Thank you Dr. Joey Tu  for a great presentation on a patient with a mild form of myxedema coma

Learning Points:

• Myxedema coma occurs as a result of long-standing, undiagnosed, or undertreated hypothyroidism and is usually precipitated by a systemic illness
• The main feature that differentiates myxedema coma from severe hypothyroidism is altered mental status (patient doesn’t have to be in a coma to qualify). Other features include bradycardia/low voltage, hyponatremia, and hypothermia
• MUST rule out or consider concomitant adrenal insufficiency because if you administer synthroid before steroids, you can cause the patient to go into adrenal crisis
• T3 is 3x as potent as T4