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Various authors have suggested that thyrotoxic myopathy is a result of the weight loss and generalized asthenia associated with hyperthyroidism. Muscle involvement has been reported to occur in about 80% of thyrotoxic patients (see section #Epidemiology), [7] and the most common causes of hyperthyroidism are Graves’ disease, toxic ...
Other features are pseudomyotonia, myokymia, slow tendon reflex, slowed muscle contractions and relaxations, muscle stiffness, proximal muscle weakness and myopathy. The severity of these symptoms are determined by the period of hypothyroidism and the degree of deficiency of thyroid hormones. [10] It may also include macroglossia. [11]
The leading cause of hypothyroidism is Hashimoto’s disease (also known as Hashimoto’s thyroiditis, chronic autoimmune thyroiditis or lymphocytic thyroiditis), per Cleveland Clinic.
Hoffmann syndrome is a rare form of hypothyroid myopathy and is not to be confused with Werdnig-Hoffmann disease (a type of spinal muscular atrophy). It was first documented in 1897 by Johann Hoffmann. [1] It has adult-onset symptoms and is comparable to the childhood-onset Kocher–Debré–Semelaigne syndrome.
Damage to neurons in the brain or spinal cord can cause prominent muscle atrophy. This can be localized muscle atrophy and weakness or paralysis such as in stroke or spinal cord injury. [14] More widespread damage such as in traumatic brain injury or cerebral palsy can cause generalized muscle atrophy. [15]
Biotin can cause this test to read "falsely low". [22] Time of day can affect the results of this test; TSH peaks early in the morning and slumps in the late afternoon to early evening, [65] with "a variation in TSH by a mean of between 0.95 mIU/mL to 2.0 mIU/mL". [66] Hypothyroidism is diagnosed more often in samples taken soon after waking. [67]
People with hypothyroidism often have no or only mild symptoms. Numerous symptoms and signs are associated with hypothyroidism and can be related to the underlying cause, or a direct effect of not having enough thyroid hormones. [15] [16] Hashimoto's thyroiditis may present with the mass effect of a goiter (enlarged thyroid gland). [15]
Certain medications can have the unintended side effect of affecting thyroid function. While some medications can lead to significant hypothyroidism or hyperthyroidism and those at risk will need to be carefully monitored, some medications may affect thyroid hormone lab tests without causing any symptoms or clinical changes, and may not require treatment.