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Hipotiroidismo primario

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  • Descripción general
  • Teoría
  • Diagnóstico
  • Manejo
  • Seguimiento
  • Recursos
Evidencia revisada por última vez: 15 Feb 2026
Tema actualizado por última vez: 25 Apr 2025

Resumen

Definición

Anamnesis y examen

Principales factores de diagnóstico

  • presencia de factores de riesgo
  • síntomas inespecíficos
Todos los datos

Otros factores de diagnóstico

  • 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
Todos los datos

Factores de riesgo

  • 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)
Todos los datos

Pruebas diagnósticas

Primeras pruebas diagnósticas para solicitar

  • hormona estimulante de la tiroides (TSH)
Todos los datos

Pruebas diagnósticas que deben considerarse

  • tiroxina sérica libre (T4)
  • anticuerpos anti-peroxidasa tiroidea (anti-TPOAbs)
  • hemograma completo (HC)
  • glucemia en ayunas
  • colesterol sérico
Todos los datos

Algoritmo de tratamiento

En curso

hipotiroidismo primario manifiesto confirmado

hipotiroidismo subclínico

Colaboradores

Autores

Wail Malaty, MD

Adjunct Clinical Professor

Department of Family Medicine

University of North Carolina

Chapel Hill

NC

Раскрытие информации

WM declares that he has no competing interests.

Рецензенты

Sun Y. Lee, MD, MSc

Assistant Professor of Medicine

Boston University School of Medicine

Boston

MA

Раскрытие информации

SYL declares that she has no competing interests.

Salman Razvi, MD, FRCP

Consultant Endocrinologist

Queen Elizabeth Hospital

Gateshead

UK

Раскрытие информации

SR declares that he has no competing interests.

Lakdasa Premawardhana, MBBS, FRCP, FRCPE

Consultant Physician

Caerphilly Miners' Hospital

Caerphilly

UK

Раскрытие информации

LP declares that he has no competing interests.

Birte Nygaard, MD, PhD

Associated Professor

Consultant Endocrinologist

Herlev Hospital

University of Copenhagen

Denmark

Раскрытие информации

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.

Список литературы

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.

Основные статьи

Taylor PN, Medici MM, Hubalewska-Dydejczyk A, et al. Hypothyroidism. Lancet. 2024 Oct 5;404(10460):1347-64. Аннотация

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.Полный текст  Аннотация

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.Полный текст  Аннотация

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.Полный текст  Аннотация

Статьи, указанные как источники

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