| Disease |
HYPOTHYROIDISM |
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| Quotation |
“She was ordered to take half a thyroids lightly fried and minceds to e taken with current jelly once a week…. Her condition now is in everyway satisfactory. |
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| Definition |
A clinical state resulting from a fall in circulating free thyroid hormonal levels or resistance to action of the hormone. Myxoedema is a state of severe hypothyroidism. |
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| Prognosis |
With early treatment return to normal state is the rule with striking transformation of appearance and mental function. Relapses will occur if treatment is interrupted. Untreated cases may go on to myxoedema coma.
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| Treatment |
Suspected when patient has a puffy face, hoarse voice, sluggish movements and laziness. Slow relaxationof tendon jerks is diagnostic. Confirm by serum T3 T4 & TSH
Treatment:
Tab. ELTROXIN 0.1mg OD x to be continued lifelong x increase the dose if necessary after 4weeks.
Tab ELTROXIN ELTROXIN |
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| Advice to Patient |
The hormone is to be taken at the same time every day, preferably in the morning, and before breakfast.
Those who have achieved stable control are not to change brands.
Should report if there is chest pain, palpitations, sweating, or tremors.
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| Follow Up |
After 6 weeks to monitory T4, and TSH, which should both be normal.
Then TSH measurement every 6-12 months is adequate.
To report in the event of pregnancy.
Patients on sodium L thyroxin have usually higher than normal values of
T4, normal or low T3, and now TSH values slightly lower than normal.
A patient taking tablets just for a few days before getting a blood check will show a normal or low T4 with a paradoxically raised TSH.
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| Inadequate Response |
Usually due to inadequate dosage.
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| Prevention |
Dietary Iodine supplementation in areas with endemic goitre.
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