1. Anatomy and physiology of the thyroid gland.


    1. The thyroid gland is located beside the windpipe and just below the voice box.

    2. The thyroid gland secretes hormones, which control the rate of metabolism.

    3. The primary hormone produced is thyroxine.


  1. Definition of "hypothyroidism."


    1. Hypothyroidism is a disease resulting from a deficiency of thyroid hormones.

    2. Hypothyroidism can affect infants, children, and adults.


  1. Possible causes of hypothyroidism.


    1. Congenital deficiency.

    2. Tumors.

    3. Inflammation of the thyroid.

    4. Hypothalamic or pituitary disease.

    5. Surgical removal of thyroid.

    6. Iodine deficiency.

    7. Radioactive iodine treatment.


  1. Signs and symptoms of hypothyroidism.


    1. Adults:

  1. Lethargy and fatigue.

  2. Forgetfulness.

  3. Weight gain.

  4. Dry, scaly skin

  5. Puffy face, swollen around the eyes.

  6. Thinning and loss of hair.

  7. Constipation.

  8. Irregular menstrual periods or heavy flow.

  9. Increased sensitivity to cold.

  10. Hypersensitivity to drugs such as barbiturates and sedatives, and to anesthesia.

    1. Infants:

  1. Excessive sleeping.

  2. Delayed mental and physical development.

  3. Constipation.

  4. Enlarged tongue.

  5. Dull facial expression.


  1. Measures for management of the disease.


    1. Exercise regularly with regular, planned rest periods.

    2. Set realistic goals to increase activity as tolerated.

    3. Eat diet low in sodium, cholesterol, and calories. (Provide "Decrease Cholesterol Levels," "Restrict Sodium," and "Weight Reduction" handouts.)

    4. Confer with a nutritionist for amount of calories required.

    5. Take thyroid medication as instructed. (Note: Thyroid medication must be taken lifelong.)

    6. Avoid over-the-counter medication. (Sedatives or hypnotics can cause respiratory depression.)

    7. Have a medical checkup at least once a year.

    8. Avoid constipation with diet high in fiber, adequate fluids, stool softeners, etc.

    9. Provide a warm environment to promote comfort.

    10. Avoid pressure or irritation to the skin to prevent skin breakdown.

    11. Report to physician any signs of hyperthyroidism, such as weight loss, restlessness, fast heart rate, fatigue, loose bowel movements, or heat intolerance.


  1. Signs and symptoms of possible complication.


    1. Heart disease (chest pain or arrhythmias of the heart).

    2. Organic psychosis (paranoia and delusions).

    3. Myxedema coma (slow breathing, low blood pressure, hypothermia, and respiratory distress).