Hypothyroidism; primary

Treatment:

The purpose of treatment is to replace the deficient thyroid hormone. Levothyroxine is the most commonly used medication, but others are available. The lowest dose effective in relieving symptoms is given. Life-long therapy is indicated as relapses will occur if therapy is interrupted. Medication must be continued even when symptoms subside.

After replacement therapy has begun, report any symptoms of increased thyroid activity (hyperthyroidism), such as restlessness, rapid weight loss, and sweating.

A high-fiber, low-calorie diet and moderate activity will help relieve constipation and promote weight loss.

Myxedema coma is treated by intravenous thyroid replacement and steroid therapy. Supportive therapy of oxygen, assisted ventilation, fluid replacement, and intensive care nursing may be indicated.

Expectations (prognosis):

With early treatment, return to the normal state is usual. However, relapses will occur if the medication is not continued. 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. Symptoms and signs of myxedema coma include:

• unresponsiveness
• decreased breathing,
• low blood pressure,
• low blood sugar,
• below normal temperature

Other complications include:

• heart disease
• increased risk of infection
• infertility
• miscarriage in pregnant women
• pituitary tumors

Calling your health care provider:

Call your health care provider if signs of myxedema are present, or if chest pain or rapid heart beat occur.

Call your health care provider if restlessness, rapid weight loss, excessive sweating, or other symptoms occur after beginning thyroid replacement.