Hypothyroidism. By: Elias S. Hypothyroidism. A common disorder associated with thyroid hormone deficiency resulting from a defect anywhere in the hypothalamic-pituitary-thyroid axis Majority primary thyroid D. Less common TSH , TRH Prevalence U.S. NHANES III on 17353 persons
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By: Elias S.
(subclinical 4.3%, overt 0.3%)
2-5% ( to 15% by the age of 75)
annual incidence: 4/1000 women, 1/1000 men
Framingham study in adults>60yrs
5.9%-women 2.4%- men
Race: more common-Japanese
whites(5.1%)>Hispanic A.(4.1%)>African A(1.7%)
- Primary H.
- Central (secondary/tertiary)
Subclinical Overt( clinical)
(TSH, N FT4,N FT3) (TSH, FT4,FT3)
TSH-R bloking Ab 20%, TBII 10-20%
Atrophy of thyroid
follicles with absence of colloid
Mild to moderate fibrosis
Present with goiter
Minimal or no Sx
Less lymph. infiltration
Thyroid follicles completely absent
Late stage of Hashimotos thyroiditis
Minimal residual thyroid tissue
congenital rubella s. - autoimmune H.
If euthyroid at one year, 0.5-1% chance of hypothyroidism each year
Amiodarone, INF-alpha, IL2
Chlestyramine,Iron salts - T4 absorption
Rifampin, Phenytoin,Carbamazepin- clearance
- conversion of T4T3
Normal ESR, +TPOAb
low T4 and T3
Amiodarone, cholecystographic dyes
TSH-producing pit. Adenoma
High HCG (early pregnancy, molar P.,
Phenytoindisorders that affect TSH
Restoration of euthyroid State
Reversion of Sx &Sns
Reduction of gotre
by the patient’s own physiologic Mech.
coadministration of drugs
that clearance orabsorbtion
marked w’t loss
insuficiency acut adrenal crisis!