Etiology, Diagnosis and Treatment of Thyroid Failure

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THYROID failure may be defined as the failure of the thyroid gland to secrete an adequate amount of hormone necessary to maintain a normal rate of body metabolism, thereby resulting in a characteristic group of symptoms and signs. The terms hypothyroidism and myxedema have been defined respectively to indicate mild and severe thyroid failure, but here they shall be used synonymously. The purpose of this paper is to present a review of our experience with the causation, differential diagnosis and treatment of thyroid failure.

The mildest degree of thyroid failure is asymptomatic and may be characterized only by a lowered basal metabolic rate. Actually, this stage is rarely diagnosed and in our experience is usually seen in those patients who have gradual enlargement of the thyroid gland due to struma lymphomatosa (Hashimoto's struma). Treatment with thyroid extract will elevate the basal metabolic rate 20 to 30 per cent, but clinically these patients may feel just the same. It is probably not of great importance to diagnose the disease at this stage.

The early stage of symptomatic thyroid failure is characterized by cold intolerance, dryness of the skin and fatigue, as well as a low basal metabolic rate, but there are no symptoms or signs of the deposition of myxedematous fluid in the intercellular tissues. The patients in this stage of the disease are difficult to diagnose and are equally difficult to separate from that large group of patients with normal thyroid function who have similar symptoms.

Most important is the. . .



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