Complications
May occur with a high initial dose of levothyroxine in patients with coronary artery disease.
Most likely due to non-adherence, and less often from drug interactions and co-existing illness.
May occur with over-treatment.
May occur with over-treatment.
Myxoedema coma is a rare life-threatening state in which severe hypothyroidism markedly worsens.
In general, it occurs in older people and is usually precipitated by an underlying medical illness. The mortality rate associated with myxoedema coma is 25% to 60%.[3][51]
Clinical features include hypothermia, change in mental status, hypotension, bradycardia, hypoventilation, and diffuse non-pitting oedema.[1][3][51]
Patients with myxoedema coma should be treated in the intensive care unit under the supervision of an endocrinologist.
Sub-clinical hypothyroidism or the presence of thyroid antibodies has been found to be associated with an increased risk of complications in pregnancy, such as pre-eclampsia, perinatal mortality, recurrent miscarriage, and fetal neurological maldevelopment.[47] There is no good evidence that treatment of sub-clinical hypothyroidism during pregnancy reduces the incidence of these complications.[39][50] However, some experts recommend treating this condition in pregnancy.[29][45]
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