What is Hypothyroidism, Hypothyroidism definition, Characteristics for Hypothyroidism, Physical examination for Hypothyroidism, Investigations for characteristics, Thyroid panel, Medications for characteristics, Patient education for Hypothyroidism.

1. Hypothyroidism
Dr. Rima Das.
B.A.M.S. (Mum); PGDEMS (Pune); DACLS, DIHM, DDM (Pune);
FPC (M.U.H.S; Nashik).
Consulting Preventive Cardiologist.
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2. Hypothyroidism is a condition in
which the thyroid gland does not
produce enough thyroid hormone.
Hypothyroidism definition

3. Clinical manifestations of
Hypothyroidism:
• Fatigue
• Feeling cold
• Poor memory and concentration
• Constipation
• Dyspepsia
• Weight gain with poor appetite
• Shortness of breath
• Hoarse voice
• Heavy menstrual periods (light periods
later)
• Decreased libido
Signs expected by physical examination:
• Dry coarse skin
• Cool extremities
• Myxedema
• Hair loss
• Slow pulse rate
• Swelling of limbs
• Delayed relaxation of tendon reflexes
• Periorbital edema

4. Orders/ investigations:
• TSH,T4 testing
TSH T4 Interpretation
Normal Normal Normal thyroid function
Elevated Low Overt hypothyroidism
Normal/ Low Low Central hypothyroidism
Elevated Normal Subclinical hypothyroidism
• Elevated creatinine kinase and liver enzymes in the blood
• Elevated cholesterol, low density lipoprotein and lipoprotein (a)
• Plasma homocysteine concentration are increased in some hypothyroid patients, including some with
recent onset hypothyroidism.

5. Components Values
TSH 0.4 to 4.0 mIU/ L
TotalT4 (TT4) 5.4 to 11.5 mcg/ dL
FreeT4 (FT4) (thyroxine) 0.7 to 1.8 ng/ dL
TotalT3 (TT3) 100 to 200 ng/ dL
FreeT3 (FT3)
(triiodothyronine)
260 to 480 pg/ dL
Thyroid Panel

6.  Severe hypothyroidism and myxedema coma:
• Low sodium levels in blood
• Elevated ADH
 Hypothyroidism with lumps or masses in the thyroid gland:
• Thyroid imaging
• Needle biopsy
Medications
• Hormone replacement - levothyroxine

7. Patient education:
 Dietary recommendations:
• Eat a balanced diet
• Monitor the soy intake
• Avoid taking medicine within several hours of eating high fiber foods.

8. Thank you!
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