Hypothyroidism

Question 1

What are the risk factors for hypothyroidism?

Answer 1

Female
Middle age
Iodine deficiency
Family history of autoimmune conditions

Question 2

What are the symptoms of hypothyroidism?

Answer 2

Lethargy 
Weakness
Cold sensitivity 
Depression 
Weight gain

Question 3

What are the signs of hypothyroidism?

Answer 3

Bradycardia
Dry skin
Eyelid oedema

Question 4

What is the pathophysiology of hypothyroidism?

Answer 4

Hashimoto’s disease

• autoimmune infiltration of the thyroid by lymphocytes
• anti TPO antibodies

Question 5

What medications can cause hypothyroidism?

Answer 5

Amiodarone

• contains iodine
• messes with thyroid hormone synthesis

Lithium
- interferes with thyroid hormone secretion

Question 6

What investigations should be done for suspected hypothyroidism?

Answer 6

Serum TSH
- high

Serum T4
- low

FBC
- rule out anaemia

Fasting glucose
- rule out DM

Question 7

How is hypothyroidism managed?

Answer 7

Levothyroxine

• 50-100 micrograms/kg/day PO
• adjust dose every 4-6 weeks

Question 8

What advice should patients be given?

Answer 8

Symptoms of

• hypothyroidism
• hyperthyroidism

Check TSH levels every 6 weeks in pregnancy

Question 9

What is the follow up of patients with hypothyroidism?

Answer 9

Blood tests every 4-6 weeks until the correct level of TSH

Then yearly bloods