Myxedema is another term for severely higher hypothyroidism. It’s a situation that occurs when your body doesn’t produce enough thyroid hormone.
The thyroid is a small gland found just in front of your neck. It excretes hormones that help your body regulate energy and control various functions. Myxedema is the result of severe undiagnosed or untreated hypothyroidism.
Pretibial myxedema describes the skin changes of a person with severe hyperthyroidism. Classic skin changes include:
- Swelling of your face may involve your lips, eyelids, and tongue.
- Swelling and condensation of the skin anywhere on the body, especially the lower legs.
It can lead to a myxedema crisis, a medical emergency. While myxedema coma has been used to describe this life-threatening condition, myxedema crisis has been substituted as a state of coma and is no longer required to diagnose the condition.
What are the symptoms of myxedema crisis?
A myxedema crisis occurs when your body can no longer tolerate the changes caused by severe hypothyroidism and therefore decompensates. It is a life-threatening condition that demands immediate medical attention. In addition to the signs and symptoms of severe hypothyroidism, symptoms of myxedema crisis may include:
- Decreased breathing (respiratory depression)
- Lower than normal blood sodium levels
- Hypothermia (low body temperature)
- Confusion or mental slowness
- Low blood oxygen levels
- Increasing percentage levels of carbon dioxide in the blood
A myxedema crisis can often result in death due to infection, bleeding, or respiratory failure complications. Mainly it occurs in women and people over the age of 60. It can also occur during pregnancy.
How Hypothyroidism causes myxedema?
Hypothyroidism occurs when the thyroid stops working correctly. This can have the following causes:
- An autoimmune disease, including Hashimoto’s thyroiditis
- Surgical removal of your thyroid
- Radiation therapy for cancer
- Some medications, such as lithium or amiodarone (pacerone)
- Iodine deficiency or excess
- Drugs for the immune system, such as those used to treat cancer
Myxedema is the result of severe undiagnosed or untreated hypothyroidism. It can also develop when someone stops their thyroid medication. In older people, it is more common than and women.
The accumulation of chains of sugar molecules in the skin causes the skin disease myxedema. These compounds attract water, causing swelling. These skin conversions are a result of hypothyroidism.
A myxedema crisis usually occurs after a long history of hypothyroidism. It is more common in the cold winter months. Any of the following can trigger it:
- Discontinuation of medications used to treat hypothyroidism
- A rapid illness, such as a heart attack or stroke
- Certain drugs that depress the central nervous system
- Exposure to cold
How is myxedema distinguished?
Your signs will lead your doctor to suspect severe hypothyroidism. Blood tests can help your doctor confirm this.
The thyroid-stimulating hormone (TSH) test measures how much TSH your pituitary gland produces. When your thyroid isn’t making enough, your pituitary gland increases its production of TSH. In other words, a high TSH level could mean you have hypothyroidism.
A TSH test is typically checked with a thyroxine (T4) test. This test measures levels of T4, a hormone produced directly by your thyroid. You have hypothyroidism if you have low T4 levels and high TSH levels.
Your doctor will likely want more tests to determine your thyroid function and other conditions that may affect it.
Myxedema crisis is a medical emergency. If there is any suspicion, the TSH and T4 levels should be checked immediately. Treatment can start as soon as possible. The initial diagnosis is usually based on a physical examination.
Emergency medical personnel will look for other characteristics of severe hypothyroidism, such as:
- Dry skin
- Sparse hair
- Swelling, especially of the face and legs
- A possible surgical scar from a thyroidectomy
- Low blood pressure and heart rate
- Confusion, confusion
- Decreased breathing
Suspect myxedema crisis, begin thyroid hormone replacement therapy. The preferred route is through a vein with an IV line.
Your doctor will order additional blood tests to get a complete picture of your body systems. A CT scan of your brain will also be needed.
Your vital functions and your state of consciousness are constantly monitored. You will need inpatient treatment in the intensive care unit (ICU) until you are stable.
What is the outlook for myxedema?
Without an immediate diagnosis, a myxedema crisis is often fatal. Even with treatment, deadlines rates can be increased by 25 to 60 percent. Older adults are at higher risk of poor outcomes.
If left untreated, advanced hypothyroidism can cause severe complications and even death. If you are on thyroid replacement therapy, the outlook for myxedema is good. But it would help if you continued treatment for the rest of your life. If hypothyroidism is well controlled, it will not shorten your lifespan.