SIGNS AND SYMPTOMS – Hypothyroidism

 Fatigue, myalgia and muscle cramps

 Reduced fertility and heavy menses
 Weight gain and constipation
 Cold intolerance and dry skin
 Mental dullness, depression and mood changes

TYPES

Painful thyroid lesions (absent TPO Ab)

1. Post-viral thyroiditis
2. Infectious thyroiditis (bacterial)
3. Immunocompromised – staphylococcal or streptococcal

Treatment: NSAIDs or systemic glucocorticoids

Painless thyroiditis (positive TPO Ab)

1. Hashimoto’s thyroiditis – goitre is present

2. Postpartum thyroiditis
3. Drug induced thyroiditis
4. Grave’s disease

MECHANISM

Autoantibodies cause inflammation and destroy the hormones or the thyroid tissue resulting in
hypothyroidism, goitre or transient thyrotoxicosis. Autoantibodies can also stimulate TSH receptor
and cause thyrotoxicosis. Thyroid Peroxidase Enzyme (TPO) antibodies cause hypothyroidism

DIAGNOSIS

1. High TPO Abs or anti-thyroglobulin Abs

2. Screening for patients with atrial fibrillation, hyperlipidaemia, diabetes mellitus, down
syndrome, turner’s syndrome, postpartum thyroiditis history