HYPOTHYROIDISM AND AUTOIMMUNE DISEASES: CLINICAL MANIFESTATIONS AND METABOLIC COMPLICATIONS

Abstract

Introduction: Autoimmune hypothyroidism is a chronic condition characterized by a deficiency in the production of thyroid hormones due to autoimmune destruction of the thyroid gland. This disease widely affects patients' metabolic health and quality of life, being associated with a variety of clinical manifestations, such as fatigue, weight gain, depression and cognitive disorders. Furthermore, metabolic impairment resulting from hypothyroidism increases the risk of cardiovascular complications, such as dyslipidemia and hypertension, and can negatively impact fertility. The complexity of this condition requires a multidisciplinary and personalized therapeutic approach, which takes into account the particularities of each patient and seeks both to control symptoms and to prevent long-term complications. Objective: The objective of this systematic literature review is to evaluate the clinical manifestations and metabolic complications associated with autoimmune hypothyroidism, as well as discuss the most effective therapeutic approaches for managing this condition. Methodology: The methodology adopted for this review was based on the PRISMA checklist, which guided the selection of studies in the PubMed, Scielo and Web of Science databases. Five main descriptors were used for the search: "autoimmune hypothyroidism", "clinical manifestations", "metabolic complications", "cardiovascular risk" and "treatment". Inclusion criteria covered studies published in the last 10 years, peer-reviewed articles, and studies that directly addressed the metabolic and cardiovascular complications of autoimmune hypothyroidism. Exclusion criteria included studies in languages ​​other than Portuguese and English, articles published outside the stipulated period and research that did not focus on adults. Results: The results of this review revealed that autoimmune hypothyroidism is associated with a wide range of clinical manifestations that affect significantly improve the quality of life of patients. Among the metabolic complications, dyslipidemia and increased cardiovascular risk stood out, as well as adverse effects on fertility. Evidence also suggested that the most effective therapeutic approach combines hormone replacement with strategies to manage metabolic risk factors. Conclusion: It is concluded that the management of autoimmune hypothyroidism must be comprehensive and individualized, considering both the clinical manifestations and the associated metabolic complications. The review highlighted the importance of a multidisciplinary approach that goes beyond simple hormone replacement, encompassing the prevention of complications and the promotion of patients' quality of life.