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Forum Name: Endocrinology Topics

Question: Underactive Thyroid/Adrenal Fatigue


 joni101 - Mon May 04, 2009 6:32 am

Hi, I've been speaking with a few people I know who have been diagnosed with underactive thyroid and hence been prescribed the drug Eltroxin. I note that on the pamphlet which comes with this drug, one of the contra-indications is uncorrected adrenal insufficiency, yet none of my friends who are being treated with this drug have ever been tested for AD.
Can you shed any light as to why this is so please?
 Dr.M.Aroon kamath - Sun Nov 15, 2009 8:12 pm

User avatar Hi,
It is very true that hypothyroidism and addison's disease may co-exist.

As you may be aware, some forms of hypothyroidism are due to auto-immune forms of thyroiditis, which can be associated with other auto-immune diseases such as Addison's disease,type 1 diabetes mellitus,auto-immune oophoritis
(very rare) etc.

It is also well known that in some cases of hypothyroidism, thyroxin therapy 'unmasks' underlying Addison's disease.

Many known diseases have disease associations.It is at times, impractical or cost-effective to test for each one of these associated diseases.

Hypothyroidism is a common disease with a lifelong risk in women (approaching 10%). but, Addison's disease is rare.
Tests for hypothyroidism are inexpensive and easily accessible, whereas biochemical diagnosis of Addison's disease usually requires more sophisticated and relatively expensive tests, more appropriate in a secondary care setting.

Whether one should routinely test every patient with Hypothyroidism for Addison's is debatable.Many workers at present believe that if a hypothyroid patient deteriorates on initiation of thyroxin therapy, he/she should be investigated for Addison's.
Also,it has been suggested that one should look carefully for stigmata of Addison's disease such as postural hypotension, weight loss, skin and mucosal pigmentation,and hyperkalaemia.
If present,one must go ahead and test for Addison's disease.

There are others who may opt for routine testing in every case of hypothyroidism.
This is an on-going debate.
Best wishes!

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