Page 298 - 2021 IDMT Digital
P. 298

Chapter 10
                           ENDOCRINOLOGY PROTOCOLS


                                   HYPOTHYROIDISM
          Introduction:
            •  +\SRWK\URLGLVP LQGLFDWHV WKDW WKHUH LV D ORZHU OHYHO RI WK\URLG KRUPRQH FLUFXODWLQJ LQ WKH
               EORRGVWUHDP WKDQ WKH ERG\ UHTXLUHV IRU KRPHRVWDVLV
            •  +\SRWK\URLGLVP LV QRWHG E\ LWV FRQVWHOODWLRQ RI V\PSWRPV
            •  '\VIXQFWLRQ RI WKH WK\URLG PD\ EH UHODWHG WR G\VIXQFWLRQ RI WKH K\SRWKDODPXV  WKH
               SLWXLWDU\ RU WKH WK\URLG JODQG LWVHOI; most common cause is autoimmune
          Subjective:
            •  6LJQV DQG 6\PSWRPV
                 o  6\PSWRPV ZLOO EH QRQVSHFLILF
                       ƒ  &ROG LQWROHUDQFH
                       ƒ  :HLJKW JDLQ
                       ƒ  )DWLJXH
                       ƒ  /HWKDUJ\
                       ƒ  :HDNQHVV
                       ƒ  +DLU ORVV
                       ƒ  'HSUHVVLRQ
                       ƒ  (QODUJHPHQW RI WKH WK\URLG JODQG  JRLWHU

          Objective:
            •  3K\VLFDO ([DP
                 o  9LWDO VLJQV
                       ƒ  %UDG\FDUGLD
                       ƒ  'LDVWROLF K\SHUWHQVLRQ LV SRVVLEOH
                 o  7KLQ QDLOV
                 o  7KLQ KDLU
                 o  3HULSKHUDO HGHPD
                 o  3DOSDEO\ HQODUJHG WK\URLG
            •  7RROV
                 o  Thyroid function tests (TSH/free T4); cRQVLGHU (.* LI DUUK\WKPLD QRWHG
          Assessment:
            •  'LIIHUHQWLDO
                 o  +\SHUWK\URLG  WDFK\FDUGLD  ZHLJKW ORVV
                 o  0RQRQXFOHRVLV  DEGRPLQDO SDLQ  VZROOHQ WRQVLOV
                 o  $QHPLD  IHPDOH SDWLHQW  KHDY\ F\FOHV  UHFHQW EORRG ORVV
                 o  *RLWHU  SRRU GLHW  GHYHORSLQJ QDWLRQV
                 o  $GUHQDO GLVHDVH  XQXVXDO WDQQLQJ RI WKH VNLQ  K\SRWHQVLRQ  ZHLJKW ORVV















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