7 Other symptoms of hypothyroidism ConstipationHeavy periodsCold dry skin, dry hair, hair lossMuscle pains/stiffness
8 Hypothyroidism Joseph Fourier, a French mathematician ‘began to suffer from a strange disease, whose main effect was to render him extremely sensitive to cold….caused him to wrap up in many layers of heavy clothing, and live in a highly heated room from which he seldom ventured forth, even in summer heatwaves’.Paul Strathern, Napoleon in Egypt
9 Treatment of Hypothyroidism Thyroid hormone, T4 (Eltroxin)Aim to abolish symptomsAim to achieve a high normal T4 and low-normal TSHNB Pregnancy issues
10 Thyroid Case  26 year old woman Noticed prominence of right eye x 3 weeksIncreased appetite – but weight decreasingDifficulty getting out of the bath
20 Thyroid nodules 5% of population have palpable thyroid nodules 30-40% of popn have non-palpable nodules detectable on ultrasoundThyroid cancer in 8% of palpable thyroid nodulesDifferentiated cancers: slow growing, good prognosis
21 Thyroid nodulesRisk stratify: risk factors, u/s characteristics, hot or coldFine needle aspirationObservation, surgery
22 SummaryThyroid disease common but treatable, wide and varied complaintsDisorders of function: Hypo/Hyper, diagnosis TFTsDisorders of structure: Goitre, nodules
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