a. Cretinism. Cretinism is the hyposecretlon of thyroxin in the newborn. This
lack of thyroxin causes retardation of skeletal and nervous system growth. Untreated,
this hyposecretion of thyroxin in a newborn can result in a mentally retarded dwarf.
Early diagnosis and treatment of hypothyroidism is critical. Once detected, the newborn
or infant can be given thyroxin so that development can be normal.
b. Myxedema. Myxedema is the hyposecretion of thyroxin in an adult (person
after puberty). Myxedema is characterized by edema, fatigue, lethargy, sensitivity to
cold, and other degenerative changes. In general, individuals suffering from myxedema
feel tired and want to sleep a great deal (perhaps from 14 to 16 hours per day).
7-5.
HYPERTHYROIDISM
Because the Irish physician, Robert Graves, first described hyper-thyroidism
around 1835, this condition is usually referred to as Graves disease. Hyperthyroidism is
increased secretion of thyroxine. Graves disease is characterized by anxious behavior,
rapid pulse rate, increased appetite, weight loss, elevated metabolic rate, tremor of the
hands, and exophthalmos (a condition in which the eyeballs slightly protrude from the
sockets giving the patient a startled appearance). Graves's disease can be treated by
the administration of Iodine 131 (I131) or by surgery. Surgery is the first choice of
treatment in patients whose age is between 25 and 40 and the second choice of
treatment in patients 0 to 25 years.
Section II. THYROID PREPARATIONS
7-6.
PRECAUTIONS FOR PATIENTS WHO ARE TAKING THYROID
PREPARATIONS
From the preceding discussion, it is obvious that thyroid preparations affect the
entire body. Therefore, persons who take these medications should be told of the
following precautions.
a. Regular Checkups. An individual taking a thyroid preparation should
schedule regular visits with the prescribing physician. These regular visits give the
physician the opportunity to monitor the patient's progress. Changes in the dosage of
the medication may be required, the dosage of each of the agents below must be
tailored to meet the individual needs of the patient. These regular checkups also give
the patient an opportunity to tell the physician of any side effects the patient might be
experiencing (e.g., changes in appetite, changes in menstrual periods, etc.).
b. Exercise or Physical Work. If the patient has certain types of heart disease,
thyroid medication may cause shortness of breath or chest pain when the patient exerts
himself when exercising or performing physical work. Hence, they should be cautioned
against overdoing exercise or physical work. Specified questions the patient has
concerning this precaution should be directed to the physician.
MD0807
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