74 - Hypothyroidism

Abstract

Thyroid hormone is critical for the functioning of all the tissues of the body. Thus, as hypothyroidism develops and progresses, the constellation of signs and symptoms that may be observed emanate from many diverse organ systems. This creates challenges in recognizing hypothyroidism as the root cause of the sign and symptoms, as the presentation may be nonspecific and overlap with the presentation of other common conditions. Once considered, hypothyroidism is relatively easy to diagnose based on the characteristic exponential rise in thyroid-stimulating hormone that signals declining thyroid hormone levels. Hypothyroidism is readily treated with synthetic thyroid hormone therapy, and replacement is satisfactory for the majority of patients. The spectrum of hypothyroidism ranges from mild disease, for which the benefits of treatment are not clearly established, to severe life-threatening myxedema coma, which results in multiorgan system failure if it is not treated. Future challenges involve identifying a more physiologic thyroid hormone replacement so that resolution of symptoms can be achieved for all and developing strategies to prevent autoimmune destruction of the thyroid gland, which is the most common cause of hypothyroidism.