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Thyroid Disorders
 
 

Hypothyroidism

 
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Overview

  • Hypothyroidism refers to underactivity of the thyroid, with reduced circulating thyroid hormones. This is usually accompanied by typical signs and symptoms of hypothyroidism.

Pathogenesis

    • Causes of Primary Hypothyroidism

    • Primary

    • Autoimmune thyroiditis - Hashimoto’s, atrophic
    • Hypothyroid phase of thyroiditis
    • Iatrogenic - radioiodine therapy, thyroidectomy, external irradiation of the neck
    • Drugs - amiodarone, lithium, interferons, interleukin-2, iodide
    • Iodine deficiency
    • Thyroid infiltration - amyloidosis, tumour
    • Congenital hypothyroidism
    • Secondary

    • Pituitary / hypothalamic pathology - trauma, tumour, surgery, radiation, infection, infarction, infiltration

Manifestations

    • Clinical Features

    • Symptoms

    • Weakness / lethargy / mental sluggishness
    • Weight gain
    • Cold intolerance
    • Dry, coarse skin
    • Constipation
    • Menorrhagia
    • Alopecia
    • Signs

    • Bradycardia
    • Psychomotor retardation
    • Impaired cognition
    • Cool, dry skin
    • Facial oedema
    • Loss of the outer ⅓ of the eyebrow
    • Tongue enlargement
    • Alopecia
    • Hyporeflexia
    • Non-pitting oedema

Diagnosis

    • TFT Interpretation

    • Primary hypothyroidism - elevated TSH with reduced T4
    • Subclinical hypothyroidism - elevated TSH with normal T4
    • Central hypothyroidism - reduced TSH with reduced T4
  •  
    Read more about thyroid function tests
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