Living with Hypothyroidism - Cure and Treatment

Hypothyroidism is one of the most common endocrine conditions with a UK prevalence of 1.4% in women, but under 0.1% in men. Underactivity of the thyroid is usually primary, from disease of the thyroid, but may be secondary to hypothalamic-pituitary disease (reduced TSH drive.

Subclinical hypothyroidism

Congenital hypothyroidism

Hypothyroidism symptom

Losing weight with hypothyroidism

Hashimotos thyroiditis

Postpartum thyroiditis


Treatment of Hypothyroidism

Replacement therapy with thyroxine (i.e. T 4 ) is given for life. The starting dose will depend upon the severity of the deficiency and on the age and fitness of the patient, especially cardiac performance. In the young and fit, 100 g daily is suitable, while 50 g daily (increased to 100 g after 2-4 weeks) is more appropriate for the small, old or frail. Patients with ischaemic heart disease require even lower initial doses, especially if the hypothyroidism is severe and long-standing. Most physicians would then begin with 25 g daily and perform serial ECGs, increasing the dose at 3- to 4-week intervals if angina does not occur or worsen and the ECG does not deteriorate. Some, however, would use T 3 beginning with 2.5 g 8-hourly, doubling the dose every 48 hours up to 10 g three times daily. If progress is satisfactory, T 4 (100 g daily) is then started and T 3 is discontinued 5 days later.

Adequacy of replacement should be assessed clinically and by thyroid function tests after at least 6 weeks on a steady dose; the aim is to restore T 4 and TSH to well within the normal range. If serum TSH remains high, the dose of T 4 should be increased in increments of 25-50 g and the tests repeated 6 weeks later. This stepwise progression should be continued until TSH becomes normal, though some physicians believe that complete well-being is only restored in some patients when the T 4 is high-normal and the TSH is slightly suppressed. The usual maintenance dose is 100-150 g given as a single daily dose; over-replacement may increase the risk of atrial fibrillation in those aged over 60. An annual thyroid function test is recommended - this is usually performed in the primary care setting, often assisted and prompted by district 'thyroid registers'.

Clinical improvement on T 4 may not begin for 2 weeks or more and full resolution of symptoms may take 6 months. The importance of lifelong therapy must be emphasized and the possibility of other autoimmune endocrine disease developing, especially Addison's disease or pernicious anaemia, should be considered. During pregnancy, an increase in T 4 dosage of about 25-50 g is often needed to maintain normal TSH levels, and the necessity of optimal replacement during pregnancy is emphasized by the finding of reductions in cognitive function in children of mothers with elevated TSH during pregnancy.


Share |

Related Articles on Deficiency Diseases

  Sideroblastic anemia
  Porphyria cutanea tarda
  Sickle-cell anemia
  Wilsons Disease
  Menkes syndrome
  Bitot's spots
  Macrocytic anemia
  Megaloblastic anemia
  Pernicious anemia
  Muscular dystrophy
  Haemolytic anaemia
  Cholestatic Jaundice Constipation
  Hypothyroidism symptom
  Losing weight with hypothyroidism
  Subclinical hypothyroidism
  Congenital hypothyroidism
  Hashimotos thyroiditis
  Postpartum thyroiditis
  Hyperthyroidism symptom
  Feline hyperthyroidism
  Graves disease
   Plummer's disease
  Thyroid storm
  Acrodermatitis enteropathica
  Metal fume fever
  Keshan disease
Metabolic Syndrome

Nutrition - Vitamins | Amino Acids | Herbs | Minerals | Nutrients | Supplements | Enzymes
Wellness - Healthy Living | Dental Care | Products | Skin Vitamins | Ayurveda | Slideshow
Health - Deficiency | Alternative Medicines | How To | Symptoms | Food Kitchen How tos?
Fitness - Exercises | Gardening
Food & Cooking - Recipes | Fruits & Vegetables
Healthy Eating & Diet - Diet | Weight Loss | Green Tea | Noni Juice | Acai
Online Vitamins Guide

Nutrition Articles | Your Feedback & Suggestions | Newsletter
Disclaimer | Blog
Home © 2001-2013 All rights reserved.