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Both NTIS and primary hypothyroidism may have reduced fT3 and fT4, and elevated TSH (which is common in the hospital, during the recovery phase of NTIS). [2] Prescribing thyroxine to treat this may lead to lifelong thyroid overtreatment. [2] Hyperthyroidism may be assumed due to decreased TSH and a transient fT4 increase.
There may be symptoms of thyroid overactivity, such as weight loss, a fast or irregular heart rate, tremor, and perspiration; [1] [2] but such symptoms occur in only half of all cases. [5] The most common type of hyperthyroidism, Graves' disease , may additionally cause eye problems ( Graves' ophthalmopathy ) and skin changes of the legs ...
Thyrotoxic symptoms are usually mild and in some individuals, the hypothyroid phase is the only symptomatic phase. [4] [5] [7] In the hypothyroid phase, patient may experience cold intolerance, fatigue, weight gain, or depression. The hypothyroidism may or may not resolve spontaneously. [5]
Subclinical hyperthyroidism is a milder form of hyperthyroidism characterized by low or undetectable serum TSH level, but with a normal serum free thyroxine level. [32] Although the evidence for doing so is not definitive, treatment of elderly persons having subclinical hyperthyroidism could reduce the number of cases of atrial fibrillation. [33]
Thyroid diseases are highly prevalent worldwide, [10] [11] [12] and treatment varies based on the disorder. Levothyroxine is the mainstay of treatment for people with hypothyroidism, [13] while people with hyperthyroidism caused by Graves' disease can be managed with iodine therapy, antithyroid medication, or surgical removal of the thyroid ...
The first case of HE was described by Brain et al. in 1966. [10] The patient was a 48-year-old man with hypothyroidism, multiple episodes of encephalopathy, stroke-like symptoms, and Hashimoto's thyroiditis confirmed by elevated antithyroid antibodies.
Subclinical hyperthyroidism in pregnancy is associated with an increased risk of pre-eclampsia, low birth weight, miscarriage and preterm birth. [50] Propylthiouracil is the preferred treatment of hyperthyroidism (both overt and subclinical) in the first trimester of pregnancy as it is associated with less birth defects than methimazole. [50]
Autoimmune diseases affecting other organs most commonly associated with Hashimoto's thyroiditis include celiac disease, type 1 diabetes, vitiligo, alopecia, [51] Addison disease, Sjogren's syndrome, and rheumatoid arthritis [13] [52] Autoimmune thyroiditis has also been seen in patients with autoimmune polyendocrine syndromes type 1 and 2. [18]