Thanks to Dr. John Feng for a great presentation on severe hypothyroidism

Learning Points:

• Symptoms include: fatigue, cold intolerance, constipation, depression, weight gain, dry skin, hair thinning or loss and memory impairment
• Exam findings include: bradycardia, diastolic HTN, coarse facies, delayed relaxation phase of deep tendon reflexes, non-pitting edema (myxedema), dry skin, hypoactive bowel sound
• Treatment: start IV levothyroxine when there is concern for gut edema (most commonly seen in myxedema crisis) and transition to po levothyroxine at 1.6ug/kg. Please note, start at lower doses in elderly and cardiac patients.

Click on this great article to learn more about hypothyroidism