What types of treatment did you or a relative receive for a myxedema coma?
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What is the treatment for myxedema coma?
Treatment may include assisting the patient to breathe
and warming them to raise the body temperature to normal. Often, antibiotics
are started until it is certain that an infection is not present.
The method of replacing thyroid hormone in patients with myxedema coma is
controversial. Many different approaches are used. In general, initial
replacement is done by intravenous infusion, since the intestinal system may not
be absorbing properly.
While common hypothyroidism without myxedema is usually
treated with T4 replacement (the hormone produced in greatest quantity by the
thyroid gland), in the case of myxedema coma, management is different. The
thyroid gland also produces a small amount of another hormone, T3. This is the
more metabolically active of the two hormones. In patients who are well, T4
is converted into T3 in the bloodstream. However, patients with myxedema coma
are often so sick that this conversion is impaired. As a result, many doctors
choose to treat these patients with T3 initially and start T4 therapy as well.
Since T4 therapy can take a month or so to work, there is usually an overlap of
these two hormones. Care is taken to avoid heart rhythm abnormalities
(arrhythmias) and stress
on the heart, which can be caused by replacing thyroid hormone too quickly,
particularly in elderly patients.
While mild thyroid disorders can be managed by primary care
physicians, myxedema coma is generally managed by a thyroid specialist
(endocrinologist) because treatment can be complicated and critical.