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.

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 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)