HYPOTHYROIDISM

Neysa Ornella D
17-102
• a common endocrine disorder resulting from
deficiency of thyroid hormone

• Thyroid can’t produce enough hormones 

unbalance chemical reactions

• Un-noticeable symptoms (early stage)

Etiologi
• Autoimmune disease
Hashimoto’s disease

• Overresponse to hyperthyroid treatment

• Thyroid surgery

• Radiation therapy
Cancers of the head&neck

• Medications
Drugs Blocking Thyroid Hormone Synthesis or Release, ex iodide and lithium

Induced thyroid destruction, ex Sunitin

• Iodine deficiency
• Congenital disease
Defect/no thyroid gland  newborn screening

• Pituitary disorders
Failure pituitary gland to produce enough TSH (benign
tumor>>)

• Pregnancy
During/post pregnancy often mom produce antibodies to
their own thyroid  miscarriage, premature,
preeclampsia affect developing fetus
Epidemiologi

• Primary hypothyroidism 99% of cases

• In the United States and other areas of adequate

iodine intake, autoimmune thyroid disease
(Hashimoto disease) is the most common cause
of hypothyroidism;

• Worldwide, iodine deficiency remains the

foremost cause
Risk Factors
• Women >>
• 60th ++
• Family history
• Autoimmune disease
• Radioactive iodine/anti thyroid med
• Radiation neck/upper chest
• Thyroid surgery (thyroidectomy)
• Pregnant/post partum (6months)
 Gejala Klinis
• ↓HR
• Fatigue, loss of energy, lethargy

• Weight gain

• Decreased appetite
• Cold intolerance

• Dry skin

• Hair loss

• Puffy face (Myxedematous)

• Sleepiness

• Muscle pain, joint pain, weakness in the extremities

• Depression
• Emotional lability, mental impairment
• Forgetfulness, impaired memory, inability to concentrate
• Constipation
• Menstrual disturbances, impaired fertility
• Decreased perspiration
• Paresthesia and nerve entrapment syndromes
• Blurred vision
• Decreased hearing
• Fullness in the throat, hoarseness
Diagnose
• Anamnesi
• Px Fisik
• Px Penunjang
Terapi Hipotiroid
Thyroid Hormone Replacement Therapy
Tiroksin (Na-levotiroksin/ T4)
Triyodotironin (Na-Liotironin (T3)

Tujuan : Meringankan keluhan/ gejala

• Menormalkan metabolisme, T3 dan T4
• Menormalkan TSH
• Menghindari komplikasi

Indikator Kecukupan : Kadar TSH

Levothroxyne (LT4)
• DOA panjang, waktu paruh 7 hr
• BSO : tablet, injeksi (iv)
• Dosis tunggal 112 mikrogram/hr atau 1,6 mikrogram/kgBB
• Kadar mantap tercapai setelah 5 minggu
• Monitoring kadar TSH plasma, tujuan terapi kadar TSH
• normal (0,5-5,0µIU/ml)
• Diminum 30 mins sebelum sarapan
Triodothyronin (Liotironin-T3)
• Onset cepat, efek hormon lebih kuat
• DOA lebih pendek dibanding T4, waktu paruh 24-30 jam
• BSO tablet
• Frekuensi pemberian lebih sering
• Dosis 25 – 50 mikrogram/ hari