What causes the insidious onset of the various complaints and conditions of the patient with hypothyroidism?

Real-Life Challenge: Hypothyroidism

A 40-year-old female reports tiredness, loss of hair, and weight gain. She has not had a menstrual period for 3 months. Her skin appears dry and scaly. On questioning, the patient reports episodes of constipation and tells of being unable to tolerate cold. Her speech is somewhat slow and slurred. A blood test for thyroid functioning shows low thyrotropin levels. Thyroid scan shows no uptake of iodine. The diagnosis of this patient is hypothyroidism.

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Questions:

1. Severe untreated hypothyroidism with onset at maturity can lead to myxedema coma. What is the term describing hypothyroidism with onset in infancy or early childhood?

2. What causes the insidious onset of the various complaints and conditions of the patient with hypothyroidism?

3. What can be the cause of the reduced production of thyroxine (T4) by the thyroid gland?

4. Hormone replacement is the usual drug therapy of choice. Research levothyroxine sodium (Synthroid) and explain its side effects.

5. For patient teaching, how long will the patient be instructed to take the medication?

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