Myxoedema coma is a rare complication of severe hypothyroidism but carries a mortality rate of over fifty per cent. It may be difficult to distinguish from hypothermia per se. Treatment is empirical, and the optimum form of management remains to be defined. One method is outlined in Fig. 15.36. As recovery proceeds, the dose of T3 can be decreased over subsequent days and eventually changed to T4 maintenance therapy. The dose of steroids can be reduced stepwise and ΓÇÿtailedΓÇÖ off.
