Phase 1a Endocrinology - Hypothyroidism Flashcards
1
Q
What are the clinical signs of primary hypothyroidism?
A
- Thyroxine (fT4) decline
- TSH climb
2
Q
What is the most common cause of primary hypothyroidism?
A
Hashimoto’s Disease (Autoimmune attack on the thyroid gland)
3
Q
What are the symptoms of primary hypothyroidism (9)?
A
- Deepening voice
- Depression and tiredness
- Cold intolerance
- Weight gain with reduced appetite
- Constipation
- Bradycardia
- Eventual myxoedema coma
4
Q
How is primary hypothyroidism managed?
A
Levothyroxine (fT4 replacement)
5
Q
How is the dose of levothyroxine adjusted?
A
According to TSH (aim to get into normal range)
Start low and increase dose until TSH in normal
Common dose 100 micrograms
6
Q
What are the adverse effects of levothyroxine (2 minor / 2 major)?
A
Minor: Weight loss / Headache
Major: Heart attack / Rapid HR
7
Q
What are the for and against of combination T4/T3 treatment (Levothyroxine + Liothyronine)?
A
- For: Some reported improvement in wellbeing (unclear if placibo)
- Against: Complicated by symptoms of ‘toxicity’ (palpitations, tremor, anxiety) / Often suppresses TSH
