Hypoplasia of the right lobe. Underdevelopment of the organ or hypoplasia of the thyroid gland in women: how to treat impaired hormone production and slow tissue growth. Signs and symptoms

Congenital underdeveloped thyroid gland or a decrease in the volume and weight of this organ in medicine is defined as.

Identification of this deviation from the norm and timely treatment are extremely important medical actions that preserve the health, and sometimes the life of the patient.

Brief information about thyroid hypoplasia

A pathological process that stops the development or leads to a gradual shrinkage of the endocrine organ for the production of essential thyroid hormones can begin at any period of life.

Hypoplastic thyroid in children can develop while in the womb. This term is used until adolescence.

Hypoplasia of the thyroid gland in adults diagnosed as atrophy, although doctors often use the first term.

hypoplasia

accompanied by a decrease in hormone production.

If the entire gland is evenly affected by the pathology (the shape of the organ is preserved, but it does not correspond to the normative volume parameters), then they speak of diffuse hypoplasia of the thyroid gland.

But there are cases when the anomaly affects a certain part of the organ.

Then the diagnosis determines specifically where the process develops: hypoplasia of the left lobe of the thyroid gland or its right lobe.

Normative volume of the gland

It has been established that the normal volume of the thyroid gland (both lobes are taken into account, the isthmus is not taken into account - its volume does not exceed 3-5%) is: no more than 25 cubic meters. cm for women, 18 cc see for men.

The standard does not set a lower limit.

In children, the volume of the gland depends on age and physiological development, the doctor determines the upper limit of the norm according to tabular data, taking into account the physiological development of the child.

Although the thyroid gland is the largest of the endocrine organs in size, each of its lobes in a healthy adult does not exceed the volume of the nail phalanx of the thumb on the hand.

With a normal volume, the gland cannot be seen on the surface of the neck and even felt on palpation.

A reliable diagnostic method for determining the volume of an organ is ultrasound. This study also informs about the structure of the gland, its contours, reveals.

The ultrasound protocol indicates the dimensions of the length, width and height in millimeters (or centimeters) of each lobe of the organ.

multiply the data of each share, sum the products obtained for the right and left shares, multiply the result by the ellipsoid coefficient equal to 0.479.

As a result, there will be a value of the volume of the gland, which is compared with the norm: the gland is increased or decreased, or the volume of the organ is normal.

It is not possible to make a definite diagnosis hypoplasia of the thyroid gland» only on the basis of a volume indicator that does not reach the tabular standard. It is necessary to analyze the whole complex of laboratory and clinical information.

Hypoplasia of the thyroid gland in women

The male part of the adult population of hypoplasia is extremely rare - 1 case in 4 thousand men.

Medical statistics states that this pathology is characteristic of the weaker sex, starting from puberty, the reproductive period and up to menopause, with some oncological diseases.

The reproductive health of a woman directly depends on the state of the thyroid gland. Organ disorders, including hypoplasia, can affect infertility, miscarriages in early pregnancy.

The disease develops slowly, the symptoms are mild, and often they are considered signs of other ailments and diseases.

depression,
anemia,
chronic fatigue.

In the treatment of infertility, a woman must necessarily include an endocrinological examination, which begins with a study of the thyroid gland.

Decreased thyroid gland and pregnancy

However, the pathological process of reducing the volume of the thyroid gland in pregnant women is not excluded. It causes a malfunction in the functioning of the gland.

Hypothyroidism begins, in which the body of the mother and the developing fetus does not receive the required amount of thyroid hormones.

Pregnancy occurring against the background of thyroid hypoplasia is classified as a pregnancy with a high risk of complications at any time. These include:

miscarriage,
frozen pregnancy,
preeclampsia - severe toxicosis of the last terms of gestation, threatening death.

A decrease in the size of the maternal thyroid gland threatens the unborn child with congenital hypoplasia of the thyroid gland, mental retardation, and malformations of various organs.

Monitoring the state of the thyroid gland before conception, during pregnancy and lactation, the strict implementation of medical prescriptions guarantees the normal intrauterine formation of the fetus, the birth of a healthy child, its normal physiological and intellectual development.

Consequences of oral contraceptives

It has been established that (hypothyroidism) and reduction in organ volume are interrelated.

