Mixedema: what is it, associated characteristics and symptoms

Myxedema is a complicated medical condition that results from not being properly diagnosed and treated with hypothyroidism.

This medical problem can be quite problematic for the life of the patient as it involves severe skin changes, fluid retention, and some cognitive issues.

It can get worse, leading to attacks of myxedema, In which the consequences can be fatal, leading to coma and death. Below we will find out more symptoms of this disease, what are its possible causes and how it is treated.

    What is myxedema?

    Myxedema is another term for severely advanced hypothyroidism. Hypothyroidism occurs when the thyroid gland does not make enough thyroid hormones. The thyroid is a gland that releases hormones responsible for regulating energy levels and the general functioning of the body. In the event of poor production of these hormones, several functions of the body are affected.

    Very advanced hypothyroidism can cause an attack of myxedema, which is a very serious medical condition requiring urgent intervention.

    The word myxedema is mainly used to denote the dermatological symptoms of advanced hypothyroidism and the associated clinical picture. Some of the main skin changes that can occur as a result of thyroid gland dysfunction include: Swelling of the face, including the lips, eyelids and tongue.

    Swelling and thickening of the skin on any part of the body, especially on the lower legs.


      In addition to the skin changes we have already mentioned, other symptoms may be associated with myxedema.

      • Low blood pressure
      • Low heart rate
      • Thinning and brittle hair
      • Goll (enlarged thyroid gland)
      • Little energy and lethargy
      • Weight gain
      • weakness
      • Cold intolerance
      • constipation
      • depressive symptoms
      • thickening of the skin
      • rough skin
      • Negative bucket sign.
      • Change in the appearance of the face
      • Thick nose.
      • Gelatinous infiltrations in the subcutaneous tissue
      • He speaks slowly
      • mental slowness
      • lethargy
      • mental problems
      • Pale yellow dry skin
      • Edematous subcutaneous tissue
      • Weight gain
      • constipation
      • Brittle and thinning hair
      • Calvas
      • muscle aches
      • Hearing loss and deafness
      • Carpal tunnel syndrome

      Myxedema attack

      Myxedema attack, also called myxedema, is an urgent medical condition that occurs when the body cannot tolerate changes associated with severe hypothyroidism. The body is decompensated, with very abnormal levels of different substances that interfere with the proper functioning of the body.

      • respiratory depression
      • Low sodium level in the blood
      • Hypothermia: body temperature below 35 °
      • Confusion and worrying mental slowness
      • Shock
      • Low level of oxygen in the blood
      • High levels of carbon dioxide in the blood
      • Coma
      • convulsions

      Myxedema crisis it can lead to death due to complications from infection, bleeding, or respiratory arrest. It is more common in women (80%) and people over 60, appearing mainly in winter. It can also happen during pregnancy.

      the causes

      As we have seen, hypothyroidism it happens when the thyroid gland is not functioning properly. There may be several reasons why the thyroid gland fails or functions less than it should, including:

      • Autoimmune disease, including Hashimoto’s disease
      • Surgical removal of the thyroid gland
      • radiotherapy
      • Certain medicines, such as lithium and amiodarone (Pacerona)
      • Deficiency or excess of iodine
      • pregnancy
      • Medicines for the immune system, such as those used for cancer

      Usually the dermatological problems of myxedema and the crisis associated with this medical problem arise when severe hypothyroidism has not been properly diagnosed or treated. It can also occur as a result of discontinuing thyroid medications, causing this clinical picture to appear.

      One of the biological explanations that have been given to explain myxedema concerns deposits of carbohydrate chains, especially mucopolysaccharides. These substances accumulate in the damaging skin. In addition, they explain the swelling because they are substances that attract water, causing it to accumulate in the skin.

      As for the myxedema crisis, which, as we mentioned, is much more serious, this usually happens more during the winter months and can be triggered by the following factors:

      • Stopping treatment for hypothyroidism
      • Suffering from a heart attack or embolism
      • infection
      • trauma
      • Use of central nervous system suppressant drugs
      • Cold exposure
      • Stress

      How is myxedema diagnosed?

      Myxedema is a medical condition that, when administered, does not go unnoticed. Whether in the form of a seizure or in its less urgent form, the doctor will quickly diagnose that you have myxedema, and will proceed to his intervention. To confirm the diagnosis, blood tests may be done to look at the levels of sodium, carbohydrates, oxygen, and carbon dioxide..

      In myxedema, it often happens that the pituitary gland increases the production of thyroid-stimulating hormone when the thyroid gland is not working hard enough. The thyroid gland test is accompanied by the test for thyroxine (T4), a hormone produced directly in the thyroid. If there is a high production of thyroid stimulating hormones but low thyroxine, there is a biological indicator that you have hypothyroidism.

      As for the myxedema crisis, given the seriousness of the situation, it will be necessary to proceed quickly and confirm the diagnosis as soon as possible. Therefore, medical staff will focus on the following symptoms to confirm or reject the diagnosis and intervene urgently:

      • dry skin
      • thinning hair
      • hypothermia
      • Swelling of the face and legs
      • goll
      • Possible scar from thyroidectomy
      • Low blood pressure and heart rate
      • confusion
      • decreased breathing

      Complications of myxedema

      The thyroid gland is very important for the proper functioning of the body, Mainly of metabolism. In very advanced hypothyroidism, it often happens that the metabolism is much slower, affecting the use of oxygen. It very negatively affects all organ systems and processes in the body, so the following medical complications can occur if myxedema is left untreated.

      • hypothermia
      • Swelling and water retention
      • Under drug metabolism and risk of accumulation
      • Problems during pregnancy, such as miscarriage, preeclampsia (high and chronic blood pressure), premature birth, and birth defects
      • heart failure
      • kidney problems
      • depression
      • Coma
      • dead

      How is myxedema treated?

      To prevent myxedema, hypothyroidism must be treated firstBecause it is this medical problem that causes it. Therefore, treatment focuses on administering a synthetic version of the T4 hormone called levothyroxine (Levothroid, Levoxyl).

      Once administered, T4 levels are restored, Make the symptoms easier to control. Although it may take weeks for there to be an acceptable improvement, it must be said that this intervention is very effective. Likewise, the patient will likely need to take the drug for the rest of his or her life.

      With regard to myxedema attacks, treatment is urgent. the patient will receive intensive care and the first treatment option is to give thyroid hormone replacement therapy, given intravenously. There will also be blood tests to confirm the levels of different substances.

      Prevention is preferable to treatment because, in a crisis, even under emergency treatment, mortality is quite high, between 25 and 60%.

      Bibliographical references:

      • Berger, William D. James, Dirk M. Elston, Timothy G. (2011). Andrew’s Skin Diseases: Clinical Dermatology (11th ed.). [London]: Saunders / Elsevier. ISBN 978-1-4377-0314-6.
      • McConahey, WM (March 1978). Diagnosis and treatment of myxedema and myxedema coma. Geriatrics. 33 (3): 61-66. ISSN 0016-867X. PMID 624451
      • Lindholm, J .; Laurberg, P. (2011). Hypothyroidism and thyroid replacement: historical aspects. Journal of Thyroid Research. 2011: 809341. doi: 10.4061 / 2011/809341. PMC 3134382. PMID 21760981.

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