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Not enough TRH, which is uncommon, can lead to not enough TSH and thereby to not enough thyroid hormone production. [10] Pregnancy leads to marked changes in thyroid hormone physiology. The gland is increased in size by 10%, thyroxine production is increased by 50%, and iodine requirements are increased.
The related drug dextrothyroxine (D-thyroxine) was used in the past as a treatment for hypercholesterolemia (elevated cholesterol levels), but was withdrawn due to cardiac side effects. [citation needed] Once weekly thyroxine (OWT) preparations are also available for clinical use.
However, deprescribing may be considered if a patient experiences side effects like rapid heart rate, anxiety, or bone loss, or if their thyroid function tests normalize.”
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.
Other side effects may include allergic reactions. [1] Use in pregnancy and breastfeeding is generally safe. [2] Regular blood tests are recommended to verify the appropriateness of the dose. [1] They contain a mixture of thyroxine (T4) and triiodothyronine (T3). [1] Desiccated thyroid has been used since the late 1800s. [3]
Side effects of thyroid replacement therapy are associated with iatrogenic hyperthyroidism. [5] Symptoms to watch out for include, but are not limited to, anxiety, tremor, weight loss, heat sensitivity, diarrhea, and shortness of breath. More worrisome symptoms include atrial fibrillation and bone density loss. [5]
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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