The occurrence of one disease causes the development of another. Symptoms of the first are signs of the second.

The appearance of hypoplasia against the background of hypothyroidism often occurs due to the use of oral contraceptives that prevent the fertilization of the egg.

Before starting to use hormonal drugs, it would be useful to study the annotation for the manifestation of possible disorders in the body.

Without paying attention to the accompanying symptoms, it is easy to endanger the loss of thyroid health, which is not always restored.

The occurrence of apathy, depression, weakness, constant nervousness, decreased sexual desire, hair loss, acne on the face and under the scalp on the head signal thyroid dysfunction.

These phenomena occur because the thyroid gland and ovaries have receptors that are sensitive to each other's hormonal substances.

Using synthetic sex hormones, a woman suppresses the natural work cycle of the ovaries and at the same time the function of the thyroid and adrenal glands.

Long-term use of hormonal contraceptives inhibits the own functions of all endocrine organs, which are difficult to restore normal operation.

Hypoplastic disease in children

For the first time, the functioning of the thyroid gland is diagnosed in maternity hospitals in newborns, conducting laboratory blood tests for thyroid hormone T4 (thyroxine) and TSH (thyroid-stimulating hormone produced by the pituitary gland).

An increased level of TSH (at a normal rate of 0.5 - 5.0 μU / ml) and low T4 values \u200b\u200b(normal 60-140 nmol / l) indicate. If abnormalities are detected, an ultrasound of the organ is prescribed.

If there is a sharp decrease in the volume of the entire organ or its partial absence, which states a congenital malformation of the gland - hypoplasia. With a complete absence, they speak of aplasia of the thyroid gland.

A post-term pregnancy should be alarming and suggest congenital hypoplasia or hypothyroidism in the newborn.

Symptoms of hypoplasia in young children

For newborns with the presence of such a pathology, they are characterized by: large weight (over 4 kg), swollen face, large tongue that does not fit in the mouth, a rough voice when crying, difficult healing of the navel, prolonged jaundice (more than 20-30 days), the original feces depart late and with difficulties.

First-year-olds have difficulty swallowing, decreased appetite, lag in physiological and psychomotor development (poor growth and weight gain, does not sit, walk, or speak in due time, teeth are not cut well or not at all), flabby muscles, dry, flaky skin, chronic constipation , ice hands and feet.

In children older than a year, in addition, as a rule, there are: delayed physical development, mental retardation, slow heartbeat, low blood pressure.

disease in adolescents

With age, the congenital pathology of the organ in the form of hypoplasia manifests itself more clearly and reaches its "climax" in adolescence, accompanied by puberty.

During this period, the lack of thyroid hormones associated with an insufficient volume of the gland externally affects weakness, drowsiness, memory loss, poor academic performance, low temperature, lack of appetite, and frequent constipation.

Forecast

It is impossible to restore the gland in normal volumes. lifelong use of hormone replacement therapy.

Early diagnosis of an abnormal deviation and a properly selected dose of hormones serve as a guarantee of the normal physical and neuropsychic development of the body, which will provide a person with a full life.

Hypoplasia of the thyroid gland - this is the name of the pathology in which there is an underdevelopment of this organ, accompanied by impaired hormone production. It is also the cause of slow growth or even atrophy of organ tissues. The disease can manifest itself in different ways: for example, the size decreases or the development of some area of the thyroid gland is disturbed. Diffuse hypoplasia or hypogenesis implies a uniform pathological process in the organ, which does not always happen. Usually one lobe is affected. Often develops hypoplasia of the left lobe of the thyroid gland, or the right.

Hypoplasia of the thyroid gland in women is observed from an earlier age than in men. Hypoplasia of the thyroid gland in children is mostly congenital. Symptoms may not appear immediately. If a child is breastfed, then he receives the necessary hormones with mother's milk. When the baby is weaned from the breast, as well as its growth becomes more intense, the need for hormones increases. Their shortcomings become apparent. The reason may be a lack of iodine in the mother's body, or developmental defects inside the womb. As well as maternal hypothyroidism.

