What is Hypothyroidism, Hypothyroidism definition, Characteristics for Hypothyroidism, Physical examination for Hypothyroidism, Investigations for characteristics, Thyroid panel, Medications for characteristics, Patient education for Hypothyroidism.
2. Hypothyroidism is a condition in
which the thyroid gland does not
produce enough thyroid hormone.
Hypothyroidism definition
3. Clinical manifestations of
Hypothyroidism:
• Fatigue
• Feeling cold
• Poor memory and concentration
• Constipation
• Dyspepsia
• Weight gain with poor appetite
• Shortness of breath
• Hoarse voice
• Heavy menstrual periods (light periods
later)
• Decreased libido
Signs expected by physical examination:
• Dry coarse skin
• Cool extremities
• Myxedema
• Hair loss
• Slow pulse rate
• Swelling of limbs
• Delayed relaxation of tendon reflexes
• Periorbital edema
4. Orders/ investigations:
• TSH,T4 testing
TSH T4 Interpretation
Normal Normal Normal thyroid function
Elevated Low Overt hypothyroidism
Normal/ Low Low Central hypothyroidism
Elevated Normal Subclinical hypothyroidism
• Elevated creatinine kinase and liver enzymes in the blood
• Elevated cholesterol, low density lipoprotein and lipoprotein (a)
• Plasma homocysteine concentration are increased in some hypothyroid patients, including some with
recent onset hypothyroidism.
5. Components Values
TSH 0.4 to 4.0 mIU/ L
TotalT4 (TT4) 5.4 to 11.5 mcg/ dL
FreeT4 (FT4) (thyroxine) 0.7 to 1.8 ng/ dL
TotalT3 (TT3) 100 to 200 ng/ dL
FreeT3 (FT3)
(triiodothyronine)
260 to 480 pg/ dL
Thyroid Panel
6. Severe hypothyroidism and myxedema coma:
• Low sodium levels in blood
• Elevated ADH
Hypothyroidism with lumps or masses in the thyroid gland:
• Thyroid imaging
• Needle biopsy
Medications
• Hormone replacement - levothyroxine
7. Patient education:
Dietary recommendations:
• Eat a balanced diet
• Monitor the soy intake
• Avoid taking medicine within several hours of eating high fiber foods.