Mortality rate has been as high as 80% now 15-20% with aggressive treatment
Some common symptoms are:
Constipation
Depression
Lethargy
Dry, Brittle hair or Alopecia
Weight Gain
Cold Intolerance
Weight Gain
Treatment consists of:
Rule out aggravating cause (i.e.: infection)
Start IV levothyroxine dosing
Initial dose 400-500 mcg (Helps to saturate the thyroid receptors)
Daily dose 100 mcg/day
Consider starting Dexamethasone or doing a Cortisol stimulation test
Patients may also have adrenal insufficiency from primary pituitary failure or may have secondary adrenal suppression due to the severe hypothyroidism. If dexamethasone is not provided they may develop severe adrenal insufficiency once you kick start their metabolism.
