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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(D-thyroxine) was used in the past as a treatment for hypercholesterolemia (elevated cholesterol levels), but was withdrawn due to cardiac side effects.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.
Hypothyroidism is common in pregnancy with an estimated prevalence of 2-3% and 0.3-0.5% for subclinical and overt hypothyroidism respectively. [8] Endemic iodine deficiency accounts for most hypothyroidism in pregnant women worldwide while chronic autoimmune thyroiditis is the most common cause of hypothyroidism in iodine sufficient parts of the world.
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.
Thyroid function tests (TFTs) is a collective term for blood tests used to check the function of the thyroid. [1] TFTs may be requested if a patient is thought to suffer from hyperthyroidism (overactive thyroid) or hypothyroidism (underactive thyroid), or to monitor the effectiveness of either thyroid-suppression or hormone replacement therapy.
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]
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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