Hypothyroidism

Extract

• Identify the possibility of hypothyroidism when the patient's symptoms include fatigue, constipation, feeling cold, impaired memory and slow heart rate.
• The disease is common and its symptoms may be vague.
• Diagnosis of hypothyroidism and treatment of hypothyroidism originating in the thyroid gland (primary hypothyroidism) are tasks of the primary health care.
• Hypothyroidism is easy to confirm or exclude by determining TSH and free T4 (FT4) concentrations.
• Check readily whether the thyroid gland functions normally by determining TSH and FT4 concentrations before possible pregnancy and after pregnancy.
• Remember also that hypothyroidism can be the cause of high serum cholesterol or creatine kinase (CK) concentrations.
• In replacement therapy, a young or middle-aged patient usually feels best if TSH concentration is about 1–2 mU/l and FT4 concentration is close to the upper limit of the reference range.
• Elderly patients with e.g. angina pectoris or arrhythmias often are more susceptible to the effects of thyroxine. In them, the maintenance dose remains slightly lower and TSH concentration respectively a little higher.
• Ultrasonography has no role in the investigation of hypothyroidism (unless it is indicated by the findings on palpation).
• Thyroxine should not be used for the treatment of e.g. depression, low energy level or overweight in a person who is biochemically euthyroid.

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Adolescent, Aged, Coronary Disease, E03, E03.2#, E03.80, E03.9, E23.05, E89.00, E89.01, Endocrinology, Hypothyroidism, Internal medicine, Iron, Pregnancy, T4 free, Thyroglobulin, Thyrotropin, Thyroxine, follicular thyroid carcinoma, hypothyroidism, central, hypothyroidism, postpartal, hypothyroidism, subclinical, thyroid cancer, papillary