Hypothyroidism

Question 1

Definition

Answer 1

The under activity of the thyroid gland, where it doesn’t produce enough thyroid hormone

Question 2

Aetiology

Answer 2

May not cause noticeable symptoms in the early stages

Primary hypothyroidism:
– a disease of the thyroid gland itself

Secondary hypothyroidism:
– secondary to hypothalamic or pituitary disease
—- where the pituitary gland is not producing enough TSH (hypopituitarism)

Common cause:
– Hashimoto’s thyroiditis:
—- may be associated with a goitre or thyroid atrophy
—- there is cell and antibody mediated destruction of thyroid tissue
——- associated with Anti TPO antibodies, and anti thyroglobulin antibodies
—- it is associated with the autoimmune conditions such as pernicious anaemia and Addison’s disease

Other causes:
– Post-partum thyroiditis (can cause both hypo and hyper thyroidism

– iatrogenic
– iodine deficiency (most common cause in developing world)
– congenital hypothyroidism

Question 3

Epidemiology

Answer 3

Affects 0.1-2% of the population. Not very common

Much more common in women

Incidence increases with age

Question 4

Clinical presentation

Answer 4

Symptoms:
– general tiredness/malaise (MC)
– weight gain
– cold intolerance
MC signs
– mental slowness
– dry thin hair
– bradycardia
– dry skin
– slow relaxing reflexes
– change in appearance
– depression
– psychosis
– arthralgia
– poor libido
– puffy eyes
– amenorrhoea (periods stop)
– poor memory
– coma

Signs:
– psychosis/dementia
– ataxia
– ‘peaches and cream’ complexion
– loss of eyebrows
– deep voice (goitre)
– carpal tunnel syndrome

Question 5

Prognosis

Answer 5

Over time if its not treated, it can lead to other health problems like- high cholesterol and heart problems