Titbits on hypothyroidism

Hypothyroidism and dyslipidmeia

In hypothyroidsim there is a decrease in lipoprotein lipase activity which leads to hypertriglyceridemia. Similarly, a decrease in hepatic low density lipoproteins (LDL) receptors cause elevated LDL levels.

CPK elevation in hypothyroidism

Creatine phosphokinase (CPK) levels can be elevated in hypothyroidism. Often there is assocated generalised aches and pains, localised rhabdomyolysis, proximal myopathy and Hoffman syndrome – a pseudo muscle hypertrophy with weakness, usually affecting the calf. Statins can aggravate the rhabdomyolysis in hypothyroidism leading to generalised rhabdomyolysis which may lead on to renal failure.

Large pituitary in hypothyroidism

Large pituitary or pseudotumor of the pituitary can occur in hypothyroidism due to undue stimulation as the feed back inhibition by thyroxine is lost.

Graves ophthalmopathy

Graves ophthalmopathy can also be unilateral and sometimes the person may be in a burnt out hypothyroid state at presentation.

Graves dermopathy can also occur.

TSH and symptoms

TSH (thyroid stimulating hormone) levels less than 10 units are unlikely to be the cause of symptoms. Be cautious about treating elderly with mild elevation of TSH.

TSH in newborn period

TSH levels are in the range of 15 units on the day of birth normally and the levels come down as days progress.