Myxedema coma, also known as myxedema crisis, is a complication of advanced hypothyroidism. Hypothyroidism is a condition where the thyroid gland does not produce enough thyroid hormones.
This article explores how hypothyroidism causes myxedema coma, before detailing its symptoms, causes, treatment, and diagnosis.
How does hypothyroidism cause myxedema coma?
body temperature
growth
heart rate
metabolism
If a lack of T3 and T4 severely disrupts these bodily functions, a person may develop symptoms of myxedema coma.
Learn more about normal T4 levels here.
What are the symptoms of myxedema coma?
Myxedema coma occurs when the body can no longer tolerate the effects of hypothyroidism.
confusion or mental slowness
hypothermia
decreased breathing
low blood oxygen levels
high blood carbon dioxide levels
lower than usual blood sodium levels
shock
seizures
coma
Contributing factors of myxedema coma
Myxedema coma is a result of untreated or undiagnosed hypothyroidism. However, some contributing factors may trigger myxedema coma sooner in some people.
These includeTrusted Source:
infection
exposure to cold
stopping hypothyroid treatment medication
stress
trauma
sudden illness, such as heart attack or stroke
If anyone has hypothyroidism, it is important that they try and keep warm. People should also contact their doctor if an infection, such as a urinary tract infection, takes longer to clear than expected.
How is myxedema coma diagnosed?
A doctor can measure T4 and thyroid-stimulating hormone levels to diagnoseTrusted Source myxedema coma.
However, they will likely start with immediate hormone replacement treatment while waiting for the test results based on other symptoms.
These symptoms may include:
sparse hair
dry skin
confusion
goiter
a possible scar from thyroid surgery
hypothermia
decreased breathing
swelling, especially in the face and legs
A doctor may perform more tests to determine thyroid function and other conditions that could be affecting the thyroid.
How is myxedema coma treated?
If a doctor suspects myxedema coma, they will begin treatmentTrusted Source with thyroid hormone therapy, which aims to ease symptoms by restoring T3 and T4 hormone levels.
Depending on how advanced the coma is, doctors will administer T3 and T4 hormones using an intravenous drip. However, a person can receive the treatment orally if they are well enough. In addition to thyroid hormone replacement therapy, people may need other medications such as steroids.
What causes hypothyroidism?
Hypothyroidism occurs when the thyroid gland does not function properly and no longer produces enough thyroid hormones. It may also develop if the pituitary gland does not stimulate it.
Many conditions could lead to hypothyroidism, including:
Hashimoto’s thyroiditis: Hashimoto’s thyroiditis is the most commonTrusted Source cause of hypothyroidism in the United States.
Congenital hypothyroidism: In some casesTrusted Source, the thyroid gland may not function properly from birth, resulting in mental and physical growth issues.
Pituitary gland abnormalities: Pituitary tumors or pituitary surgery may affect the function of the gland. When this happens, the pituitary gland is unlikely to produce the right amount of TSH.
Sheehan’s syndrome: This involves damage to the pituitary gland and may result in an underactive thyroid.
Iodine imbalance (deficiency or excess): If a person does not consume enough iodine, hypothyroidism may occur.
Medication and treatment side effects
Several drugs are known to interfere with thyroid hormone production.
Examples of these drugs includeTrusted Source:
interferon
lithium (Priadel)
amiodarone (Pacerone)
interleukin-2
People receiving radiation therapy for head and neck cancer may also developTrusted Source hypothyroidism months or years after treatment.
In addition, thyroid surgery may also lead to hypothyroidism. Treatment for conditions, such as thyroid cancer, thyroid nodules, hyperthyroidism, and goiter, involve partial or full removal of the thyroid gland.
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