Myxedema Coma

Myxedema Coma Overview

The thyroid gland, located at the front part of the neck, is responsible for making substances called thyroid hormones that are important for all body cells to work properly.

In certain conditions, the thyroid becomes underactive and produces fewer amounts of its hormones, a situation called hypothyroidism. People with hypothyroidism have problems that reflect underactivity of the organs of the body, resulting in symptoms such as fatigue, feeling cold, weight gain, dry skin, constipation, and sleepiness. When the levels of thyroid hormones become very low, the symptoms get worse and can result in a serious condition called myxedema coma. Myxedema coma is a rare but life-threatening condition. People with hypothyroidism who are in or near a coma should be taken to an emergency department immediately. Some of the hallmark symptoms are lethargy, confusion, weakness, and difficulty breathing. 

Myxedema Coma Causes

If you have severe hypothyroidism, then any of the following can contribute to myxedema coma:

• Infections, especially lung and urine infections
• Heart failure
• Stroke
• Trauma
• Surgery
• Drugs, such as phenothiazines, amiodarone, lithium, and tranquilizers, and prolonged iodide use
• Not taking prescribed thyroid medications

Myxedema Coma Symptoms

Symptoms of hypothyroidism may include the following:

• Weakness or lethargy
• Confusion or non-responsiveness
• Feeling cold
• Low body temperature
• Swelling of the body, especially the face, tongue, and lower legs
• Difficulty breathing

People who have myxedema coma are in or near a coma and not able to function normally.  In the emergency room, they may be treated for shock, low blood pressure, hypothermia, and electrolyte abnormalities.

When to Seek Medical Care

People who have hypothyroidism and develop fever, changes in behavior or mental status, slowness of breath, or increased swelling of the hands and feet should be taken to an emergency department.

Exams and Tests

• Blood tests are performed to check blood cell count, electrolytes, sugar, and thyroid hormone levels. Tests are also performed on cortisol hormone levels to evaluate how the liver and adrenal glands are functioning.
• Blood gases are evaluated to check for oxygen and carbon dioxide levels.
• An ECG of the heart is performed to check for disturbances in the activity of the heart.
• Additional tests are performed at the discretion of the treating doctor.