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Hypothyroid
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<<forEachTiddler where 'tiddler.tags.contains(context.inTiddler.title)' sortBy tiddler.title ascending write '"*[["+tiddler.title+"]]\n"'>> <<tiddler AutoRefresh with: force>> In UK 1.9% women and 0.1% men are hypothyroid while 15% F and 10% M are sub-clinically hypothyroid may have raised MCV with hypothyroid (remember alcohol, B12, folate) ''Investigations'' recheck bloods in 6-8/52 if sub-clinical Thyroid peroxidase antibodies (TPO) Baseline lipids and ECG (subclinical hypothyroid ? risk factor for CHD) Coeliac serology ''Causes'' Chronic autoimmune - Hashimoto (most common) or atrophic thyroiditis (post De Quervains (subacute) thyroiditis - usually hyperthyroid initially (?painful thyroid with raised ESR), may then go hypothyroid Postpartum thyroiditis - 15% pregnant women in 1st yr post partum - hyper and then hypo - need to stop thyroxine at one year and assess recovery Iodine deficiency (commonest worldwide) Infiltration eg Sarcoid or Haemochromatosis Iatrogenic - post Rx for hyper - radioactive, surgery, neck radiotherapy drugs - Lithium, Amiodarone ''refer if ....'' pregnant or under 16 secondary hypothyroid or subacute thyroiditis Sx getting worse Co-morbid eg CHD or on drugs ''Annually test'' Those on thyroxine those who've had Rx for hyperthyroid or recieved neck irradiation those on lithium, amiodarone those with turners or downs or diabetes Test 3/12 till dose stable and 6-8/52 post dose change
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Thyroid