Types and degrees

When the thyroid gland is completely absent, this condition is called aplasia. If there is an underdevelopment of the thyroid gland, that is, its size is less than normal, then this is called diffuse hypoplasia. It happens that one lobe (right or left) is missing, then a diagnosis is made - hypogenesis of the thyroid lobe. To accurately determine the type and severity of the disease, the endocrinologist conducts ultrasound diagnostics. The doctor has special tables, and, focusing on the indicators, he correctly diagnoses.

Unfortunately, it is impossible to completely restore the thyroid gland. But if you immediately make a diagnosis and start treatment (usually a lifelong intake of hormones), then the child will not lag behind other children in development. If treatment is started late, then the symptoms can be weakened, but the child will lag behind in development. In full-term babies, after 4 or 5 days, blood is taken to determine the level of thyrotropin and thyroxine hormones; in premature babies, such an analysis is taken a week later. If there is suspicion, conduct additional research.

Symptoms in children

In infants, signs of thyroid hypoplasia coincide with those of hypothyroidism. These can be: overweight (more than 4 kg); late cleansing of the body from feces after birth; swollen lips, eyelids, cheeks; large, flat tongue that does not fit into the mouth; rough voice when crying; long non-healing navel; physiological jaundice lasting longer than usual.

If treatment is started immediately, signs of thyroid hypoplasia in childhood may appear as early as 2 months. Triiodothyronine and thyroxine in this case are produced in insufficient quantities. Such a disease manifests itself as follows:

the child is constantly falling asleep,
appetite worsens,
body weight is lost
reaction to external stimuli slows down or is completely absent,
voice changes, hoarseness appears,
increased frequency of constipation
extremities are constantly cool.

During pregnancy, the mother's body may not receive enough iodine, which causes insufficient production of hormones that both need. Also, a woman may develop hypoplasia of the thyroid gland, pituitary gland, or even before pregnancy. All this can lead to such complications during pregnancy as hypogenesis in the fetus, or even its death.

If the symptoms are not detected in time and the treatment of hypoplasia is not started, the child may develop a dangerous disease - this disease is also called dementia. With this disease, a person is far behind in mental development and suffers from neurological disorders.

Symptoms in the female half of the population

The disease becomes a frequent occurrence in women over 30 years old, and after 60 its probability increases significantly. It appears slowly, so it is difficult to detect at an early stage.

Symptoms of increased thyroid function may include:

dry skin;
constantly breaking hair and nails;
muscle pain.

A symptom of decreased thyroid activity is chronic depression. Any hormonal disorders, lack or excess of hormones catastrophically affect the body. Hormonal disorders can take various forms:

autoimmune or simple thyroiditis,
nodular toxic goiter,

Different types of the disease may have similar symptoms. Many people complain about the so-called "lump in the throat." It may be difficult for the person to swallow, as if something is in the way. The disease may be similar to the onset of a sore throat. The pain is aggravated by swallowing saliva and taking a deep breath. The mood changes suddenly and drastically.

May be accompanied by headache, weakness, increased sweating and weight loss. The autoimmune form is accompanied by pain in the neck. Fibrous thyroiditis is manifested by tinnitus, as well as visual impairment. The acute stage of inflammation is manifested by inflammation of the lymph nodes, pain in the back of the head, and also in the neck.

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Treatment

If the size of the thyroid gland exceeds the allowable values, an operation is prescribed. After it, an almost imperceptible scar remains. Radiological treatment may also be offered. Constant supervision is necessary in any case. If they do not grow, then they are treated with medicines, and if they grow, then an operation is suggested. Often, doctors recommend eating foods that contain a large amount of iodine (for hypothyroidism), and for hyperthyroidism, on the contrary, a diet with a low content of iodine in foods is prescribed.

An important role in the treatment is played by cleansing the body of toxins, especially blood, lymph, and intestines. This point should be remembered by all people, even those who do not develop thyroid hypoplasia. Minerals such as:

manganese;
selenium;
cobalt;
copper.

A large number of them are found in beets, turnips, rose hips, garlic, blueberries, as well as other vegetables and berries. Help in the treatment of thyroid gland are folk remedies, but you can take anything only with the permission of a doctor.

