Hypothyroidism
Definition
Insufficient thyroid hormone production
Epidemiology
F>M; 10:1
Aetiology
Clinical Features
Symptoms
Menorrhoea, lethargy, low mood
Signs
B alding
R eflex slow to release
A taxia (cerebellar)
D ry skin/ hair
Y awn (fatigue)
C old
A scites/ non-pitting oedema
R ound (obese)
D efeated demeanour
I mmobile/ ileus
C CF
Insufficient thyroid hormone production
Epidemiology
F>M; 10:1
Aetiology
- Iodine deficiency (most common cause worldwide)
- Primary (90%)
- Thyroid defect
- Thyroidectomy
- Autoimmune (Hashimoto, burnt out Graves)
- Hypothyroid phase of subacute thyroiditis
- Drugs (Lithium)
- Iodine def
- Congenital
- Neoplasia
- Secondary
- Pituitary insufficiency
- Tertiary
- Hypothalamus insufficiency (rare)
Clinical Features
Symptoms
Menorrhoea, lethargy, low mood
Signs
B alding
R eflex slow to release
A taxia (cerebellar)
D ry skin/ hair
Y awn (fatigue)
C old
A scites/ non-pitting oedema
R ound (obese)
D efeated demeanour
I mmobile/ ileus
C CF
Investigations
Treatment
Source
Toronto Notes 2012
OHCM 8th Ed 2010
- TFT (hi TSH, lo T4)
- Anti-TgAb, Anti-TPOAb
Treatment
- Thyroxine (T4)
- Avoid amiodarone (T4 like --> inhibits T4 release)
Source
Toronto Notes 2012
OHCM 8th Ed 2010