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People with hypothyroidism often have no or only mild symptoms. Numerous symptoms and signs are associated with hypothyroidism and can be related to the underlying cause, or a direct effect of not having enough thyroid hormones. [15] [16] Hashimoto's thyroiditis may present with the mass effect of a goiter (enlarged thyroid gland). [15]
Certain medications can have the unintended side effect of affecting thyroid function. While some medications can lead to significant hypothyroidism or hyperthyroidism and those at risk will need to be carefully monitored, some medications may affect thyroid hormone lab tests without causing any symptoms or clinical changes, and may not require treatment.
Levothyroxine, also known as L-thyroxine, is a synthetic form of the thyroid hormone thyroxine (T 4). [5] [8] It is used to treat thyroid hormone deficiency (hypothyroidism), including a severe form known as myxedema coma. [5] It may also be used to treat and prevent certain types of thyroid tumors. [5] It is not indicated for weight loss. [5]
Thyroxine, also known as T 4, is a hormone produced by the thyroid gland. It is the primary form of thyroid hormone found in the blood and acts as a prohormone of the more active thyroid hormone, triiodothyronine (T 3 ). [ 1 ]
Desiccated thyroid has roughly a 4:1 ratio of thyroxine (T4) to triiodothyronine (T3). In humans, the ratio is 11:1. [10] A combination of various ratios of T4 and T3 might not provide benefits over T4 alone. Some controlled trials have shown inconsistent benefits of various ratios of T4 and T3. [11] [12]
Treatment consists of lifelong administration of thyroxine (T4). Thyroxine must be dosed as tablets only, even to newborns, as the liquid oral suspensions and compounded forms cannot be depended on for reliable dosing. For infants, the T4 tablets are generally crushed and mixed with breast milk, formula milk or water.
Other side effects include granulocytopenia (dose dependent, which improves on cessation of the drug) and aplastic anemia, and in case of propylthiouracil, severe, fulminant liver failure. [20] Patients on these medications should see a doctor if they develop sore throat or fever. The most common side effects are rash and peripheral neuritis. [21]
Myxedema psychosis is a relatively uncommon consequence of hypothyroidism, such as in Hashimoto's thyroiditis or in patients who have had the thyroid surgically removed and are not taking thyroxine. A chronically under-active thyroid can lead to slowly progressive dementia , delirium , and in extreme cases to hallucinations , coma , or ...
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