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Thyroid Disorders

What type of thyroid condition do you have?#

Thyroid disorders can be broadly subdivided into hypothyroidism and hyperthyroidism.

Some of these disorders are autoimmune, such as Graves' disease and Hashimoto’s disease, also known as Hashimoto's thyroiditis, but the etiology is not always evident.

Each condition is defined by characteristic signs and symptoms, comorbid conditions, and laboratory studies.

The best test to determine thyroid function is a serum thyroid stimulating hormone (TSH) assay.

Low TSH suggests hyperthyroidism, while high TSH levels suggest hypothyroidism.

Is your thyroid condition stable?#

Both hypo- and hyperthyroid states may influence dental treatment modifications.

Of particular concern is an uncontrolled hyperthyroid state, where the patient is at high risk for experiencing adverse effects during dental treatment.

A stable thyroid state is called euthyroid.

What signs and symptoms do you have when your thyroid condition is not controlled?#

Although a patient may report having a stable thyroid state, this may change rapidly. Dental providers need to recognize the more common signs and symptoms associated with a patient’s condition.

Signs and symptoms of hypothyroidism
CardiomegalyReduced cardiac outputBradycardiaHypotension
Reduced respiratory rateSeizuresCretinism (in children) Cold intolerance
HypertelorismWeight gainConstipationLethargy
ParesthesiaDry hairGoiterMyxedema
AnemiaElevated AST, ALT, LDHElevated creatineHyperlipidemia
Inverted T low-amplitude QRS waves in ECGIncreased TSH
Signs and symptoms of hyperthyroidism
Heart mumurArrhythmiaIncreased cardiac outputPalpitations
TachycardiaProptosisPsychosisAbdominal pain
FatigueFine HairGoiterHeat intolerance
Increase appetiteNervousnessDiplopiaTremor
Warm skinWeight lossElevated AST, ALT, LDHHypercalcemia
Decreased TSH

What types of medications are you taking?#

Synthetic preparations of thyroid hormones (T4 [Synthroid] and T3 [Leotrix]) are used to treat hypothyroid disorders.

The most common medications for hyperthyroidism are propylthiouracil preparations, in conjunction with medications used to treat comorbid conditions such as tachycardia (heart rate >:120 beats/minute).

Antihyperthyroid agents may induce mild leukopenia.

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