Hypothyroidism
Description
- Deficient thyroid hormone action
| TSH | fT4 | |
|---|---|---|
| Primary (gland) | inc | dec |
| Subclinical | inc | Normal |
| Central (pit/hypothal) | Low or inappropriately normal | dec |
| Poor adherence | inc | Normal/inc |
- Central hypothyroidism is missed by TSH-only screening - if you suspect it, order fT4
- Hashimoto = commonest acquired cause in iodine-replete populations
- Autoantigens: TPO, thyroglobulin, pendrin
- Myxoedema coma - decompensated hypothyroidism: hypothermia, hyponatraemia, hypoventilation, hypotension, obtundation
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