hypothyroidism
HYPOTHYROIDISM
Hypothyroidism is a common endocrine disorder where in the thyroid does not make enough thyroid hormone.
Subclinical/mild hypothyroidism refers to the state of slightly increased serum TSH with normal serum FT4 in patients who are usually asymptomatic.
Most common cause of primary hypothyroidism is autoimmune thyroiditis or Hashimoto's disease.
Levothyroxine is the first-line agent for treatment of hypothyroidism.

Hypothyroidism Signs and Symptoms

Definition

Thyroid hormone deficiency due to underactive thyroid that may be secondary to hypothalamic-pituitary disease or primary thyroid disease

Signs and Symptoms

  • Variable signs and symptoms but typical symptoms are fatigue, weight gain, cold intolerance, constipation and dry skin
  • Neurological
    • Weakness
    • Depression
    • Poor memory
    • Delayed relaxation of deep tendon reflexes
  • Head and neck
    • Periorbital puffiness
    • Hair loss/alopecia
    • Voice change; hoarseness
    • Slow speech
  • Gastrointestinal
    • Constipation
  • Cardiovascular
    • Bradycardia
    • Hyperlipidemia
    • Pericardial effusion
  • Others
    • Menorrhagia
    • Myxedema (non-pitting edema)
    • Pallor
    • Goiter
    • Myalgia
    • Anemia
    • Galactorrhea

Risk Factors

Special Population with Higher Risk of Developing Hypothyroidism

  • Postpartum women
  • Infertile individuals
  • Individuals with a family history of autoimmune thyroid disorders
  • Patients with previous head and neck or thyroid irradiation
  • Other autoimmune endocrine conditions
    • Type 1 diabetes mellitus (DM), adrenal insufficiency (AI), ovarian failure
  • Other non-endrocrine autoimmune disorders
    • Celiac disease, vitiligo, pernicious anemia, Sjogren’s syndrome, multiple sclerosis
  • Down’s and Turner’s syndrome
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