The problem of the treatment of autoimmune thyroiditis

To suppress the clinical manifestations of autoimmune disease is possible by means of hormonal drugs (glucocorticoid hormones). But their purpose in thyroid cancer has its own characteristics, different from the principles of treatment of thyroid hormonal agents, so in some cases it becomes a problematic issue. Manifestation immunosuppressive effect when glucocorticoid drugs is possible only after prolonged use of relatively high dosages of hormones. This feature naturally affects the development of side effects. Most often face complications in the form of steroid formation of ulcers in the lining of the digestive tract, hypertension.

In chronic thyroiditis should be strictly based approach to the appointment of glucocorticoid hormones. The main indications for the choice of this type of therapy are:

• ineffectiveness of thyroid hormone replacement therapy for up to four months. Performance indicators are the size of the prostate, that is, they should decrease the intake of drugs. If not, the complex of therapeutic measures should be incorporated additional hormonal
• the presence of a rare form of autoimmune disease with severe pain. Co-administration with thyroid hormones glkokortikoidov provides anti-inflammatory effect. Therapy begins with the dose of prednisone and 40 mg per day. While improving the general condition and good dynamics of clinical picture can reduce the dose of 5 mg every ten days

Treatment of autoimmune thyroiditis is the appointment of thyroid hormones. By increasing the blood levels of thyroxine and triiodothyronine the inhibition of the synthesis and release of the hormone TSH, therefore stops further increase in cancer, goiter does not progress. Preference should be given the drug, which contains iodine in a minimum amount. For autoimmune diseases, iodine may be a precipitating factor, so its intake should be limited. The most frequently used drugs "tireotom", "tireotom fort", "novotirol", which are a combination of thyroxine and triiodothyronine.

The need for replacement therapy

It is very important to choose the correct therapeutic dose for the patient. It is proved that the thyroid gland has an individual sensitivity to the action of thyroid hormones. Dose selection as determined by the age of the patient. If the patient is over 60 years, it is not recommended for more than 50 micrograms of thyroxine. Triyodtironii better to start with a minimal dose to 2 mg and gradually increasing it under the control of the electrocardiogram.

Available inflammatory changes in the tissue of the thyroid gland is well served by hormonal treatment facilities. If there has been the development of fibrous tissue, the expression of the positive effects will not be observed. Unfavorable sign is considered to be continued growth in the gland when crop is progressing, despite taking medication. In such a situation should be conducted urgently needle biopsy and the indications for surgery. In chronic thyroiditis is a list of indications for surgical intervention, which are considered absolute indications. These include the rapid growth of the crop, as there is a risk of malignancy. The large size of education leads to compression of the trachea and main large vessels, which is also a risk factor for the health of the patient.

In most clinical cases of autoimmune disease prognosis is favorable. The determining factor is early diagnosis and early initiation of therapy. There is evidence of a high risk of malignancy in chronic thyroiditis, but to date, these data are considered controversial. Questions oncological alertness should be given special attention. The volume of transaction is typically total strumectomy. Patients who suffer from autoimmune thyroiditis, who had surgery, are under the constant supervision of an endocrinologist. Accounting for these patients should be life for life. This is due to the need for correction of drugs to prevent the development of complications during surgery.

State compensation of the patient affects his ability to work and quality of life, so it is important to promptly appoint a full replacement therapy. It should exclude the presence of other autoimmune diseases that may be combined with thyroid disease. An integrated approach to diagnostic measures subsequently facilitates the choice of treatment strategy, allows to achieve remission of the disease.

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