Myxedema Coma

When the levels of thyroid hormones become very low, the symptoms get worse and can result in a serious condition called myxedema coma.

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, 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 call 911 or go to the nearest Urgent Care or Emergency Department immediately.

If a person with hypothyroidism develops the following:

• a fever,
• If you notice changes in their behavior or mental status,
• have shortness of breath, or
• increased swelling of the hands and feet.

Call 911 immediately or go to the nearest Urgent Care or Emergency Department. Be sure to tell the doctor that the patient has hypothyroidism.

If you have hypothyroidism, any of these conditions can contribute to myxedema coma including: 

• infections,
• especially lung and urine infections,
• heart failure,
• stroke,
• trauma,
• surgery,
• drugs, such as phenothiazines, amiodarone, lithium, tranquilizers, narcotics, and prolonged iodide use, and
• not taking prescribed thyroid medications.

Blood tests are performed to check blood cell count, electrolytes, sugar, and thyroid hormone levels. Tests are also performed 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.

If you have hypothyroidism, be alert to your condition call your doctor if you are concerned; check your blood sugar level if you are diabetic; warm yourself up with a warm blanket and seek help; and take your prescribed thyroid medications if you did not take them earlier.

People with myxedema coma are in a coma or nearly in a coma. They are not able to function normally. Friends or family members should take them to an emergency department immediately. Friends or family members should not give the person in myxedema coma any thyroid medication before taking him or her to the emergency department. If adrenal insufficiency is present, then administration of thyroxin (in the thyroid medication) will provoke an adrenal crisis.

Following the start of treatment, careful monitoring, usually in the intensive care unit, is necessary. Follow-up with the doctor after discharge is important to monitor the thyroid condition and decide on the right thyroid hormone dose to be taken.

Myxedema coma can be prevented with

• early treatment of hypothyroidism,
• taking thyroid medication regularly, and
• recognition of the warning symptoms of myxedema coma.

It is a very serious condition that can result in death. Early and aggressive treatment can improve the outcome.