Hypothyroidism
HYPOTHYROIDISM
- Hypothyroidism is caused due to iodine deficiency.
ETIOLOGY
Primary
- Autoimmune hypothyroidism- hashimoto’s thyroiditis
- Iatrogenic
- Drugs- lithium, ethionamide, p-aminosalicyclic acid(antitubercular drug)
- Congenital hypothyroidism
- Iodine deficiency (in India most common cause)
- Infiltrative disorder- scleroderma, hemochromatosis
Secondary
- Hypopittuitarism
- TSH deficiency
- Hypothalamic disease
Transient
- Silent thyroiditis
- Subacute thyroiditis
- Thyroidectomy
CLINICAL FEATURES
- Common symptoms are- Weight gain, Fatigue, Dry skin and hair, Menorrhagia, Hoarseness, coldness
- CVS– Bradycardia, Myxoedema, hypertension
- Nervous system– Carpal tunnel syndrome,
- Facial features– purplish lips, malar flush, periorbital oedema
- Yellowing of skin occurs due to accumulation of increase carotene.
INVESTIGATION-
- Primary hypothyroidism- T4 is low and TSH elevated
- Secondary hypothyroidism- failure of TSH secretion, T4 is low and TSH low
TREATMENT-
- Levothyroxine therapy 50μg daily for 3weeks (maintence at 100 μg).
Exam Important
- Hypothyroidism is caused due to iodine deficiency.
Primary
- Autoimmune hypothyroidism- hashimoto’s thyroiditis
- Iatrogenic
- Drugs- lithium, ethionamide, p-aminosalicyclic acid(antitubercular drug)
- Congenital hypothyroidism
- Iodine deficiency (in India most common cause)
- Infiltrative disorder- scleroderma, hemochromatosis
- Yellowing of skin occurs due to accumulation of increase carotene.
- Primary hypothyroidism- T4 is low and TSH elevated
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