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Management

Last reviewed dd mmm yyyy. Last edited dd mmm yyyy

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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

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