Bibliography

Restoration of the thyroid gland - Ushakov A.V. - Patient Guide
Diseases of the thyroid gland - Valdina E.A. - Practical guide
Diseases of the thyroid gland. - Moscow: Mashinostroenie, 2007. - 432 p.
Diseases of the thyroid gland. error-free treatment. - M.: AST, Owl, VKT, 2007. - 128 p.
Henry, M. Cronenberg Diseases of the thyroid gland / Henry M. Cronenberg et al. - M .: Reed Elsiver, 2010. - 392 p.
Grekova, T. Everything you didn't know about the thyroid gland / T. Grekova, N. Meshcheryakova. - M.: Tsentrpoligraf, 2014. - 254 p.
Danilova, N.A. Diseases of the thyroid gland. Effective methods of treatment and prevention / N.A. Danilova. - M.: Vector, 2012. - 160 p.

⚕️ Olga Alexandrovna Melikhova - endocrinologist, 2 years of experience.

Deals with issues of prevention, diagnosis and treatment of diseases of the endocrine system: thyroid gland, pancreas, adrenal glands, pituitary gland, gonads, parathyroid glands, thymus gland, etc.

The thyroid gland plays an important role in the human body, it takes part in various metabolic processes, promotes the growth of cells and bone tissue. The thyroid gland is located in the larynx, where the trachea begins.

In medical practice, there are frequent cases of its increase, and a reduced thyroid gland in women is diagnosed less, but this does not make the situation less serious and also requires a special approach to treatment. In our editorial, we will talk about how the reduced thyroid gland manifests itself in women, for what reasons pathology appears and how to deal with it.

Why does the size of the thyroid gland decrease, and what forms is the pathology divided into?

In medicine, the process of reducing the thyroid gland is called hypoplasia, which is mainly manifested in the female population. The delay in diagnosing pathology leads to the transition of the disease into a chronic form, which can develop without any particular manifestations of symptoms.

Hypoplasia is a rare pathological phenomenon, which is characterized by underdevelopment of the thyroid gland. It is accompanied by a violation of hormonal synthesis and a decrease in tissue growth. It manifests itself as a decrease in the size of the thyroid gland or its uneven development.

Forms

An insufficiency of the thyroid gland to synthesize the required amount of hormones is called hypofunction.

It mainly manifests itself in women, since their body is subject to biorhythms, such as:

pregnancy (see );
childbirth;
lactation;
menstrual cycle;
menopause.

A greater risk of developing pathology is observed in women after 60 years, as well as in pregnant and lactating mothers. Diagnosing pathology is quite difficult, because when the thyroid gland is reduced in women, there are clear signs of normal overwork, there may be similarities with diseases of the kidneys, heart and blood vessels (see). In medicine, there are two forms of the disease.

Table number 1. Forms of hypoplasia:

The provoking factors for the development of hypoplasia can be a variety of reasons, and they are of a completely different nature.

Hypoplasia of the thyroid gland is a rare pathological condition of the body, which is characterized by underdevelopment of the gland and, as a result, a violation of the secretion of hormones and a slowdown in the growth of gland tissues. This disease can occur in the form of a diffuse decrease in the size of an organ or an uneven distribution of parts of the gland, for example, hypoplasia of the left lobe of the thyroid gland.

This disease may not have characteristic symptoms and not provoke functional defects (pathology is detected in 1:2000 schoolchildren in regions with insufficient iodine in food). In the US, only 200,000 people have been diagnosed with hypothyroidism. The incidence of this pathology is 1 case for every 3-4 thousand newborns.

Most often, hypoplasia begins to develop when the child is still in the womb, and its symptoms can be noticed immediately after the birth of the baby.

The reasons

The reason for the development of this pathology is a gene mutation that occurs in the fetus during the gestation period due to the influence of various factors:

exposure to chemicals and radiation;

mother taking hormonal drugs;

hereditary factor (there are some observations that demonstrate a genetic predisposition to thyroid hypoplasia, but this information has not yet received official confirmation);

insufficient intake of iodine with food in the body of the carrying mother, the presence of thyroiditis, hypothyroidism in her.

Symptoms

Signs that are characteristic of thyroid hypoplasia begin to appear in a child from 2-3 months of age. The occurrence of the symptoms listed below is due to insufficient synthesis of the hormone thyroxine and triiodothyronine in the body.

