shows mild cerebral atrophy. In hypothyroidism associated with an autoimmune process, reversible diffuse changes in the white matter of the cerebral hemispheres can also be detected [15].

Diagnostics

Diagnosis of hypothyroidism is carried out on the basis of anamnestic data, the results of a clinical study and the detection of a low index of free thyroxine, the detection of primary hypothyroidism is based on the determination of an elevated TSH level. Secondary (associated with dysfunction of the pituitary gland) and tertiary (associated with dysfunction of the hypothalamus) hypothyroidism is characterized by the presence of a low level of TSH in combination with a low level of T3 and T4.

Differential diagnosis between secondary and tertiary hypothyroidism is difficult and not always possible. For this purpose, a thyroid-releasing stimulation test is used – intravenous administration of 400 μg of thyroid-releasing hormone with determination of the level of TSH in the blood serum initially and 30 and 60 minutes after administration. Normally, the level of TSH increases by 2 times compared to the original. This indicates the normal functioning of the pituitary gland and allows us to suspect dysfunction of the hypothalamus as the cause of hypothyroidism. Another method that helps in the differential diagnosis of these two conditions is an MRI of the brain with a detailed assessment of the pituitary and hypothalamus.

Prevention and treatment

Prevention of hypothyroidism in iodine-deficient areas is the addition of iodine to food, in particular in the form of iodized salt [15]. Hypothyroidism is treated with L-thyroxine and, in some cases, oral triiodothyronine. In most cases, adults require the appointment of 100 to 150 micrograms of L-thyroxine per day; for the treatment of coma, L-thyroxine is administered parenterally [15].

Treatment begins with small doses of the drug and gradually increases over the course of months, achieving a euthyroid state [15]. It should be noted that the effectiveness of such therapy in the presence of severe neuromuscular disorders in patients with hypothyroidism is significantly lower than in patients with thyrotoxicosis [12]. With adequate therapy of hypothyroidism, patients may experience positive changes in the cognitive sphere [7, 21]. Therefore, dementia in patients with hypothyroidism is considered as a potentially reversible condition (although no relevant epidemiological and placebo-controlled clinical studies have been conducted) [25].

Sweating in hypothyroidism: causes and methods of treatment

Home Diseases Sweating in hypothyroidism: causes and methods of treatment

Hypothyroidism is a fairly common disease, which is accompanied by a prolonged and sustained lack of thyroid hormones. This disorder has various symptoms. So, quite often there is excessive sweating in hypothyroidism. The appearance of this symptom should be the basis for contacting a doctor.

Content

• 1 Essence of pathology
• 2 Features of sweating
• 3 Methods of treatment
• 4 Nutrition
• 5 Hygiene

Su pathology

Various factors lead to a weakening of the activity of the thyroid gland. Thus, the primary form of hypothyroidism is due to hereditary disorders of the formation of the thyroid gland. Also, the reasons may lie in inflammation or autoimmune processes. In addition, hypothyroidism is caused by a lack of iodine.

The secondary form of the disease is due to a malfunction of the pituitary gland that secretes thyroid-stimulating hormone. It is this substance that is responsible for stimulating the thyroid gland.

The causes of the disease include hormonal disorders, which are the result of problems in the immune system. However, most often hypothyroidism appears due to the chronic form of autoimmune thyroiditis . With this disease, the thyroid gland is destroyed.

Surgical interventions on the organ and the use of radioactive iodine for therapeutic purposes can be provoking factors.

Important! The main insidiousness of this disorder is that it is asymptomatic for a long time. The manifestations that occur are implicit in nature and are often perceived as the result of fatigue.

At the same time, hypothyroidism still has characteristic signs. These include the following:

• apathy;
• general weakness;
• chronic fatigue;
• loss of appetite;
• weight set;
• swelling of the limbs and face;
• memory loss;
• constipation;
• overweight;
• cold intolerance.

However, these symptoms are not considered specific, and therefore it can be quite difficult to make an accurate diagnosis. In some cases, increased sweating occurs with hypothyroidism.

Features of sweating

With a decrease in thyroid function, sweating is a secondary disorder. In this case, the following manifestations can be observed:

• generalized body sweating;
• increased sweating in the evening and at night;
• symmetrical localization of areas of sweating;
• no association of hyperhidrosis with physical or nervous tension;
• high intensity of seizures.

Important! In order to diagnose a pathology and choose a treatment, the patient must inform the doctor about the symptoms. A person may experience dry skin, general weakness, swelling. This will help the specialist refer the patient to the necessary examinations.

Methods of treatment

If sweating is due to hypothyroidism, the treatment should be determined by an endocrinologist. Also, therapy is prescribed by a dermatologist. The basis of treatment is hormonal drugs that help restore the functions of the endocrine glands.

Other methods are aimed at improving the patient’s condition, but they cannot eliminate the causes of the disease. So, the effective methods of normalizing the state include the following:

• Antiperspirants . Their ingredients provide constriction of the ducts and slow down the functions of the sweat glands. It is important to consider that there is a risk of allergic reactions and irritations.
• Physiotherapy . Under the influence of a low-frequency current, the ducts of the sweat glands and skin vessels reflexively contract. This helps to reduce sweating.

• Botulinum toxin injections . With the help of this substance, the transmission of impulses responsible for the functions of the sweat gland is disrupted. However, in endocrine hyperhidrosis, sweating usually affects the entire body, so chipping some areas does not help.
• Local surgery . It can be used exclusively for local hyperhidrosis. With hypothyroidism, this problem is very rare.
• Sympathectomy . In such a situation, the surgeon damages or destroys the nodes of the nerves responsible for transmitting impulses to the sweat glands. This treatment is effective for hyperhidrosis of the armpits and palms.

Nutrition

In hypothyroidism it is very important to stick to special diet . This will improve the prognosis of the disorder and help manage sweating. It is best to completely eliminate meat products. Instead, you need to eat fish and seafood. Seaweed must be on the menu.

It is very useful to eat fresh vegetables and fruits. It is especially important to use pumpkin, cauliflower, spinach. Broccoli, dandelion leaves are no less useful. Tea is recommended to be prepared from wild rose or wormwood. Also be sure to drink mineral water.

Important! Sprouted grains of wheat and oats should be eaten if the disease develops. With the help of these products, you can successfully cope with excessive sweating.

At the same time, it is recommended to remove smoked meats, spicy foods, pickles from the menu. It is also worth excluding spices, alcoholic beverages, pastries, milk. Under the ban and sweets. Instead of milk, it is better to use sour-milk products.

Hygiene

Day and night sweating in hypothyroidism significantly reduces the quality of life. To reduce its manifestations, you need to follow these recommendations:

• Wear loose clothing made from natural materials.
• Use special antibacterial insoles and insoles.
• Wear quality footwear made from natural materials.

• Take twice daily contrast shower. This method helps with generalized hyperhidrosis. Due to the change in temperature, blood circulation normalizes and the ducts of the glands responsible for sweating narrow.
• Make baths and applications with herbal decoctions, which include tanning elements and antibacterial components.
• Take vitamins. The condition of the skin and sweat glands is normalized by vitamins of groups B, A, E.
• Take sedatives . Remedies such as valerian and motherwort reduce the nerve stimulation of the glands.

Hypothyroidism is considered a fairly serious disease, which is accompanied by a number of unpleasant manifestations.