Hypothyroidism

WHAT YOU SHOULD KNOW

Causes

• Damage or removal of some or all of the thyroid gland
• Excessive treatment for hyperthyroidism (overactive thyroid)
• Infection of the thyroid gland

Signs/Symptoms

• Constant fatigue
• Difficulty paying attention
• Forgetfulness
• Unexplained weight gain
• Thinning hair or hair loss
• Thick, swollen, puffy skin
• Constant low temperature
• Constipation
• Menstrual problems
• Difficulty becoming pregnant
• Miscarriage

• Extremely low blood pressure
• Slow heartbeat
• Very slow breathing
• Very low temperature

Care

IF YOU'RE HEADING FOR THE HOSPITAL...

What to Expect While You're There

• Taking Vital Signs: These include your temperature, blood pressure, pulse (counting your heartbeats), and respirations (counting your breaths). A stethoscope is used to listen to your heart and lungs. Your blood pressure is taken by wrapping a cuff around your arm.
• Blood Tests: You may need blood taken for tests. It can be drawn from a vein in your hand or from the bend in your elbow. Several samples may be needed.
• Blood Gases: This test measures the amount of oxygen, acids, and carbon dioxide in the blood---measurements that are especially important if you're having any trouble breathing. The blood sample for the test is taken from an artery in the wrist, elbow, or groin.
• Heart Monitor: (Also called an electrocardiogram [e-LEK-tro-KAR-di-o-gram] or EKG). Typically, three to five sticky pads are placed on different parts of your body. Each pad has a wire that is hooked to a TV-type screen or to a small portable box (telemetry unit) that shows a tracing of each heartbeat.
• IV: A tube placed in your vein for giving medicine or liquids. It will be capped or have tubing connected to it.
• Pulse Oximeter: With a little clip connected to your ear, finger, or toe, this machine measures the oxygen in your blood.
• Activity: You'll need plenty of rest until your thyroid level returns to normal. Nurses will help you with bathing and other physical activities. To prevent exhaustion, your visitors may be limited.
• Medicines:
• Thyroid Hormone: To bring your thyroid level back to normal, you'll be given hormones through your IV, by mouth, or through a feeding tube in your nose or mouth.
• Tranquilizers: These drugs may be given by IV, as a shot, or by mouth.
• Glucose: If you blood sugar level is low, you may be given this medicine through your IV.
• Stool Softeners: Constipation often accompanies hypothyroidism, so you may receive stool softeners to ease the problem.
• Oxygen: At times during your stay, your body may need extra oxygen. It is given either through a plastic mask over your mouth and nose or through nasal prongs. If the oxygen dries out your nose or the nasal prongs bother you, tell your nurse, but don't take off the oxygen on your own.
• 24-Hour Urine Test: This test requires your entire output of urine for a day, including any nighttime trips to the bathroom. At the start of the test, you'll be given a radio__iodine medicine to drink. After 24 hours, the amount of radio__iodine that shows up in your urine will be measured at a lab.

WHAT YOU SHOULD DO

• Take your thyroid medicine in the morning on an empty stomach. If you take it at night, you may have trouble sleeping. Keep it in a dark, dry place. Heat and dampness can cause the medication to break down.
• Because hypothyroidism usually leads to excess weight, you'll need to follow a low-calorie diet. Limit sugar, fat, and cholesterol. Choose items from all 5 food groups: fruits, vegetables, breads, dairy products, meat and fish. Drink 6 to 8 large glasses of liquid per day.
• If constipation remains a problem, try to get regular walks---they're the best way to get your bowels moving. Eating foods high in fiber, such as high fiber cereals, beans, vegetables, and whole grain breads, may also be helpful. Prune juice is a natural stool softener.
• Low thyroid levels can make your skin dry and scaly. Lotion will help relieve the discomfort. Shower every day, making sure to wash between folds of skin. If you feel dizzy, take a bath or use a shower chair.
• To adjust your thyroid dosage, your doctor will need to run periodic blood tests. At first they may be needed every 2 to 3 months; later, twice-yearly testing should be sufficient.

Call Your Doctor If...

• You have a high fever.
• Your heartbeat isn't normal.
• You feel very anxious or nervous.
• You contract an infection. This can throw your thyroid level out of control
• You run out of thyroid medicine.

Seek Care Immediately If...

• You have chest pain that spreads to your arms, jaw, or back.
• You faint or feel too dizzy to stand up.
• You suddenly have trouble breathing. This could be a sign of overdose with your thyroid medicine.