What labs are used to diagnose hypo/hyper thyroid? - TSH, T3, and T4. High TSH = hypo and low TSH = hyper. Opposites.
Timeframe for re-check of labs
... [Show More] after starting levothyroxine - 6-8 weeks (long half-life). Yearly after stable.
Signs and symptoms of hypothyroidism - Dry hair, puffy face, goiter in the neck, slow heartbeat, weight gain, constipation, infertility, increased risk of miscarriages, irregular menstrual cycle, cold intolerance.
Drug of choice for hypothyroidism - Levothyroxine (Synthroid)
§ Signs and symptoms of hyperthyroidism - Hair loss, bulging eyes, goiter, rapid heartbeat, weight loss, diarrhea, menstrual periods loss often or longer.
Drug of choice for hyperthyroidism - Methimazole (Tapazole)
Treatment of thyroid storm - high doses of potassium iodide or strong iodine solution are given to suppress thyroid hormone release. Methimazole is given to suppress thyroid hormone synthesis. Beta blocker given to reduce HR. additional measures include sedation, cooling, and giving glucocorticoids and IV fluids.
Result of not treating hypothyroidism during pregnancy: - Permanent neuro-psychological deficits in the child. Decrease IQ/neuropsychological function. First trimester.
Medication to treat symptoms of hyperthyroidism (notice this is treating symptoms and not the hyperthyroidism itself): - Beta blockers (tachycardia) - propranolol/atenolol most popular.Non-radioactive iodine. ADJUNCTIVE THERAPY.
Drug/Food/Supplement interactions with levothyroxine: - Do not take antacids, Calcium or Iron, how to take it (morning 30-60 min b4 eat.
How to confirm a diagnosis of DM prior to beginning treatment: - Fasting plasma glucose above 126. A random plasma glucose of over 200 plus symptoms of diabetes, an oral glucose tolerance test of two hours, plasma glucose of over 200, or a A1C higher than 6.5.
A1c general goals - <7, patients that experience severe hypoglycemia/have a limited life expectancy may have an A1C goal of <8.
A1c older adults - <8, those with multiple coexisting chronic illnesses, cognitive impairment, or functional dependence should have less stringent glycemic goals such as <8.0-8.5.
When should insulin be considered? - For treatment of persistent hyperglycemia starting at a threshold of >180.
Early introduction of insulin should be considered if there is evidence of ongoing weight loss, if symptoms of hyperglycemia are present, or whenA1C levels >10% or BGS >300 [Show Less]