Hypothyroidism

Question 1

What is Hypothyroidism?

Answer 1

Reduced Thyroid Hormone Levels

Question 2

1ary Hypothyroidism?

Answer 2

Low Thyroid hormone due to destruction of gland tissue OR iodine deficiency.

Question 3

2ndary Hypothyroidism?

Answer 3

Underactive Pituitary Gland = Low Thyroid Hormone levels

Question 4

Common causes of 1ary Hypothyroidism?

Answer 4

MOST common: Hashimoto’s, Iodine deficiency

Other: Thyroidectomy, radiotherapy (iodine) + Iatrogenic (lithium, amiodarone)

Question 5

Common presentations of Hypothyroidism?

Answer 5

Clammy skin, intolerance to cold, hair loss/recession + fatigue
Late signs: weight gain, bradycardia, loss of consciousness
Hashimoto’s: Smooth goitre

Question 6

Investigations for 1ary Hypothyroidism?

Answer 6

1) TFTs - HIGH TSH (compensation), low T4.
Anti-TPO antibodies (Hashimoto’s)
2) Neck Ultrasound
3) Aspiration + Biopsy

Question 7

Management for Hypothyroidism

Answer 7

Treat underlying cause

1) Iodine deficiency = replacement
2) Hashimoto + Others = Levothyroxine