Hypothyroidism
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Hypothyroidism - Topic Overview
Hypothyroidism is a condition of thyroid hormone deficiency, ranging from mild subclinical elevation of TSH to severe, life-threatening myxedema coma. It's one of the most common endocrine disorders, more prevalent in women and increasing with age, most often caused by autoimmune (Hashimoto's) thyroiditis in iodine-sufficient regions and iodine deficiency worldwide.
Key subtopics this covers:
- Etiology & Classification - primary (thyroid gland failure, e.g. Hashimoto's thyroiditis, post-ablative/surgical, iodine deficiency), secondary (pituitary TSH deficiency), tertiary (hypothalamic), and drug-induced (amiodarone, lithium, immune checkpoint inhibitors)
- Pathophysiology - loss of negative feedback, reduced T3/T4 effects on metabolism, myxedematous tissue changes
- Clinical Features - fatigue, cold intolerance, weight gain, bradycardia, dry skin, myxedema, constipation, menstrual irregularities, cognitive slowing
- Diagnosis - TSH/free T4 interpretation, antibody testing (anti-TPO), subclinical vs overt hypothyroidism
- Treatment - levothyroxine dosing, monitoring, special considerations (pregnancy, elderly, cardiac disease)
- Special Populations - pregnancy (fetal neurodevelopment risk), congenital hypothyroidism, subclinical hypothyroidism management controversy
- Complications - myxedema coma, cardiovascular effects, dyslipidemia
- Related systemic effects - across organ systems (renal, GI, dermatologic, neurologic - as seen in specialty textbooks)
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