Summary
Definition
History and exam
Key diagnostic factors
- presença de fatores de risco
- sintomas inespecíficos
Other diagnostic factors
- letargia
- constipação
- ganho de peso
- depressão
- irregularidade menstrual
- pele seca ou áspera
- mudança na voz
- bradicardia
- hipertensão
- retardo do relaxamento dos reflexos tendinosos
- sensibilidade ao frio
- cabelo grosso
- edema palpebral
- bócio
Risk factors
- deficiência de iodo
- sexo feminino
- meia-idade
- história familiar de tireoidite autoimune
- doenças autoimunes
- tratamento para doença tireoidiana
- tireoidite pós-parto
- Síndromes de Turner e de Down
- diabetes do tipo 1
- radioterapia de cabeça e pescoço
- doença infiltrante
- excesso de iodo
- exposição a pesticidas
- uso da amiodarona
- uso de lítio
- laringectomia
- tratamento para tuberculose (TB) resistente a múltiplos medicamentos
Diagnostic tests
1st tests to order
- hormônio estimulante da tireoide (TSH) sérico
Tests to consider
- tiroxina livre sérica (T4)
- anticorpos antitireoperoxidase (anti-TPOAbs)
- Hemograma completo
- glicemia de jejum
- colesterol sérico
Treatment algorithm
hipotireoidismo primário evidente confirmado
hipotireoidismo 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.
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