Hashimoto's thyroiditis Flashcards
Hashimoto’s is primary/secondary hypo/hyper ____
primary hypothyroidism
What antibodies are involved in Hashimoto’s thyroiditis?
Thyroid peroxidase (TPO) antibodies and antithyroglobulin antibodies.
[TPO antibodies are also called anti-TPO antibodies]
What other autoimmune conditions is Hashimoto’s thyroiditis associated with?
T1DM and Coeliac disease
What are symptoms of Hashimoto’s thyroiditis?
Fatigue
Low energy
Cold intolerance
Constipation
Weight gain
Menorrhagia
Poor growth
Poor school performance
Dry skin
Hair loss
What are signs of Hashimoto’s?
Bradycardia
Slow reflexes
Cold hands
Goitre
Pretibial myxoedema
What are the levels of TSH and T4 in Hashimoto’s?
High TSH
Low T4
What are the levels of TSH and T4 in secondary hypothyroidism?
Low TSH
Low T4
What are the levels of TSH and T4 in subclinical hypothyroidism?
High TSH
Normal T4
Those with Hashimoto’s often will also have
anaemia
What other investigation can be taken?
Full thyroid function blood tests (T3, T4 and TSH)
Thyroid ultrasound
Thyroid antibodies
How do you manage Hashimoto’s?
Levothyroxine, once daily
What can too much levothyroxine cause?
Hyperthyroidism
If a patient with Hashimoto’s gets an infection, what are they at increased risk of?
Myxoedema coma
Rapidly falling T4 levels
What are symptoms of myxoedema coma?
Hypothermia
Los of consciousness
Heart failure
How do you treat myxoedema coma?
Levothyroxine
Antibiotics
Hydrocortisone until adrenal insufficiency has been ruled out