Symptoms of thyroid hypoplasia:

lag in psychomotor development (slowed physical development, impaired attention, impaired pronunciation, begins to catch the eye from 4-6 months of a child's life);

prolonged yellowness of the skin;

frequent development of constipation;

complete absence or inhibition of reaction to external stimuli (light, sound);

weight loss and loss of appetite;

lethargy, lethargy, drowsiness.

In the case of late diagnosis and a long-term absence of thyroid hormone replacement, there is a high probability of developing a very serious complication of this pathology - cretinism. This disease is characterized by the presence of a deep lag in psycho-emotional development, as well as serious neurological disorders.

Hypoplasia of the thyroid gland in women

In women, hypoplasia provokes dysfunction of the organs of the reproductive system and, as a result, leads to the development of infertility. Signs of the development of cretinism are:

speech disorder;

clumsy gait and impaired coordination of movements;

underdevelopment of the genital organs;

thin nail plates (break, crumble, exfoliate), brittle hair, thick skin;

low location of the navel and protrusion of the abdomen;

short stature and disproportionate physique (depressed bridge of the nose, excessively large head, strabismus).

In the later stages of the pathology, mysedematous edema occurs, which are characterized by the accumulation of a mucus-like viscous fluid in the physiological cavities of the patient's body. Note:

bradycardia - a sign of the presence of heart failure (pallor of the skin, cold extremities);

hearing impairment (due to swelling of the middle ear);

respiratory failure (swelling of the nasopharyngeal mucosa);

swollen eyelids, smoothness of facial contours.

Diffuse hypoplasia in an adult becomes one of the causes of the development of disorders of the heart and gradually provokes the growth of the organ, which is accompanied by the accumulation of fluid in the cavity of the heart sac (pericardium). Heart failure, in turn, provokes the development of chronic renal failure and disorders in the digestive system.

Diagnostics

The main principle is timely prevention. To detect hypoplasia of the thyroid gland in the early stages, you need to visit an endocrinologist annually. If the doctor during the examination suspected the presence of hypoplasia, the diagnosis should be confirmed by ultrasound and determination of the level of thyroid hormones in the blood. Today, perinatal screening is widely used. Thanks to this method, the level of thyroid hormones is recorded in each newborn, so it is possible to determine the pathology immediately after the birth of the baby.

Treatment

Replacement therapy is the main method of treatment of thyroid hypoplasia. This technique involves the systematic use of hormonal drugs that can compensate for the lack of thyroid hormones. Such hormonal therapy should be carried out throughout the life of the patient, and hormone levels should also be monitored. Early initiation of therapy makes it possible to prevent the progression of pathology and prevent the development of severe complications. The maximum effectiveness of treatment can be achieved if it is started from the first months of life of a newborn with this pathology.

In the case of a later start of therapy, all the disorders that have already occurred will go into an irreversible stage, but further progression of the pathology will be stopped.

The prognosis of treatment depends on the time of diagnosis of this pathology. If treatment is started early, irreversible changes can be prevented. In the opposite situation, in the absence of treatment and the development of a severe degree of hormonal deficiency, irreversible changes occur in the condition and body of the patient, which ultimately can cause death.

Hypoplasia of the thyroid gland occurs due to a mutation of a certain gene in a developing fetus. This process occurs under the influence of external and internal factors:

due to the use of hormonal drugs;
when exposed to the body (especially a pregnant woman) of certain chemical or radioactive substances;
with a lack of iodine in the body of a woman who is carrying a child (when she is diagnosed with hypothyroidism, thyroiditis);
predisposition to hypoplasia can be inherited.

With pathologies of the hypothalamic-pituitary system, hypoplasia of the thyroid gland can also develop. Thyroid stimulating hormone (TSH) is synthesized in the pituitary gland, which stimulates the thyroid gland and, accordingly, ensures its proper functioning. With a lack of thyroid-stimulating hormone in the gland, the secretion of thyroxine and triiodothyronine is disturbed.

Important! Dysfunctions of the hypothalamic-pituitary system lead to inhibition of thyroid function.

