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06/02/13 11:38 AM
U.S. National Library of Medicine - The World's Largest Medical Library Home > Diseases and Conditions > Hypothyroidism Print
The thyroid gland is a vitally important hormonal gland, which mainly works for bodys metabolism. It is located in the front part of the neck below the voice box and is butterfly-shaped. The functions of the thyroid gland include the production of the thyroid hormones triiodothyronine (T3) and tetraiodothyronine, also called thyroxine (T4).
PubMed Health. A service of the National Library of Medicine, National Institutes of Health.
Hypothyroidism
Myxedema; Adult hypothyroidism
Last reviewed: June 4, 2012.
Hypothyroidism is a condition in which the thyroid gland does not make enough thyroid hormone.
Symptoms
Early symptoms: Hard stools or constipation Increased sensitivity to cold Fatigue or feeling slowed down Heavier menstrual periods Joint or muscle pain Paleness or dry skin Sadness or depression Thin, brittle hair or fingernails Weakness Weight gain without trying Late symptoms, if left untreated:
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Decreased taste and smell Hoarseness Puffy face, hands, and feet Slow speech Thickening of the skin Thinning of eyebrows
Treatment
The purpose of treatment is to replace the thyroid hormone that is lacking. Levothyroxine is the most commonly used medication. Doctors will prescribe the lowest dose possible that relieves your symptoms and brings your blood hormone levels back to normal. If you have heart disease or you are older, your doctor may start you on a very small dose. Most people with an underactive thyroid will need lifelong therapy. When starting your medication, your doctor may check your hormone levels every 2 - 3 months. After that, your thyroid hormone levels should be monitored at least every year. Important things to remember when you are taking thyroid hormone: Do NOT stop taking the medication when you feel better. Continue taking them exactly as your doctor prescribed. If you change brands of thyroid medicine, let your doctor know. Your levels may need to be checked. What you eat can change the way your body absorbs the thyroid medicine. Talk with your doctor if you are eating a lot of soy products or are on a high-fiber diet. Thyroid medicine works best on an empty stomach and when taken 1 hour before any other medications. Do NOT take thyroid hormone with fiber supplements, calcium, iron, multivitamins, aluminum hydroxide antacids, colestipol, or medicines that bind bile acids. While you are taking thyroid replacement therapy, tell your doctor if you have any symptoms that suggest your dose is too high, such as: Palpitations Rapid weight loss
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Restlessness or shakiness Sweating Myxedema coma is a medical emergency that occurs when the body's level of thyroid hormones becomes very low. It is treated with intravenous thyroid hormone replacement and steroid medications. Some patients may need supportive therapy (oxygen, breathing assistance, fluid replacement) and intensive-care nursing.
Expectations (prognosis)
In most cases, thyroid levels return to normal with proper treatment. However, you must take thyroid hormone replacement for the rest of your life. Myxedema coma can result in death.
Complications
Myxedema coma, the most severe form of hypothyroidism, is rare. It may be caused by an infection, illness, exposure to cold, or certain medications in people with untreated hypothyroidism. Symptoms and signs of myxedema coma include: Below normal temperature Decreased breathing Low blood pressure Low blood sugar Unresponsiveness Other complications are: Heart disease Increased risk of infection Infertility Miscarriage People with untreated hypothyroidism are at increased risk for: Giving birth to a baby with birth defects Heart disease because of higher levels of LDL ("bad") cholesterol Heart failure People treated with too much thyroid hormone are at risk for angina or heart attack, as well as osteoporosis (thinning of the bones).
Prevention
There is no prevention for hypothyroidism. Screening tests in newborns can detect hypothyroidism that is present from birth (congenital hypothyroidism).
References
1. Brent GA, Davies TF. Hypothyroidism and thyroiditis. In: Melmed S, Polonsky KS, Larsen PR, Kronenberg HM, et al. Williams Textbook of Endocrinology. 12th ed. Philadelphia, Pa: Saunders Elsevier; 2011:chap 13. 2. Kim M, Ladenson P. Thyroid. In: Goldman L, Schafer AI, eds. Cecil Medicine. 24th ed. Philadelphia, Pa:
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