Hypothyroidism is a clinical entity very commonly encountered in clinical practices. Untreated hypothyroidism can lead to hypertension, dyslipidemia, infertility, cognitive impairment, neurological and neuromuscular involvements. Neurological complications include reversible cerebellar ataxia, dementia, peripheral neuropathy, psychosis, coma, encephalopathy (Hashimoto's encephalopathy), neuromuscular disorders. The disease identification in the initial stage remains difficult as it presents with a large number of clinical features. Neonatal screening protocols in all patients of hypothyroidism can help in the timely detection as well as treatment. Most of the neurological manifestations can be reversed on timely administration of levothyroxine which works well even in reversing of the symptoms as it reverses the metabolic abnormalities. It is important to evaluate every patient with hypothyroidism or with the suspicion of the disease for any neurological abnormalities.
Comprising of trillions of various bacteria, protozoan, fungi and viruses, the gut microbiota live in human body as a super complex ecosystem mostly in gastro intestinal tract (70%). Apart from GI tract they also inhabit skin, mouth and sexual organs as an essential ecological community of commensal, symbiotic or even pathogenic relationship. These microbiota interplay with bodily immune, endocrinal, metabolic and nervous system and produces various pathological changes responsible for disease etiology. These microbiota play a major role in digestion and absorption of macro molecules, maturation of immune system, protection of gut and behavioural development of an individual. In gut disorders like inflammatory bowel disease (IBD) or irritable bowel syndrome (IBS) the altered brain axis is responsible for disorders like depression, anxiety, schizoaffective disorders, autistic spectrum disorders, multiple sclerosis and parkinson’s disease.
Hyperthyroidism with its excess circulatory thyroid hormones commonly presents with systemic features like palpitation, weight loss and heat intolerance. This hyperadrenergic, hypermetabolic state with its peripheral and central nervous system affection produces protean neurological manifestations which are generally overlooked by internist. Features of neuropsychiatric nature, cognitive impairment, and dementia movement disorder like tremors or chorea may be presentation of undetected hyperthyroidism. Affliction for muscles presents with proximal myopathy with or without myalgia in 50-70% of long standing hyperthyroid state. Similarly thyrotoxic periodic paralysis due to low serum potassium in adult male is often misdiagnosed as Guillain-Barré syndrome, however replacement of potassium drastically reverse the condition. There is a strong association between autoimmune thyroiditis and ocular myesthenia which post difficulties in clinical diagnosis. Despite of so much variability in clinical presentation attainment of euthyroid state coupled with beta blocker in many situations is helpful to resolve most of the issues. Keywords: Hyperthyroidism, Grave's, Tremors, Myopathy, Periodic paralysis.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.