USMLE/COMLEX - Step 2 - Hypothyroidism

USMLE/COMLEX - Step 2 - Hypothyroidism Hypothyroidism results from decreased production and synthesis of thyroid hormones and decreased tissue responsiveness to thyroid hormones. These alterations may be due to autoimmune destruction of the thyroid gland, surgery, radiation therapy, medications, or iodine deficiency. Additionally, alterations in the hypothalamic-pituitary-thyroid axis may contribute to impaired thyroid hormone production. Fatigue and weakness Weight gain and difficulty losing weight Cold intolerance Constipation Dry skin and hair Hair loss Depression and anxiety Memory impairment and decreased concentration Muscle and joint pain Menstrual irregularities or heavy periods in women Bradycardia Cold, pale, and dry skin Coarse, brittle, or thinning hair Swelling or puffiness of the face, hands, and feet Hoarseness or other voice changes Hypertension Delayed relaxation of reflexes Decreased sweating Goiter Impaired memory and concentration Thyroid-stimulating hormone test Free thyroxine test Total triiodothyronine test Thyroid peroxidase antibody test Thyroid ultrasound Radioactive iodine uptake test The treatment of hypothyroidism usually involves the replacement of thyroid hormone through medication. The most common medication for this purpose is synthetic thyroxine (T4), levothyroxine. Treatment goals include restoring normal thyroid hormone levels, relieving symptoms, and preventing complications. The treatment of hypothyroidism: 1. Synthetic T4 is the preferred medication for hypothyroidism treatment, as it is well-tolerated and has a long half-life, allowing for once-daily dosing. 2. The dosage of synthetic T4 should be individualized based on the patient's age, weight, and severity of hypothyroidism. 3. Symptoms may take several weeks or even months to improve after starting thyroid hormone replacement therapy. 4. Regular monitoring of thyroid function through blood tests is necessary to ensure that the patient receives an appropriate thyroid hormone dosage. 5. In some cases, hypothyroidism may be caused by an autoimmune disorder, such as Hashimoto's thyroiditis, which may require additional treatment with immunosuppressive medication. 6. Patients should also be advised to maintain a healthy diet, exercise regularly, and avoid smoking and excessive alcohol consumption to help manage their condition.