When viewing this topic in a different language, you may notice some differences in the way the content is structured, but it still reflects the latest evidence-based guidance.

Hipotiroidismo primario

Last reviewed: 20 Aug 2025
Last updated: 25 Apr 2025

Summary

Definition

病史和体格检查

关键诊断因素

  • presencia de factores de riesgo
  • síntomas inespecíficos
完整详情

其他诊断因素

  • 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
完整详情

危险因素

  • 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)
完整详情

诊断性检查

首要检查

  • hormona estimulante de la tiroides (TSH)
完整详情

需考虑的检查

  • tiroxina sérica libre (T4)
  • anticuerpos anti-peroxidasa tiroidea (anti-TPOAbs)
  • hemograma completo (HC)
  • glucemia en ayunas
  • colesterol sérico
完整详情

治疗流程

持续性治疗

hipotiroidismo primario manifiesto confirmado

hipotiroidismo subclínico

撰稿人

作者

Wail Malaty, MD

Adjunct Clinical Professor

Department of Family Medicine

University of North Carolina

Chapel Hill

NC

利益声明

WM declares that he has no competing interests.

同行评议者

Sun Y. Lee, MD, MSc

Assistant Professor of Medicine

Boston University School of Medicine

Boston

MA

利益声明

SYL declares that she has no competing interests.

Salman Razvi, MD, FRCP

Consultant Endocrinologist

Queen Elizabeth Hospital

Gateshead

UK

利益声明

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

Our in-house evidence and editorial teams collaborate with international expert contributors and peer reviewers to ensure that we provide access to the most clinically relevant information possible.

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 Differentials
  • Guidelines

    • Thyroid disease: assessment and management
    • Subclinical hypothyroidism and hypothyroidism in pregnancy
    More Guidelines
  • Patient information

    Tiroides hipoactiva

    Tiroides hipoactiva: preguntas que debe hacer a su médico

    More Patient information
  • padlock-lockedLog in or subscribe to access all of BMJ Best Practice

Use of this content is subject to our disclaimer