Hypothyroidism: Difference between revisions
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== Characteristics/Clinical Presentation == | == Characteristics/Clinical Presentation == | ||
Clinical signs are widespread and affect numerous body systems. With early onset of the disease signs may be indistinct and go undetected such as general fatigue, slight weight gain from fluid retention and decreased metabolism, dry skin, or cold sensitivity. Elderly patients have significantly fewer symptoms than do younger adults, and complaints are often subtle. Many elderly patients with hypothyroidism present with nonspecific geriatric symptoms like confusion, falling, incontinence, and decreased mobility. With progression, clinical signs become more obvious and severe. Myxedema usually appears in the later stages if not treated resulting in nonpitting edema present around the eyes, hands, and feet. Myxedema may also cause thickening of the tongue and tissues of the larynx and pharynx, slurred speech and hoarseness. Rarely, a goiter may be present if not medically treated and presents as a large swelling on the anterior neck resulting from marked thyroid gland growth. Although goiters are not frequently seen in the United States because its main cause is due to low iodine intake it can also be seen in elevated levels of TSH often present in progressed hypothyroidism. It is more commonly seen in other parts of the world where commercial foods containing iodine aren’t as abundant. Other frequent clinical manifestations are listed in the systemic involvement section of this page. <ref name="Goodman and Synder">Goodman C, Snyder T. Differential Diagnosis for Physical Therapists: Screening for Referral. St. Louis, Missouri: Saunders Elsevier, 2007.</ref><ref name="Goodman and Fuller">Goodman C, Fuller K. Pathology: Implications for the Physical Therapist. St. Louis, Missouri: Saunders Elsevier; 2009.</ref><ref name="Porter">Porter R, Hypothyroidism. The Merck Manual Online Medical Library. 2008. Available at: http://www.merck.com/mmpe/index.html . Accessed February 17, 2010.</ref><ref name="Allahabadia">Allahabadia A., Razvi S., Abraham P., Franklyn . Diagnosis and treatment of primary hypothyroidism. British Medical Journal (International Edition) [serial online]. 2009;338:1090. Available from: Health Module. Accessed February 19, 2010, Document ID: 1731734701.</ref><br> | |||
== Associated Co-morbidities == | == Associated Co-morbidities == | ||
Revision as of 20:19, 19 February 2010
Original Editors - Students from Bellarmine University's Pathophysiology of Complex Patient Problems project.
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Definition/Description[edit | edit source]
Hypothyroidism is caused by an insufficient amount of the thyroid hormone in the body resulting in an overall slowing of metabolism. There are two categories to classify Hypothyroidism which are primary and secondary. [1][2]
Prevalence[edit | edit source]
Hypothyroidism is more prevalent in women who have a four to ten times greater likelihood of developing this than men. Hypothyroidism can be present at birth, but has a higher occurrence rate between the ages of 30 and 60. It occurs in close to 10% of women and 6% of men over the age of 65. Primary Hypothyroidism is more common than secondary with approximately 95% of all people diagnosed categorized as the primary type. [1][2][3]
Characteristics/Clinical Presentation[edit | edit source]
Clinical signs are widespread and affect numerous body systems. With early onset of the disease signs may be indistinct and go undetected such as general fatigue, slight weight gain from fluid retention and decreased metabolism, dry skin, or cold sensitivity. Elderly patients have significantly fewer symptoms than do younger adults, and complaints are often subtle. Many elderly patients with hypothyroidism present with nonspecific geriatric symptoms like confusion, falling, incontinence, and decreased mobility. With progression, clinical signs become more obvious and severe. Myxedema usually appears in the later stages if not treated resulting in nonpitting edema present around the eyes, hands, and feet. Myxedema may also cause thickening of the tongue and tissues of the larynx and pharynx, slurred speech and hoarseness. Rarely, a goiter may be present if not medically treated and presents as a large swelling on the anterior neck resulting from marked thyroid gland growth. Although goiters are not frequently seen in the United States because its main cause is due to low iodine intake it can also be seen in elevated levels of TSH often present in progressed hypothyroidism. It is more commonly seen in other parts of the world where commercial foods containing iodine aren’t as abundant. Other frequent clinical manifestations are listed in the systemic involvement section of this page. [4][2][3][5]
Associated Co-morbidities[edit | edit source]
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Medications[edit | edit source]
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Diagnostic Tests/Lab Tests/Lab Values[edit | edit source]
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Causes[edit | edit source]
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Systemic Involvement[edit | edit source]
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Medical Management (current best evidence)[edit | edit source]
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Physical Therapy Management (current best evidence)[edit | edit source]
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Alternative/Holistic Management (current best evidence)[edit | edit source]
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Differential Diagnosis[edit | edit source]
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Case Reports[edit | edit source]
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Resources
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References[edit | edit source]
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- ↑ 1.0 1.1 Goodman C, Snyder T. Differential Diagnosis for Physical Therapists: Screening for Referral. St. Louis, Missouri: Saunders Elsevier, 2007.
- ↑ 2.0 2.1 2.2 Goodman C, Fuller K. Pathology: Implications for the Physical Therapist. St. Louis, Missouri: Saunders Elsevier; 2009.
- ↑ 3.0 3.1 Porter R, Hypothyroidism. The Merck Manual Online Medical Library. 2008. Available at: http://www.merck.com/mmpe/index.html . Accessed February 17, 2010.
- ↑ Goodman C, Snyder T. Differential Diagnosis for Physical Therapists: Screening for Referral. St. Louis, Missouri: Saunders Elsevier, 2007.
- ↑ Allahabadia A., Razvi S., Abraham P., Franklyn . Diagnosis and treatment of primary hypothyroidism. British Medical Journal (International Edition) [serial online]. 2009;338:1090. Available from: Health Module. Accessed February 19, 2010, Document ID: 1731734701.
