Myxedema Coma – 7/27/17

Most common presentation

  • Altered mental status
  • Hypothermia
  • Precipitating event
  • **Myxedema and coma do not have to be present**

Physical exam findings

  • Hypothermia
  • Bradycardia
  • Hypotension
  • Cool skin
  • Diffuse soft tissue swelling without pitting
  • Altered mental status

Lab abnormalities

  • Hyponatremia
  • Elevated CK
  • Elevated transaminases
  • Hypoglycemia
  • Elevated TSH with frankly low T4 level


  • IV levothyroxine
  • Use of T3 is controversial
  • Stress dose steroids because of concern for precipitating adrenal insufficiency
  • Supportive measures

Leave a Reply

Fill in your details below or click an icon to log in: Logo

You are commenting using your account. Log Out /  Change )

Twitter picture

You are commenting using your Twitter account. Log Out /  Change )

Facebook photo

You are commenting using your Facebook account. Log Out /  Change )

Connecting to %s