Hypothyroidism
It is a metabolic state resulting from a deficiency of thyroid hormone that may occur at any age. Congenital hypothyroidism results in a condition called cretinism.
Causes
* Congenital defects of the thyroid gland
* Defective hormone synthesis
* Iodine deficiency (prenatal and post natal)
* Anti thyroid drugs
* Surgery of management with radioactive agents for hyperthyroidism
* Chronic inflammatory (acute immune) disease such as hashimoto’s disease, amylodois sarcoidosis
Signs and Symptoms
The manifestation of the hypothyroidism depend on whether it is mild, severe (Myxedema) or complicated (Myxedema coma)
Myxedema:
* Respiratory failure
* Heart failure
* Cerebral vascular accident
* Trauma (injury)
* Metabolic disturbances
Myxedema coma:
* Drastic increase in metabolic rate
* Hypoventilation leading to respiratory acidosis
* Hypothermia
* Hypocalcaemia
* Hypoglycemia
Diagnostic evaluation:
* History and physical examination
* Serum TSH and free T4
* TRH stimulation test
Management
Medical management:
* Antithyroid drugs such as Propylathiouracil (PTU) which inhibits thyroid hormone synthesis
* Radioactive iodine offers a more permanent option because it destroys thyroid tissue
* Client with hypothyroidism must receive lifelong thyroid hormone replacement therapy
