BAD HOMBURG. Thyroid disorders can be accompanied by both hyperthyroidism and hypothyroidism. It is not always easy for doctors to make a diagnosis. Prof. Dr med. Dr h.c. Christian Wüster heads the Hormone and Metabolism Centre in Mainz, where he also treats patients from the Bad Homburg area. He explains how an underactive thyroid can be diagnosed: ‘An underactive thyroid is characterised by an excessively high level of the regulatory hormone TSH, also known as thyroid stimulating hormone. At the same time, hypothyroidism is accompanied by low levels of the thyroid hormones triiodothyronine and levothyroxine. They are also referred to as free T3 and free T4. If the TSH value is elevated and the values for free T3 and free T4 are also within the normal range, this is referred to as incipient hypothyroidism, medically labelled as subclinical hypothyroidism.’
The corresponding hormone diagnostics therefore reveal a difficult picture from which hypothyroidism can be deduced. Prof Wüster always develops an individual treatment plan for his patients from the Bad Homburg area. After all, hypothyroidism does not always require drug treatment. What are the typical symptoms of hypothyroidism?
If the hormone function becomes unbalanced in the direction of hypothyroidism, this can result in sensitivity to cold, shivering, a slower pulse rate, significant weight gain, fatigue, concentration problems and even depressive moods and constipation. Prof Wüster names autoimmune thyroidopathy, too low a dosage of thyroid hormones or too high a dosage in the treatment of hyperthyroidism as typical causes.
Hypothyroidism can also occur as a result of surgical removal or partial removal of the thyroid gland. Hypothyroidism has also been observed after radioiodine therapy. With medication and regular blood tests, hypothyroidism can be controlled as a consequence of therapy. Congenital hypothyroidism is also conceivable. Depending on the underlying cause and the extent of the symptoms associated with the hypofunction, Prof Wüster will initiate an individual therapy. For the endocrinologist, the focus is always on avoiding overtreatment and only prescribing medication if this is diagnostically and therapeutically justifiable.