Hipotiroidismo primario
Summary
Definition
History and exam
Key diagnostic factors
- presencia de factores de riesgo
- síntomas inespecíficos
Other diagnostic factors
- letargo
- estreñimiento
- aumento de peso
- depresión
- irregularidades menstruales
- piel seca o áspera
- cambio en la voz
- bradicardia
- hipertensión
- relajación retrasada de los reflejos osteotendinosos
- sensibilidad al frío
- cabello áspero
- edema palpebral
- bocio
Risk factors
- deficiencia de yodo
- sexo femenino
- edad mediana
- antecedentes familiares de la tiroiditis autoinmune
- trastornos autoinmunitarios
- tratamiento de la enfermedad tiroidea
- tiroiditis posparto
- Síndromes de Turner y Down
- diabetes tipo 1
- radioterapia en cabeza y cuello
- enfermedad infiltrante
- exceso de yodo
- exposición a plaguicidas
- uso de amiodarona
- uso de litio
- laringectomía
- tratamiento de la tuberculosis multirresistente (TB)
Diagnostic tests
1st tests to order
- hormona estimulante de la tiroides (TSH)
Tests to consider
- tiroxina sérica libre (T4)
- anticuerpos anti-peroxidasa tiroidea (anti-TPOAbs)
- hemograma completo (HC)
- glucemia en ayunas
- colesterol sérico
Treatment algorithm
hipotiroidismo primario manifiesto confirmado
hipotiroidismo subclínico
Contributors
Authors
Wail Malaty, MD
Adjunct Clinical Professor
Department of Family Medicine
University of North Carolina
Chapel Hill
NC
Disclosures
WM declares that he has no competing interests.
Peer reviewers
Sun Y. Lee, MD, MSc
Assistant Professor of Medicine
Boston University School of Medicine
Boston
MA
Disclosures
SYL declares that she has no competing interests.
Salman Razvi, MD, FRCP
Consultant Endocrinologist
Queen Elizabeth Hospital
Gateshead
UK
Disclosures
SR declares that he has no competing interests.
Lakdasa Premawardhana, MBBS, FRCP, FRCPE
Consultant Physician
Caerphilly Miners' Hospital
Caerphilly
UK
Disclosures
LP declares that he has no competing interests.
Birte Nygaard, MD, PhD
Associated Professor
Consultant Endocrinologist
Herlev Hospital
University of Copenhagen
Denmark
Disclosures
BN declares that she has no competing interests.
Peer reviewer acknowledgements
BMJ Best Practice topics are updated on a rolling basis in line with developments in evidence and guidance. The peer reviewers listed here have reviewed the content at least once during the history of the topic.
Disclosures
Peer reviewer affiliations and disclosures pertain to the time of the review.
References
Key articles
Taylor PN, Medici MM, Hubalewska-Dydejczyk A, et al. Hypothyroidism. Lancet. 2024 Oct 5;404(10460):1347-64. Abstract
Alexander EK, Pearce EN, Brent GA, et al. 2017 guidelines of the American Thyroid Association for the diagnosis and management of thyroid disease during pregnancy and the postpartum. Thyroid. 2017 Mar;27(3):315-89.Full text Abstract
American Association of Clinical Endocrinologists; American Thyroid Association. Clinical practice guidelines for hypothyroidism in adults: cosponsored by the American Association of Clinical Endocrinologists and the American Thyroid Association. Endocr Pract. 2012 Nov-Dec;18(6):988-1028.Full text Abstract
Jonklaas J, Bianco AC, Bauer AJ, et al. Guidelines for the treatment of hypothyroidism: prepared by the American Thyroid Association Task Force on Thyroid Hormone Replacement. Thyroid. 2014 Dec;24(12):1670-751.Full text Abstract
Reference articles
A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.
Differentials
- Hipotiroidismo secundario o central
- Depresión
- Demencia tipo Alzheimer
More DifferentialsGuidelines
- Thyroid disease: assessment and management
- Subclinical hypothyroidism and hypothyroidism in pregnancy
More GuidelinesPatient information
Tiroides hipoactiva
Tiroides hipoactiva: preguntas que debe hacer a su médico
More Patient information
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