Practice diagnosis and treatment of hypothyroidism

2021-03-25 12:00 AM

Hypothyroidism can be an autoimmune disease, where the body makes antibodies against the thyroid gland, reducing hormone production, such as in the case of Hashimoto's thyroiditis.

An underactive thyroid condition that reduces the production of hormones such as thyroxine (or tetra-iodothyronine-T), triiodothyronine (T) and calcitonin.

Hypothyroidism is common in the elderly with.

the symptoms are nonspecific, hence the threshold test.

the solution is usually low. Thyroid failure in children, if not detected and treated, will lead to slow growth, delayed sexual development and inhibition of normal brain development.


Hypothyroidism can be an autoimmune disease, where the body makes antibodies against the thyroid gland, reducing hormone production, such as in the case of Hashimoto's thyroiditis.

Hypothyroidism can also be caused by surgery to remove part of the thyroid gland.

Hypothyroidism can also be caused by using radioactive isotope iodine to treat hyperthyroidism.

About 1% of adults have unexplained hypothyroidism, with older women having the highest incidence.


Thyroid hormones stimulate energy production.

Due to decreased production of thyroid hormones, patients often have the following signs:


Sleep a lot.

Muscle weakness.


The heart beats slowly.

Dry, flaky skin.

Hair loss.

The voice was husky.

Fat gain due to fat accumulation.

The syndrome of thickening of the mucous membranes, skin and tissues.

Aneurysm of the thyroid gland.

Depending on the severity or severity of hypothyroidism, the above symptoms may appear in varying degrees. Mild hypothyroidism may be asymptomatic or be very faint. All of the above symptoms will be evident in severe hypothyroidism.

Measurement of serum TSH (thyroid stimulating hormone) content for screening. Normal results allow to rule out both hypothyroidism and hyperthyroidism.

If the TSH is high, measure the content of free thyroxine (T) ï in the blood. If the result shows low T4, the diagnosis of hypothyroidism is confirmed.

In latent hypothyroidism, serum TSH results are high but free T 4 levels are normal. In this case, when to start giving T4 to the patient is up to the attending physician.

The difficulty of diagnosing with thyroid function tests in the elderly is often caused by diseases that are not related to the thyroid gland or by the effects of existing drugs.


Most cases of hypothyroidism in the elderly are well treatable. Referral to hospital is recommended for patients who are young or in very weak condition.

Treatment of hypothyroidism with oral thyroxin. Start with a dose of 100μg per day (50μg for patients over 50 years). Using a dose of 25 - 50μg for patients who are too old or have heart disease. If starting with a lower dose, increase the dose by 25μg per day per month and stay the same after reaching 100μg per day.

Check TSH once a month. Stop the drug as soon as TSH returns to normal. The usual maintenance dose is 100 - 150μg per day. In young patients, if TSH levels are controlled, the dose of thyroxin should be reduced to avoid osteoporosis.

During treatment, patients should be monitored and checked annually. Thyroid function tests should be performed in young patients, or when there is suspicion of insufficient or excess treatment. Measurement of serum TSH levels is the best way to monitor thyroxin treatment adjustment as this approach allows the assessment of thyroid function in the preceding weeks. However, serum T4 levels vary rapidly from TSH levels, so the T4 level can remain normal even if the patient has not been in compliance for a while and has only started treatment just before. Test marks.