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Endocrine Disorders, Contraception, and Hormone Therapy during Pregnancy
Published in “Bert” Bertis Britt Little, Drugs and Pregnancy, 2022
Symptomatic hypothyroidism in women impairs fertility. It increases the frequency of spontaneous abortion, stillbirth, and congenital anomalies (Davis et al., 1988; Mestman, 1980; Montoro et al., 1981; Pekonen et al., 1984). Hypothyroidism is caused by iodine deficiency, iatrogenic (thyroidectomy or 131I therapy) etiologies, or thyroiditis. Hypothyroidism symptoms include cold intolerance, irritability, and difficulty with concentration, dry skin, coarse hair, and constipation. Many of these symptoms are commonly seen in normal pregnancy, making clinical diagnosis difficult.
Pituitary emergencies:
Published in Nadia Barghouthi, Jessica Perini, Endocrine Diseases in Pregnancy and the Postpartum Period, 2021
Jessica Perini, Nadia Barghouthi, Gayatri Jaiswal
Necrosis of the thyrotrophs of the pituitary will impair secretion of TSH, which stimulates the production of thyroid hormone by the thyroid gland.Symptoms of hypothyroidism will not be apparent in the immediate postpartum period due to the long half-life of thyroid hormone (7 days).Symptoms of hypothyroidism include fatigue, weight gain, trouble concentrating, cold intolerance, and constipation. Severe symptoms include bradycardia, hypothermia, and altered mental status.
Helping women to ovulate
Published in David J Cahill, Practical Patient Management in Reproductive Medicine, 2019
Treatment of hypothyroidism is relatively straightforward. Start thyroxine (usually 50 μg daily) immediately, and measure TSH levels within a month. They should be normal – and if not, increase the dose by 25–50 μg. Once TSH levels are normal, cycles should return within 4–6 weeks. Remember that if the woman conceives on thyroxine, she will almost certainly require an increase in dose within the first few weeks – so she should be directed to inform her prescribing doctor immediately on confirming that she is pregnant, recognising she might otherwise not interact with health care providers until 8–10 weeks amenorrhoea.
Using the Biopsychosocial Approach to Identify Factors Associated with Major Depressive Disorder for Individuals with Hypothyroidism
Published in Issues in Mental Health Nursing, 2022
Kennedy S. Anderson, Krista J. Howard, Kelly B. Haskard-Zolnierek, Julia Pruin, Rebecca G. Deason
Hypothyroidism, or underactive thyroid, is described as a deficiency of thyroid hormones (American Thyroid Association, 2020). A diagnosis of hypothyroidism is made following a blood test to assess the function of thyroid stimulating hormone (TSH), and treatment typically consists of the thyroid hormone supplement thyroxine (T4) while some patients also are given the additional triiodothyronine (T3) supplement. Common physical symptoms of hypothyroidism include lethargy, sensitivity to cold, constipation, dry skin, weight gain, sexual dysfunction, and neck swelling (Ali et al., 2017; El Saide Sayyah et al., 2013). Hypothyroidism has also been implicated in changes in mood and cognition, such as poorer attention, memory, and executive function and increased rates of anxiety and depression (Samuels, 2014).
The continuum of care of anticancer treatment-induced hypothyroidism in patients with solid non-thyroid tumors: time for an intimate collaboration between oncologists and endocrinologists
Published in Expert Review of Clinical Pharmacology, 2022
Maria V. Deligiorgi, Dimitrios T. Trafalis
No confirmatory tests to distinguish the anticancer treatment-induced hypothyroidism from hypothyroidism of another etiology exist. Anticancer treatment-induced hypothyroidism is diagnosed based on history of related treatment and/or correction of hypothyroidism after treatment cessation. However, in most cases, cessation of a potentially life-saving treatment is not viable option unless hypothyroidism is severe, or life-threatening. Therefore, the diagnosis of anticancer treatment-induced hypothyroidism is presumptive after excluding non-thyroidal illness syndrome (NTIS) – aberrant HPT function in response to severe illness. Although the pathophysiology of NTIS remains elusive, it reflects the function of HPT as dynamic adaptive system credited with regulation of life-history trade-offs between reproduction, growth, immunity, and basal metabolic rate during demanding conditions [144,145].
Fatigue and its management in cancer patients undergoing VEGFR-TKI therapy
Published in Expert Opinion on Drug Safety, 2022
Thyroid hormones promote metabolism, and hypothyroidism develops if the body fails to produce enough of these hormones for whatever reason. The main symptom of hypothyroidism is fatigue, and other symptoms include lethargy, edema, feeling cold, weight gain, and slow movements. Hypothyroidism is treated with the synthetic T4 thyroid hormone levothyroxine (e.g. Thyradin S, ASKA Pharmaceutical Co., Ltd.) taken in oral form [60,61]. When 25 colon cancer patients were treated with regorafenib, thyroid-stimulating hormone (TSH) levels increased in all patients after administration, and they were persistently elevated in 11 of these patients. When levothyroxine was administered to these 11 patients, TSH returned to the normal range, and fatigue improved, as assessed on a 5-point scale. Severity of fatigue was also found to correlate with TSH levels [62]. I would suggest regular TSH testing, but levothyroxine therapy is recommended when patients develop persistent serum TSH elevation ≥10 IU/L or patients have milder hypothyroidism (THS between 7 and 10 IU/L), associated with clinical signs and symptoms highly suggestive of thyroid failure.