Heart & thyroid DR. SHARDA JAIN DR. JYOTI AGARWAL RELATIONSHIP that mattersEvery doctor should know IN PATIENTS WITH DYSLIPIDEAMIA, HYPOTHYROIDISMIS CAPABLE OF AGGRAVATING PRE- EXISTING LIPID DYSFUNCTION

1. DR. SHARDA JAIN
DR. JYOTI AGARWAL
…Caring hearts, healing hands
Heart
&
thyroid

2. RELATIONSHIP that matters
Every doctor should know

3. IN PATIENTS WITH DYSLIPIDEAMIA,
HYPOTHYROIDISM
IS CAPABLE OF AGGRAVATING PRE- EXISTING
LIPID DYSFUNCTION
DECREASED
THYROID
FUNCTION
Increased
TC
& LDL – C
levels

4. IN HYPOTHYROID PATIENTS
Reduced
activity of
HMG – Coa
reductase
Decreased
LPL activity
Decreased
activity of
LDL-
receptors
Decreased
receptor-
Mediated
Catabolism of
LDL & IDL
Reduced
cholesterol
Biosynthesis
Decreased
clearance
of TG – rich
lipoprotein
Increase in the
serum total cholesterol
concentration
Elevated TG levels

6. SCREENING FOR HYPOTHYRODISM IS IMPORTANT IN
Dyslipidaemia & in all patients with unexpected
alteration of lipid profile
INDIAN THYROID GUIDELINES 2011
Recommends all patients with elevated lipid levels should
be screened for hypothyroidism

7. IN PATIENTS WITH HYPOTHYROIDISM
CATEGORY START WITH TITRATE CONTINUE TILL
Adults 50-100mcg/day
By 50 mcg /day at 4-6
weeks interval
Attainment of clinical
& biochemical
euthyroidism
Elderly (>50 Y) Not to exceed
50 mcg/ day
In patients with
Cardiac diseases
25 mcg/ day
(or 50 mcg on
alternate days)
By 25mcg/day
(or 50 mcg on
alternate days) at
4 weeks intervals

8. • ELTROXIN has a narrow therapeutic index. During the initial
titration period, careful dosage titration & monitoring is
necessary to avoid the consequences of under or over –
treatment.
• Special care is needed in the elderly & in patients with
symptoms of myocardial insufficiency or ECG evidence of
myocardial infarction or ischaemia & also those with diabetes
mellitus or insipidus.
• ELTROXIN raises blood suger levels & this may upset the
stability of patients receiving
References
1. Rizos CV, elisaf MS, liberopoulos EN. Effects of thyroid dysfunction on lipid profile. Open cardiovasc med j 20011;5:76-84.
2. Liberopoulos EN elisaf MS dyslipidemia in patients with thyroid disorde. Hormones (athens) 2002 oct-dec;1(4):218-23
3. Tandon N,et all j assoc physician india jan 20011;59 suppl:21-5
4. Prescribing information of eltroxin version :ELT/PL/IN 2015/01 dated 12 june 2015
Important safety information for eltroxin

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