Decompensated Hypothyroidism

Decompensated Hypothyroidism: 

Why do we miss it, and how do we improve?

emDocs - November 30, 2020 - By Faiz Ahmed and Brian Meier

Reviewed by: Andrew Grock; Alex Koyfman; Brit Long

"Pearls:

• Consider decompensated hypothyroidism in anyone with altered mental status associated with hypothermia, bradycardia, and hypotension, especially for an elderly female in the winter months.
• Work up and treat both the precipitating event and the hypothyroidism simultaneously.
• The diagnosis of decompensated hypothyroidism is DO NOT wait for laboratory confirmation to initiate treatment.
• First line treatment is with IV Hydrocortisone (100mg) and IV thyroxine (T4) 200-400 mcg."