management
Last reviewed 01/2018
General supportive measures:
- IV fluids - but be careful not to precipitate left ventricular failure
- oxygen if cyanosed
- antibiotics if infection suspected
- treat hypothermia
- treat heart failure
Replacement of thyroid hormone:
- traditionally, T3 - 100 microg i.v. bolus followed by 20 micro g tds until condition improves; then substitute T4 50 micro g per 24 hours p.o.; T3 acts most quickly but may worsen ischaemic heart disease; alternatively, 400-500 micro g T4 i.v.
- glucocorticoid replacement - usually, hydrocortisone, 100mg tds i.v. - in conjunction with T3 in suspected secondary hypothyroidism