{"id":1058,"date":"2025-01-30T16:36:21","date_gmt":"2025-01-30T13:36:21","guid":{"rendered":"https:\/\/azu-uffenheim.de\/diagnostic-et-therapie-de-lhypothyroidie-en-medecine-generale\/"},"modified":"2025-01-30T16:36:21","modified_gmt":"2025-01-30T13:36:21","slug":"diagnostic-et-therapie-de-lhypothyroidie-en-medecine-generale","status":"publish","type":"post","link":"https:\/\/azu-uffenheim.de\/fr\/diagnostic-et-therapie-de-lhypothyroidie-en-medecine-generale\/","title":{"rendered":"Diagnostic et th\u00e9rapie de l\u2019hypothyro\u00efdie en m\u00e9decine g\u00e9n\u00e9rale"},"content":{"rendered":"\n\n\n<p>L\u2019hypothyro\u00efdie touche environ 4 millions de personnes en Allemagne, les femmes repr\u00e9sentant environ <strong>80 %<\/strong> des cas. La probabilit\u00e9 de cette affection augmente consid\u00e9rablement apr\u00e8s 50 ans. On distingue l\u2019hypothyro\u00efdie manifeste, c\u2019est-\u00e0-dire une insuffisance thyro\u00efdienne compl\u00e8te, de la forme latente, beaucoup plus fr\u00e9quente, qui constitue un stade pr\u00e9alable \u00e0 une carence en hormones thyro\u00efdiennes. L\u2019iode est essentiel \u00e0 la synth\u00e8se des hormones thyro\u00efdiennes. L\u2019organisme s\u2019efforce de maintenir l\u2019approvisionnement en hormones thyro\u00efdiennes aussi longtemps que possible. En cas de carence, cela d\u00e9clenche initialement un stimulus de croissance de la thyro\u00efde. Une carence prolong\u00e9e peut entra\u00eener des zones autonomes (c\u2019est-\u00e0-dire des r\u00e9gions d\u00e9coupl\u00e9es du syst\u00e8me de r\u00e9gulation, appel\u00e9es \u00ab nodules chauds \u00bb), des cicatrices (\u00ab nodules froids \u00bb) et, rarement, des tumeurs malignes.        <\/p>\n\n\n\n<p>Les causes les plus fr\u00e9quentes d\u2019hypothyro\u00efdie incluent les maladies auto-immunes (thyro\u00efdite de Hashimoto), les chirurgies thyro\u00efdiennes, les traitements \u00e0 l\u2019iode radioactif et les d\u00e9fauts cong\u00e9nitaux de la thyro\u00efde chez les enfants. L\u2019hypothyro\u00efdie caus\u00e9e par des m\u00e9dicaments, une chimioth\u00e9rapie ou d\u2019autres troubles m\u00e9taboliques est beaucoup plus rare. <\/p>\n\n\n\n<p>Les sympt\u00f4mes de l\u2019hypothyro\u00efdie peuvent inclure une fatigue rapide, un manque d\u2019\u00e9lan, une constipation, une prise de poids involontaire et une humeur d\u00e9pressive. D\u2019autres signes r\u00e9v\u00e9lateurs incluent une peau s\u00e8che, une perte de cheveux, une intol\u00e9rance au froid ou un pouls lent. Chez les patients \u00e2g\u00e9s, l\u2019\u00e9volution peut \u00eatre insidieuse. Chez les nourrissons, une hypothyro\u00efdie prolong\u00e9e peut entra\u00eener des retards physiques et mentaux.   <\/p>\n\n\n\n<p>Pour <strong>le m\u00e9decin de famille<\/strong>, l\u2019anamn\u00e8se, les r\u00e9sultats de l\u2019examen physique et les niveaux de TSH, fT3 et fT4 sont d\u00e9terminants. Dans l\u2019hypothyro\u00efdie latente, le niveau de TSH est \u00e9lev\u00e9, tandis que l\u2019approvisionnement en fT3 et fT4, les v\u00e9ritables hormones thyro\u00efdiennes, reste suffisant. \u00c0 ce stade, les sympt\u00f4mes peuvent encore \u00eatre l\u00e9gers. Dans l\u2019hypothyro\u00efdie manifeste, les niveaux de fT3 et fT4 sont \u00e9galement r\u00e9duits. Cependant, la taille de la thyro\u00efde ne permet pas de tirer de conclusions sur son \u00e9tat fonctionnel.    <\/p>\n\n\n\n<p>Les options th\u00e9rapeutiques incluent l\u2019iodure et l\u2019hormone thyro\u00efdienne L-thyroxine. La quantit\u00e9 quotidienne d\u2019iode n\u00e9cessaire pour les adultes en Allemagne est d\u2019environ 200 \u00b5g. Les hypertrophies thyro\u00efdiennes li\u00e9es \u00e0 une carence en iode sans alt\u00e9ration fonctionnelle significative peuvent \u00eatre trait\u00e9es avec 200 \u00b5g d\u2019iodure par jour. Selon les directives de la DEGAM (Soci\u00e9t\u00e9 allemande de m\u00e9decine g\u00e9n\u00e9rale), l\u2019hypothyro\u00efdie manifeste constitue une indication claire pour une th\u00e9rapie de substitution hormonale, tandis que dans l\u2019hypothyro\u00efdie latente avec des niveaux de TSH compris entre 4 et 10 mU\/L, le traitement doit \u00eatre \u00e9valu\u00e9 au cas par cas. En revanche, pour l\u2019hypothyro\u00efdie auto-immune (Hashimoto), les directives recommandent clairement une substitution hormonale.     <\/p>\n\n\n\n<p>Le lait et d\u2019autres aliments peuvent r\u00e9duire l\u2019absorption de la L-thyroxine. Pour garantir une absorption fiable, le m\u00e9dicament doit \u00eatre pris avec de l\u2019eau au moins 30 minutes avant le petit-d\u00e9jeuner. Apr\u00e8s l\u2019initiation d\u2019une th\u00e9rapie de substitution, les niveaux de TSH doivent \u00eatre contr\u00f4l\u00e9s au plus t\u00f4t apr\u00e8s huit semaines. Une fois la posologie stabilis\u00e9e, des contr\u00f4les de suivi sont recommand\u00e9s tous les six \u00e0 douze mois et peuvent \u00eatre facilement effectu\u00e9s par le <strong>m\u00e9decin de famille<\/strong>.    <\/p>\n","protected":false},"excerpt":{"rendered":"<p>L\u2019hypothyro\u00efdie touche environ 4 millions de personnes en Allemagne, les femmes repr\u00e9sentant environ 80 % des cas. La probabilit\u00e9 de cette affection augmente consid\u00e9rablement apr\u00e8s 50 ans. On distingue l\u2019hypothyro\u00efdie manifeste, c\u2019est-\u00e0-dire une insuffisance thyro\u00efdienne compl\u00e8te, de la forme latente, beaucoup plus fr\u00e9quente, qui constitue un stade pr\u00e9alable \u00e0 une carence en hormones thyro\u00efdiennes. L\u2019iode<\/p>\n","protected":false},"author":1,"featured_media":947,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[58],"tags":[],"class_list":["post-1058","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-conseils-de-sante-fr"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.4 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>Diagnostic et th\u00e9rapie de l\u2019hypothyro\u00efdie en m\u00e9decine g\u00e9n\u00e9rale - azu-uffenheim.de<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/azu-uffenheim.de\/fr\/diagnostic-et-therapie-de-lhypothyroidie-en-medecine-generale\/\" \/>\n<meta property=\"og:locale\" content=\"fr_FR\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Diagnostic et th\u00e9rapie de l\u2019hypothyro\u00efdie en m\u00e9decine g\u00e9n\u00e9rale - azu-uffenheim.de\" \/>\n<meta property=\"og:description\" content=\"L\u2019hypothyro\u00efdie touche environ 4 millions de personnes en Allemagne, les femmes repr\u00e9sentant environ 80 % des cas. La probabilit\u00e9 de cette affection augmente consid\u00e9rablement apr\u00e8s 50 ans. On distingue l\u2019hypothyro\u00efdie manifeste, c\u2019est-\u00e0-dire une insuffisance thyro\u00efdienne compl\u00e8te, de la forme latente, beaucoup plus fr\u00e9quente, qui constitue un stade pr\u00e9alable \u00e0 une carence en hormones thyro\u00efdiennes. 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