If a pregnant woman has a lack of iodine in the diet, due to which the amount of thyroid hormones insufficient for the life of the mother and child is produced, then the following problems appear:

premature birth;
miscarriage;
preeclampsia (severe toxicosis in late pregnancy);
malformations of the child;
intrauterine fetal death.

If a pregnant woman has an iodine deficiency for a long time, then autoantibodies begin to form in the body that affect their own tissues, in which case the thyroid gland is destroyed (autoimmune thyroiditis).

Important! In the fetus in this situation, the gland remains underdeveloped and therefore does not function after birth or does not produce enough hormones.

Types of hypoplasia

Endocrinologists distinguish three types of underdevelopment of the thyroid gland:

Aplasia is the complete absence of a gland in a child from birth.
Diffuse hypoplasia is a uniform decrease in the size of the thyroid gland.
Single hypoplasia - characterized by the absence or underdevelopment of only one of the lobes of the thyroid gland.

With the help of special tables, after an ultrasound examination, the doctor determines the stage of the disease at the moment.

Signs of hypoplasia

The peak manifestation of pathology is observed at the age of 2-3 months after birth. This is due to the lack of education in the baby's body of thyroid hormones (thyroxine and triiodothyronine). When sick in infants, it is noted:

lack of appetite (as a result - low body weight, which does not meet age standards);
lethargy, drowsiness, lack of interest in the outside world;
lack of response to external stimuli (light, sound), or inhibition of the reaction;
prolonged postpartum jaundice;
regular problems with stool (constipation in a breastfed baby);
hoarseness of voice.

At the age of 4-6 months, underdevelopment of the baby is noted. He has impaired attention, pronunciation of sounds, and physical underdevelopment is also observed.

Attention! If hypoplasia is not diagnosed on time, then with age, the lack of thyroid hormones in a baby leads to the development of cretinism - a lag in physical and mental development, combined with neurological disorders.

The manifestation of hypoplasia in women

In adult women, a lack of thyroid hormones and atrophy of thyroid tissue lead to disturbances in the functioning of the reproductive system. Often it is endocrine diseases that are the cause of infertility or miscarriage.

Symptoms of cretinism include:

low location of the navel;
protrusion of the abdomen;
impaired speech, coordination, gait;
cosmetic defects (too thick skin, fragility and hair loss, delamination of the nail plate);
hoarseness of voice;
underdevelopment of external and internal genital organs;
short stature, lack of proportional physique (strabismus, head enlargement, and others).

As the disease progresses, mucus-like fluid begins to accumulate in the body cavities of the patient, and myxedematous edema develops. As a result, the patient shows:

swollen eyelids;
smoothed facial contours;
swelling of the mucous membrane of the upper respiratory tract, as a result of which the breathing process is disturbed;
swelling of the middle ear with hearing loss;
bradycardia;
signs of heart failure (pallor of the skin, cold extremities).

In an adult, hypoplasia causes mainly a violation of cardiac activity, as a result, the size of the heart increases, and fluid begins to accumulate in its cavity (pericardium).

Heart failure provokes pathologies in the digestive system, as well as kidney failure.

Diagnosis of hypoplasia

Since the first stages of hypoplasia are almost asymptomatic, for the timely diagnosis of thyroid pathology, it is necessary to undergo preventive examinations and take a blood test for the level of thyroid hormones.

If the doctor has doubts during palpation of the thyroid gland, then he prescribes an ultrasound examination. All newborn babies are also checked for thyroid hormone levels to detect hypoplasia and immediately begin its treatment.

Adults may also be assigned a puncture. Hypoplasia in this case is diagnosed by the amount of glandular tissue (with a low content or absence, the diagnosis is confirmed).

Treatment of hypoplasia

The way to eliminate thyroid hypoplasia is hormone replacement therapy. It is carried out throughout life, while the level of thyroid hormones must be constantly monitored.

Important. The effectiveness of treatment increases in cases where the disease is diagnosed at an early stage. It also helps to prevent the progression of the pathology and the development of serious complications, which were described above. It is necessary to treat a child from the first months of life.

If treatment is started at a late stage, then it is impossible to restore the functioning of the organ, as well as eliminate all the complications that have appeared. In this case, replacement therapy will only stop the development of hypoplasia and prevent further complications.